A patient with a pancreatic disease may develop foci of panniculitis and fat necrosis.
Conditions where described:
(1) acute or traumatic pancreatitis
(2) pancreatic carcinoma, especially acinic cell carcinoma
(3) pancreatic pseudocyst (which is usually secondary to pancreatitis)
(1) The lesions may be focal or widespread.
(2) The lesions are erythematous or reddish-brown edematous nodules.
(3) The lesions may ulcerate and drain a viscous, chalky or brownish material.
(4) If periarticular fat is affected then the patient may develop an arthralgia.
(1) Serum levels of lipase and amylase are usually elevated.
(1) Affected lipocytes lose their nuclei and may show:
(1a) a thickened eosinophilic membrane with cytoplasmic pallor ("ghost cells")
(1b) a deep basophilia due to calcium deposition.
(1c) liquefaction and necrosis
(2) Extracellular granular calcium deposits may be present.
(3) Early lesions show a mixed lobular and septal inflammation. Areas of necrosis may be surrounded by a mixed inflammatory cell infiltrate.
(4) Late lesions may be surrounded by a granulomatous infiltrate. Healing involves fibrosis and atrophy.
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