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Clinical assessment Painless, symmetrical, non-encapsulated midline fat masses on physical exam History of chronic alcohol use Imaging Ultrasound: Reveals an irregular, diffuse thickening of non-encapsulated subcutaneous fat CT/MRI: Defines the extent of fat deposits and excludes malignancy Biopsy Obtained via fine-needle aspiration Performed to exclude malignancy What is the differential diagnosis for Madelung disease

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2.1.1.2 Subcortical structures Subcortical structures, including the amygdala, hypothalamus, and thalamus, integrate emotional and sensory information with autonomic and neuroendocrine responses to maintain cardiovascular homeostasis ( The Amygdala, a paired limbic structure in the medial temporal lobe, mediates the relationship between psychological stress and CV disease by processing emotional and environmental stimuli (31)

Obici S, Feng Z, Morgan K, Stein D, Karkanias G, Rossetti L: Central administration of oleic acid inhibits glucose production and food intake