Skin nontumor
Pancreatic panniculitis

Topic Completed: 1 August 2011

Minor changes: 28 August 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Pancreatic fat necrosis

Mowafak Hamodat, M.B.Ch.B., M.Sc.
Page views in 2019: 1,328
Page views in 2020 to date: 1,147
Cite this page: Hamodat M. Pancreatic panniculitis. website. Accessed October 26th, 2020.
Definition / general
  • Due to acute pancreatitis or pancreatic carcinoma
  • Lesions may be widespread, may drain chalky material
  • Associated with elevated serum amylase and lipase
  • Males are affected more than females
Clinical features
  • 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
Microscopic (histologic) description
  • 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
Microscopic (histologic) images

Contributed by Angel Fernandez-Flores, M.D., Ph.D.

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