脂肪坏死
脂膜炎
医学
胰腺炎
病理
病理学
恶性肿瘤
急性胰腺炎
胰腺疾病
自身免疫性胰腺炎
胃肠病学
胰腺
内科学
疾病
作者
Mireia Seguí,Pedro Rodríguez‐Jiménez,Javier Fraga,José M. Navas,Juan José Ríos-Martín,David Revilla,Ángel Santos‐Briz,José Lluch,M.T. Fernández Figueras,Melani Luque,Mar Llamas‐Velasco
摘要
Abstract Background Pancreatic panniculitis is a rare form of panniculitis generally associated with acute or chronic pancreatitis, and less frequently with pancreatic carcinoma. Clinically, it presents with subcutaneous nodules usually located in the lower extremities, however, it presents an almost pathognomonic histopathological finding with enzymatic fat necrosis in the adipose tissue. Methods In this retrospective case series of five hospitals, biopsy specimens of cutaneous lesions of pancreatic panniculitis were reviewed. Clinical information was obtained through medical records. Results A total of 34 cases were included, 23 women and 11 men, aged between 31 and 92 years. The most common associated pancreatic disease was acute pancreatitis (23 cases) and its main triggering cause was gallstones (17 cases). In two patients it was related to chronic pancreatitis and six cases were associated with malignancy. Histopathological findings were always the key to diagnosis. In the biopsies reviewed, mostly lobular panniculitis with the characteristic necrosis of the adipocytes was observed. In addition, nine of the cases presented with Splendore–Hoeppli phenomenon. Conclusions We present the largest series of pancreatic panniculitis. Clinically, the female predominance and biliary lithiasis as the main cause of acute pancreatitis are to be emphasized. Histopathologically, a peripheral eosinophilic striated rim surrounding aggregates of ghost adipocytes consistent with Splendore–Hoeppli is an additional clue to its diagnosis.
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