Massive Obesity Simulating Lymphedema

Panel A shows massive obesity of the lower legs of a 64-year-old woman. Note the bilateral symmetric, nonpitting swelling of the legs with sparing of the feet, which can be mistaken for lymphedema. In Panel B, a radionuclide lymphangiogram taken 30 minutes after the injection of 99mTc-labeled human albumin demonstrates normal lymphatic vessels and regional lymph nodes with prompt cephalad migration of the radionuclide. In Panel C, transaxial (above) and coronal (below) magnetic resonance images confirm the presence of diffuse subcutaneous fat deposits without the accumulation of free fluid. The irregular high-intensity subcutaneous signals on the coronal images represent venous . . .