Skin-nontumor / Clinical Dermatology - Pancreatic fat necrosis

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Skin-nontumor / Clinical Dermatology

Other dermatoses

Pancreatic fat necrosis

Reviewer: Mowafak Hamodat, MB.CH.B, MSc., FRCPC, Eastern Health, St. Johns, Canada (see Reviewers page)
Revised: 1 August 2011, last major update August 2011
Copyright: (c) 2002-2011, PathologyOutlines.com, Inc.

Definition
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● Due to acute pancreatitis or pancreatic carcinoma
● Lesions may be widespread, may drain chalky material
● Associated with elevated serum amylase and lipase

Epidemiology
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● Males are affected more than females

Clinical description
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● Tender violaceous and erythematosus nodules, usually in trunk, buttocks and lower extremities
● Also joint involvement, pleural effusion, ascitis and pericardial effusion
● Peripheral blood eosinophilia is quite common

Micro description
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● Changes are lobular in distribution and characterized by ghost cells, which are anucleate cells composed of amorphous granular debris and a rim of eosinophilia; also stippled basophilia due to calcification
● Usually neutrophils around foci of fat necrosis and hemorrhage
● Uninvolved surrounding fat is heavily infiltrated by acute and chronic inflammatory cells including large numbers of macrophages, many with foamy cytoplasm due to ingested lipid, and occasional multinucleated giant cells
● No evidence of vasculitis
● Birefringent crystals have been described in the mesenteric fat and within affected joints, but not in subcutaneous fat

Micro images
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Contributed by Dr. Angel Fernandez-Flores, M.D., PhD, Hospital El Bierzo and Clinica Ponferrada, Spain

End of Skin-nontumor / Clinical Dermatology > Other dermatoses > Pancreatic fat necrosis

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