Journal of Pathology and Translational Medicine

Case Reports

A Case of Pancreatitis Presenting with Pancreatic Panniculitis: A Case Report.: Seong Hyun Kim, Sun Hee Chang, Hai Jin Park; Korean J Pathol. 2009;43(6):566-569.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.6.566

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Pancreatic panniculitis is a rare disease in which necrosis of fat in the panniculus and other distant foci occur in the setting of pancreatic disease. The most common pancreatic disorders associated with pancreatic panniculitis are acute and chronic pancreatitis, especially the alcohol-related types and pancreatic carcinoma. We now report a case of pancreatic panniculitis in which skin eruptions, not abdominal symptoms, were the presenting symptom. A 45-year-old man presented with multiple erythematous tender subcutaneous nodules on the shins, arthralgia of both ankles and swelling of the left foot. He was diagnosed as having pancreatitis 15 months ago. Histopathologic findings of a skin biopsy showed focal fat necrosis with anucleated "ghost-like" fat cells with a thick shadowy wall. Laboratory evaluation revealed an increase in serum amylase and lipase. We diagnosed this patient's problem as pancreatic panniculitis associated with a relapse of pancreatitis.

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Pancreatic Panniculitis in Patients with Chronic Pancreatitis: Case Report and Review of Literature
Eui Joong Kim, Min Su Chu, Ki Chang Sohn, Dong Ho Cho, Ga Hye Na, Haak Cheoul Kim, Eun Young Cho
The Korean Journal of Gastroenterology.2017; 69(1): 83. CrossRef

Eosinophilic Fasciitis Associated with Overlying Intraepidermal Blister Formation: A Case Report.: Na Rae Kim, Dong Hae Chung, Seung Yeon Ha; Korean J Pathol. 2009;43(5):478-481.; DOI: https://doi.org/10.4132/KoreanJPathol.2009.43.5.478

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Abstract PDF: Eosinophilic fasciitis is a scleroderma-like disease and it may present with paraneoplastic syndrome or as an isolated form of the disease. We report here on a case of eosinophilic fasciitis in a 20-year-old woman who presented with an abrupt onset of subcutaneous limb swelling and peripheral eosinophilia. Pathologically, the specimen was characterized by acute inflammation and thickening of the collagen bundles in the reticular dermis and superficial muscle fascia in addition to the overlying intraepidermal blisters that contained many eosinophils. Eosinophils, some lymphocytes and plasma cells were infiltrated in the superficial muscle fascia and subcutaneous fat. The diagnosis of eosinophilic fasciitis was confirmed by biopsy. It is intriguing that eosinophilic fasciitis showed the microscopic findings of intraepidermal blister with predominant inflammation, and the patient showed a good response to steroid therapy.

Subcutaneous Fat Necrosis Associated with Pancreatic Adenocarcinoma: A case report.: Hee Jung Kim, Kwang Gil Lee; Korean J Pathol. 1996;30(2):155-160.

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Abstract PDF: Subcutaneous fat necrosis is manifested by erythematous tender nodules on the legs, buttock or trunk and is associated with pancreatic disease including acute and chronic pancreatitis, pancreatic carcinoma, pseudocyst, pancreatic stone and other diseases. Its histologic findings are pathognomonic and reveal foci of subcutaneous fat necrosis with "ghost-like" anucleated cells with thick "shadowy wall" and surrounding inflammatory infiltrate consisting of polymorphonuclear cells, eosinophils, lymphocytes, histiocytes, foam cells and foreign body giant cells. We experienced a case of subcutaneous fat necrosis associated with pancreatic adenocarcinoma manifested by subcutaneous nodules in the buttock and lower extremities and by arthralgia of the left knee in a 67-year-old woman. Therefore, we are reporting to emphasize the importance of the skin findings of the internal disease.

Cytophagic Histiocytic Panniculitis: 2 cases report.: Gil Ro Han, Hye Seon Ahn, In Sook Kim, Jin Hee Sohn, Jung Il Suh; Korean J Pathol. 1990;24(3):321-325.

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Abstract PDF: Cytophagic histiocytic panniculitis is a rescently described histiocytic disorder. It is characterized by the presence of fever, pancytopenia, and subcutaneous nodules resulting from the infiltration of lympho-histiocytes in the dermis and subcutaneous adipose tissue. The characteristic findings is presence of bean-bag histiocytes containing phagocytized red blood cells, lymphocytes, and platelets. We experienced two cases of cytophagic histiocytic panniculitis with hard and erythematous subcutaneous nodules. These skin lesions exhibited infiltration of the subcutaneous tissue by large, benign histiocytes with cytophagic features. Hemophagocytic histiocytes were observed in the cervical lymph node in case 1, and bone marrow in case 2. One patient is alive, while the other one died with hemorrhagic complications.

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