Necrotizing Panniculitis as an Uncommon Manifestation of Acute Pancreatitis

Bruno, Cosimo Marcello and Pricoco, Gabriele Sebastiano and Bellinvia, Salvatore and Amaradio, Maria Domenica and Cantone, Damiano and Polosa, Riccardo (2017) Necrotizing Panniculitis as an Uncommon Manifestation of Acute Pancreatitis. European Journal of Case Reports in Internal Medicine, 4 (3). ISSN 2284-2594

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Pancreatic panniculitis is a rare disorder affecting 2–3% of patients with pancreatic disease. The findings are characterized by tender, erythematous, subcutaneous nodules which may undergo spontaneous ulceration with discharge of brownish and viscous material derived from colliquative necrosis of adipocytes. The lesions are usually localized in the lower limbs, although they may also extend to the buttocks and also involve the trunk, upper limbs and scalp. They can precede overt pancreatic disease in 40% of cases. The typical histological features observed in these lesions are characterized by necrotic adipocytes with absent nuclei (better known as ‘ghost cells’) in the context of a predominantly lobular panniculitis. We describe the case of a 78-year-old cirrhotic woman admitted to our department with abdominal pain affecting the upper abdomen and a 3-day fever. On physical examination, multiple tender erythematous nodules, with irregular margins, were present on the pretibial regions of both lower legs, ranging in size from 0.8 to 1.5 cm. Pancreatic amylase and lipase were elevated and abdominal computed tomography revealed acute pancreatitis with oedema, focal gland enlargement of the pancreatic tail and perivisceral inflammation. Histological examination of the lesions was consistent with a diagnosis of necrotizing granulomatous panniculitis.

Item Type: Article
Uncontrolled Keywords: Panniculitis; acute pancreatitis; erythematous nodules; enzymatic fat necrosis; ghost adipocytes
Subjects: 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) > 616.4 Malattie del sistema emopoietico, linfatico, ghiandolare; Malattie del sistema endocrino
Depositing User: Rita Negrini
Date Deposited: 21 Sep 2017 13:00
Last Modified: 21 Sep 2017 13:00

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