Pancreatic and liver ultrasound examinations of twenty-five patients without evidence of liver or pancreatic disease and who had been on Prednisone (greater than 7.5 mg per day for longer than six months) were compared with corresponding age- and sex-matched normal controls. Statistical analysis enabled effects of known variables that determine pancreatic echogenicity to be taken into account and showed that steroid ingestion had a statistically significant effect on pancreatic echogenicity, a previous unreported observation.

463ipomas arising within veins have most commonly been described in association with the inferior vena cava. They are considered an incidental finding with a frequency of 0.35% in abdominal CT examinations [1]. Intravascular lipomas involving the superior vena cava are rare [2,3]; one case previously documented a lipoma extending into a brachiocephalic vein [3]. A recent report describes a lipoma arising from the soft tissues of the thigh, causing extrinsic compression on the femoral vein, with resultant chronic deep venous thrombosis [4]. To our knowledge, there are no previous reports of an intraluminal lipoma arising within the wall of the femoral vein causing symptomatic venous obstruction. Case ReportA 76-year-old previously healthy man noted painless swelling of the left calf after a 2-hr airplane flight. The swelling persisted for 18 months and eventually progressed to involve the thigh. He had no risk factors for deep venous thrombosis. On physical examination, the patient appeared healthy apart from nontender swelling of the entire left lower limb and distended superficial veins in the calf. Results of hematologic and biochemical profiles were normal. Doppler sonography of the left leg revealed a noncompressible echogenic intraluminal mass, approximately 2 cm in length (Fig. 1A), causing local expansion of the common femoral vein. Minimal flow was seen anterior to the lesion with aliasing surrounding the severely stenotic segment. A diagnosis of localized common femoral vein thrombosis was made, and oral anticoagulation therapy was started.Because of the discrepancy between the severe and prolonged leg swelling and the localized thrombus suggested on sonography, CT was performed to exclude a pelvic mass (Figs. 1B and 1C). The IV contrast-enhanced CT examination showed a 2-cm intraluminal lesion of fat attenuation (-112 H) distending the lumen of the common femoral vein. The mass extended posterolaterally through the vein wall into the intermuscular soft tissues of the thigh. The patient was referred to a vascular surgeon for resection of the lesion because of its associated symptoms and the need for ongoing anticoagulation to prevent venous thrombosis.A venogram (Fig. 1D) and MR image of the left leg were obtained for surgical planning. The mass was of high signal intensity on T1-weighted images (Fig. 1E) and intermediate signal intensity on T2-weighted images; the mass showed uniform signal drop on fat-suppressed sequences. There was no evidence of a hemorrhagic component or invasion of adjacent structures.At surgery, the intravascular lesion and its posterior extension were resected, and a venous graft was interposed at the resection site. Pathology revealed a benign lipoma arising from the venous wall (Fig. 1F). Within days after surgery, the leg swelling decreased dramatically. Anticoagulants were discontinued 3 months after surgery. DiscussionIntravascular lipomas are uncommon lesions and, to our knowledge, have not previously been described in the femoral vein or as a cause of leg swelling. Other p...