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Breast-nonmalignant
Inflammatory / infectious
Hemorrhagic necrosis in breast
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 27 September 2012, last major update April 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Unusual complication of warfarin therapy (Ann Surg 1972;175:647)
● Warfarin causes rapid onset of hemorrhagic necrosis of skin in 0.1 to 1.0% of patients (Br J Plast Surg 2000;53:624)
Terminology
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Epidemiology
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Sites
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Etiology
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● Associated with protein S/C deficiency
● Warfarin induces paradoxical thrombosis in breast and other areas of excessive fat
● Warfarin reduces synthesis of both vitamin K dependent procoagulant factors and inhibitors of coagulation (including proteins S / C), but in patients with existing reductions of proteins S or C, the major clinical effect is towards thrombosis
Clinical features
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Prognostic factors
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Case reports
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● 38 year old woman with mass resembling inflammatory carcinoma (J Postgrad Med 2004;50:268)
Treatment
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● May require mastectomy
Clinical images
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Hemorrhagic necrosis of breast
Gross description (Macroscopy)
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Gross images
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Micro description (Histopathology)
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● Widespread necrosis with multiple small vessel thrombi
Micro images
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Venous thrombosis and Necrotizing arteritis
necrotizing arteritis
Intimal necrosis of artery
Virtual Slides
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Videos
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Cytology description
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Cytology images
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Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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Additional references
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End of Breast-nonmalignant > Inflammatory / infectious > Hemorrhagic necrosis
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