title: Pancreatic panniculitis as the first manifestation of visceral disease--case report.
abstract: Pancreatic panniculitis is a rare pathological condition affecting 2-3% of patients with pancreatic disease. In 40% of cases the condition precedes manifestations of pancreatic disease. We report the case of a 71-year-old female who presented with an erythematous tender node which had appeared one month previously, progressing to ulceration and yellowish exudation. No abdominal symptoms. Biopsy revealed fat necrosis and vacuolated macrophages represented by amorphous amphophilic areas. Laboratory examination and CT scan revealed chronic pancreatitis. It is assumed that release of pancreatic enzymes such as trypsin may enhance the permeability of the microcirculation leading to lipase and amylase causing the subcutaneous fat necrosis observed in the lesions. Histology showed "ghost cells" and, firstly, septal panniculitis, followed later by lobular panniculitis. Treatment focused on resolution of the underlying pancreatic disease.
authors: Faculdade Evangélica do Paraná, Hospital Universitário Evangélico de Curitiba, Curitiba, PR, Brasil. nandahms@gmail.com
authors: Fernanda Homem de Mello de
authors: FH
authors: Souza
authors: Elisa Beatriz Dalledone
authors: EB
authors: Siqueira
authors: Lismary
authors: L
authors: Mesquita
authors: Lincoln Zambaldi
authors: LZ
authors: Fabricio
authors: Felipe Francisco
authors: FF
authors: Tuon
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D009336:Necrosis / Q000209:etiology / Q000473:pathology; D050500:Pancreatitis, Chronic / Q000150:complications / Q000473:pathology*; D015434:Panniculitis / Q000209:etiology / Q000473:pathology*; D050151:Subcutaneous Fat / Q000473:pathology*