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Fat necrosis is necrosis affecting fat tissue (adipose tissue) .[1] The term is well-established in medical terminology despite not denoting a specific pattern of necrosis.[2] Fat necrosis may result from various injuries to adipose tissue, including: physical trauma, enzymatic digestion of adipocytes by lipases ,[3] radiation therapy ,[4] hypoxia , or inflammation of subcutaneous fat (panniculitis) .[citation needed ]
The gross appearance of fat necrosis is as an irregular, chalky white area within otherwise normal adipose tissue.[1]
Pathophysiology
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Trauma
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Traumatic injury of adipose tissue liberates stored fat[1] [3] as well as lipases[1] from adipocytes . The extracellular fat then elicits a swift inflammatory response, attracting macrophages and polymorphonuclear leukocytes which proceed to phagocytose the freed fat. The process eventually leads to fibrosis . The necrotic tissue may eventually form a palpable mass (especially if situated at a superficial site like the breast).[3]
Traumatic fat necrosis commonly affects the breast and may resemble a tumour (especially in case of calcification of the necrotic mass).[1]
Enzymatic digestion
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Pancreatic conditions like acute pancreatitis,[3] pancreatic carcinoma , and pancreatic trauma [5] result in liberation of pancreatic lipase which proceeds to digest fat to form free fatty acids which subsequently combine with calcium to form soapy precipitates.[3] [2]
Although the peripancreatic region is the most commonly affected (due to direct contact with enzymes), associated fat necrosis may occur throughout the body in subcutaneous tissue , hand and foot joints, and bone marrow. These extrapancreatic complications are known as pancreatic panniculitis .[5]
Clinical significance
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Breast fat necrosis
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Causes
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Examples of causes include but are not limited to:[citation needed ]
Epidemiology
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Fat necrosis in the breast occurs around 0.6%, this represents 2.75% of lesions that end up being benign . However, 0.8% of fat necrosis occurs from tumors of the breast, 1–9% occurs in breast reduction surgery. Individuals that are high risk include women around the age of 50yrs along with pendulous breasts.[8]
See also
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References
[ edit ]
^ a b c d e Strayer, David S.; Rubin, Emanuel; Saffitz, Jeffrey E.; Schiller, Alan L., eds. (2015). Rubin's Pathology: Clinicopathologic Foundations of Medicine (7th ed.). Philadelphia: Wolters Kluwer Health. pp. 34–35. ISBN 978-1-4511-8390-0 .
^ a b Kumar, Vinay; Abbas, Abul K.; Aster, Jon C., eds. (2015). Robbins and Cotran pathologic basis of disease (Ninth ed.). Philadelphia, PA: Elsevier/Saunders. pp. 43–44. ISBN 978-1-4557-2613-4 .
^ a b c d e Cross, Simon S. (2013). Underwood's Pathology (6th ed.). Churchill Livingstone. p. 85. ISBN 978-0-7020-4672-8 .
^ "https://www.cancer.gov/publications/dictionaries/cancer-terms/def/fat-necrosis" . www.cancer.gov . 2011-02-02. Retrieved 2024-06-16 .
^ a b Lee, P. C.; Howard, J. M. (May 1979). "Fat necrosis" . Surgery, Gynecology & Obstetrics . 148 (5 ): 785–789. ISSN 0039-6087 . PMID 432796 .
^ Kerridge, William D.; Kryvenko, Oleksandr N.; Thompson, Afua; Shah, Biren A. (2015-03-16). "Fat Necrosis of the Breast: A Pictorial Review of the Mammographic, Ultrasound, CT, and MRI Findings with Histopathologic Correlation" . Radiology Research and Practice . 2015 : 613139. doi :10.1155/2015/613139 . PMC 4378709 . PMID 25861475 .
^ Genova, Rafaella; Garza, Robert F. (2020), "Breast Fat Necrosis" , StatPearls , Treasure Island (FL ): StatPearls Publishing, PMID 31194348 , retrieved 2020-11-12
^ Rice, Hannah; Warland, Jane (October 2013). "Bearing Witness: Midwives experiences of witnessing traumatic birth" . Women and Birth . 26 : S39. doi :10.1016/j.wombi.2013.08.215 . ISSN 1871-5192 .
External links
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R e t r i e v e d f r o m " https://en.wikipedia.org/w/index.php?title=Fat_necrosis&oldid=1229461321 "
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