Conditions where described:
(1) acute or traumatic pancreatitis
(2) pancreatic carcinoma, especially acinic cell carcinoma
(3) pancreatic pseudocyst (which is usually secondary to pancreatitis)
Clinical features:
(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.
Laboratory findings:
(1) Serum levels of lipase and amylase are usually elevated.
Histologic features:
(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.
