<prompt> A 45-year old man presented with 3-year history of a painless soft and slow growing swelling of the neck, upper trunk, upper back and shoulders. The patient had a history ofheavy alcohol consumpution and was a non-smoker. Laboratory blood analysis showed minor elevations in aspaate aminotransfe! rase 71U per liver, alanine amino-transferase 49 U per liter, and total cholesterol . Triglycerides were elevated at 1,020 mg per deciliter 11.52 mmol per liter. Magnetic resonance imgaing revealed diffuse, non-encapsulated fatty deposits in the mediastinum and in the subcutaneous and deeper fascial compaments of the neck, upper trunk and back. The probable diagnosis of the patient is -TuberculosisRheumatoid almtisMadelungs diseaseHodgkins lymphoma  <response>: Madelungs disease is characterized by massive deposits of fatty tumors lipoma located symmetrically around the neck, and on the shoulders, upper arms and upper trunk. These abnormal fat deposits may grow rapidly over the course of months or more slowly over a period of years Ref Davidson 23rd edition pg 739 