case_images: PMC6419468_01
case_images: Development of Physical Features of Lipodystrophy. Panel (a) shows the patient before the diagnosis of T-cell lymphoma and does not show convincing evidence for generalized lipodystrophy. Physical transformations are shown in panel (b) during the diagnosis of the T-cell lymphoma, suggesting that she may have already developed features of lipodystrophy at least around her face and neck. Panel (c) shows her appearance during chemotherapy and panel (d) is after the chemotherapy. Currently (4 years after the completion of therapy) patient's appearance is like the picture as shown in (b) suggesting that the chemotherapy and steroid use temporarily masked the diagnosis of lipodystrophy and were able to modify the physical appearance
case_images: 40842_2019_76_Fig1_HTML.jpg
case_images: PMC6419468_01_40842_2019_76_Fig1_HTML.jpg
case_images: Fig1
case_images: Figure 1 panels a-d show her pictures; before diagnosis (a), at diagnosis of T-cell lymphoma(b), during chemotherapy (c) and after chemotherapy (d).
case_images: Clinical Examination of Fat Distribution. Panel (a) show the "Fat Shadow" obtained from Dual X-ray Energy absorbtiometry (DXA) scan as described previously in Reference. The fat shadow shows minimally retained fat around the neck and axilla, but loss of fat in a generalized fashion though not totally absent from the body. Close-up pictures taken in clinic setting demonstrate fat loss in the face and trunk (b), back (c), buttock and back of the legs (d), and forearms and legs (e). The absence of fat from the face together with the entire abdomen, trunk and extremities favor the diagnosis of generalized lipodystrophy as opposed to partial lipodystrophy. Neck fat is preserved, but not excessive. Mons pubis fat was not increased
case_images: 40842_2019_76_Fig2_HTML.jpg
case_images: PMC6419468_01_40842_2019_76_Fig2_HTML.jpg
case_images: Fig2
case_images: Fig. 2. For her metabolic complications of her AGL, she is currently not being treated with Metreleptin and this possibility is still under discussion.