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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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