ABSTRACT
Resumen: Introducción: Las paniculitis constituyen un grupo de enfermedades que afectan al tejido graso subcutáneo y se manifiestan clínicamente como nódulos. Su patogenia no es del todo clara, por lo general es asintomático. El diagnóstico confirmatorio es histológico. Objetivo: describir las características clínicas e histopatológicas de un caso de necrosis grasa, una forma especifica de paniculitis en el recién nacido (RN). Caso Clínico: RN femenino de 40 semanas, parto cesárea de urgencia por taqui cardia fetal más meconio, APGAR 7-8-9. Requirió oxigeno y presión positiva por 5 min. Al quinto día de vida presentó aumento de volumen en tronco posterior, de coloración eritematosa - violácea, remitente a la palpación, no doloroso. Ecotomografría de piel y partes blandas informó aumento de la ecogenecidad del tejido celular subcutáneo y pérdida de definición de las celdillas adiposas de aproximadamente 42.3 x 9.7 x 20.1 mm, sin presencia de vascularización. Biopsia de piel: epidermis con acantosis irregular y ortoqueratosis en cestas; dermis papilar con infiltrado inflamatorio y dermis reticular y tejido adiposo con presencia de infiltrado linfohistocitiario con tendencia a la formación de nódulos, sin compromiso vascular, leves depósitos de colesterol; compatible con necrosis grasa del recién nacido (NGRN). Paciente tuvo regresión completa de la lesión a los tres meses de vida. Conclusiones: se describe un caso compatible clínica e histológicamente con NGRN; sin complica ciones durante su observación. Por lo general esta patología tiene buen pronóstico, con resolución espontánea, como en nuestro caso.
Abstract: Introduction: Panniculitis is a group of diseases that affect subcutaneous fat tissue and clinically manifest as nodules. Its pathogenesis is not entirely clear, and it is usually asymptomatic. The confirma tory diagnosis is histological. Objective: To describe the clinical and histopathological characteristics of a case of fat necrosis, a specific form of panniculitis in the newborn (NB). Clinical Case: 40-week female NB, born by emergency cesarean section due to fetal tachycardia with meconium, Apgar score 7-8-9. She required oxygen and positive pressure for five minutes. On the fifth day of life, she presen ted an increased volume in the posterior trunk region, with an erythematous - purplish discoloration, which is soft and non-tender to palpation. Skin and soft tissues ultrasound showed increased echo genicity of the subcutaneous cellular tissue and loss of definition of the adipocytes of 42.3 x 9.7 x 20.1 mm approximately, without vascularization. Skin biopsy showed epidermis with irregular acanthosis and basket-weave orthokeratosis; papillary dermis with inflammatory infiltrate, and reticular dermis and adipose tissue with presence of lymphohistiocytic infiltrate with a tendency to form nodules, without vascular involvement, and small cholesterol deposits, compatible with subcutaneous fat ne crosis (SBFN) of the newborn. The patient at three months of age had complete regression of the lesion. Conclusions: a clinically and histologically compatible case with SBFN is described, that did not present complications during observation. In general, this pathology has a good prognosis, with spontaneous resolution as in our case.
Subject(s)
Humans , Female , Infant, Newborn , Panniculitis/diagnosis , Fat Necrosis/diagnosis , Remission, Spontaneous , Panniculitis/pathology , Fat Necrosis/pathologyABSTRACT
Abstract: Subcutaneous fat necrosis of the newborn is a rare benign panniculitis found in term and post-term neonates. Diagnosis is based on clinical characteristics and specific alterations in the adipocytes, detected by anatomical pathology. Subcutaneous fat necrosis of the newborn can occur in uncomplicated pregnancy and childbirth. However, perinatal complications such as asphyxia, hypothermia, seizures, preeclampsia, meconium aspiration, and even whole-body cooling used in newborns with perinatal hypoxia/anoxia may be associated with this entity.
Subject(s)
Humans , Infant, Newborn , Subcutaneous Fat/pathology , Fat Necrosis/pathology , Biopsy , Panniculitis/pathology , Diagnosis, DifferentialABSTRACT
Membranous lipodystrophy is a distinct type of membranocystic fat necrosis. It is associated with many local and systemic diseases, including vascular disorders. The histopathological changes which characterize this phenomenon are variably sized cysts in the fat lobules of the subcutaneous tissue, which are surrounded by eosinophilic membranes projecting into the cystic space. We report a case of secondary membranous lipodystrophy associated with both hypertension and venous insufficiency.
.Subject(s)
Humans , Male , Middle Aged , Fat Necrosis/pathology , Lipodystrophy/pathology , Venous Insufficiency/pathology , Biopsy , Erythema Induratum/pathology , Hypertension/complications , Leg/blood supply , Leg/pathologyABSTRACT
Subcutaneous fat necrosis of the newborn is an unusual form of panniculitis, with few cases described in medical literature. The disease affects newborns at term or post-term, with normal general health. We describe two cases of newborns affected by the disease. One of them already had lesions since birth. Also, we discuss the use of puncture for diagnostic assistance.
A Necrose Gordurosa Subcutânea do Recém-Nascido é uma paniculite incomum com poucos casos descritos na literatura médica. A doença acomete recém-nascidos a termo ou pós-termo, com saúde geral normal. Relatamos dois casos de recém-nascidos acometidos pela doença. Um deles já apresentava lesões ao nascer. Também discutimos o uso da punção para auxílio diagnóstico.
Subject(s)
Female , Humans , Infant, Newborn , Male , Fat Necrosis/pathology , Subcutaneous Fat/pathology , Biopsy, Fine-Needle , Panniculitis/pathology , Skin/pathologyABSTRACT
A necrose adiposa subcutânea do recém-nascido é uma paniculite rara do período neonatal. Surge, geralmente, em recém-nascidos de termo ou pós-termo, nas primeiras 4 semanas de vida, e em associação com trauma obstétrico. Caracteriza-se pelo aparecimento de placas ou nódulos subcutâneos duros, localizados ao tronco, nádegas ou coxas. O seu curso é, geralmente, benigno e autolimitado, embora possa acompanhar-se de hipercalcemia, o que obriga a uma vigilância periódica até à resolução das lesões cutâneas. Os autores descrevem 2 casos de necrose adiposa subcutânea do recém-nascido, um num recémnascido de termo, outro num prematuro, ambos associados a partos traumáticos e a sofrimento fetal.
Subcutaneous fat necrosis of the newborn is an uncommon disorder occurring during the prenatal stage. Generally occurring in full-term neonates or during the first four weeks after a traumatic delivery, the disorder is characterized by the appearance of hard subcutaneous nodules or plaques on the trunk, buttocks or thighs. It is normally a benign and transient condition, although it may be complicated by hypocalcemia, which requires close monitoring until skin lesions are cured. The authors describe two cases of subcutaneous fat necrosis of the newborn, one occurring in a full-term neonate and the other in a premature newborn, both related to traumatic delivery and fetal distress.
Subject(s)
Female , Humans , Infant, Newborn , Male , Fat Necrosis/pathology , Subcutaneous Fat/pathologyABSTRACT
Pancreas acinar cell carcinoma (ACC) accounts for only 1-2% of pancreatic exocrine malignant tumor. The symptoms of patients with ACC are usually non-specific, for example the anorexia and weight loss. Patients may develop Schmid's triad including subcutaneous fat necrosis, polyarthritis, and eosinophilia. We reported a case of ACC which was manifested by subcutaneous nodule as initial clinical symptom. To our knowledge, this is the first reported case of ACC presenting as subcutaneous fat necrosis in Korea.
Subject(s)
Humans , Male , Middle Aged , Carcinoma, Acinar Cell/diagnosis , Fat Necrosis/pathology , Keratins/metabolism , Pancreatic Neoplasms/diagnosis , Subcutaneous Fat/pathology , Synaptophysin/metabolism , Tomography, X-Ray ComputedABSTRACT
Subcutaneous fat necrosis [SCFN] occurs in term newborn with history of difficult delivery. Apart from the soft tissue lesions, the infants may suffer from life threatening hypercalcemia as a complication of disease requiring various medications. A case of subcutaneous fat necrosis with history of birth asphyxia is presented and clinical course and treatment options are discussed
Subject(s)
Humans , Female , Fat Necrosis/pathology , Infant, Newborn , Asphyxia NeonatorumABSTRACT
A test drug (Lipistat) comprising of equal-proportions of extracts of Terminalia arjuna, Inula racemosa Hook, latex of Commiphora mukul, in three different doses (225 mg/kg; 350 mg/kg; 450 mg/kg) were administered orally daily for 6 days a week for 60 days in rats. Thereafter, the rats were subjected to isoproterenol (ISO) induced (85 mg/kg, s.c. for 2 days) myocardial necrosis. Gross and microscopic examinations (histopathology) were done along with estimations of myocardial tissue high energy phosphates (HEP) stores and lactate content. Gross examination showed significant (P < 0.05) cardioprotection in Lipistat treated animals. On microscopic examination no statistically significant reduction in myocardial damage by 350 and 450 mg/kg of Lipistat were observed although loss of myocardial HEP stores and accumulation of lactate were significantly prevented. The results of the present study suggest the potential usefulness of Lipistat in the prevention of ischemic heart disease.
Subject(s)
Adenosine Triphosphate/metabolism , Adrenergic beta-Agonists , Animals , Hypolipidemic Agents/therapeutic use , Cardiomyopathies/chemically induced , Fat Necrosis/pathology , Female , Isoproterenol , Lactic Acid/metabolism , Male , Myocardium/pathology , Myofibrils/pathology , Phosphocreatine/metabolism , Phytotherapy , Rats , Rats, WistarABSTRACT
A necrose gordurosa da mama é um processo de desintegraçäo de células adiposas, acompanhado de uma reaçäo granulomatosa de intensidade variável. É decorrente do reconhecimento de lipídios extravasados do citoplasma de adipócitos como substâncias estranhas ao meio extracelular. O quadro clínico-radiológico pode ocasionar dificuldades no diagnóstico diferencial com neoplasias mamárias. Neste relato é descrito um caso de necrose gordurosa multinodular mamária sendo enfatizada a importância da citologia por punçäo aspirativa com agulha fina para a confirmaçäo do diagnóstico.
Subject(s)
Humans , Female , Middle Aged , Biopsy, Needle , Breast Neoplasms/pathology , Fat Necrosis/diagnosis , Fat Necrosis/etiology , Fat Necrosis/pathology , Diagnosis, DifferentialABSTRACT
Foram estudados os tamanhos tumorais de 75 pacientes com nôdulos sólidos benignos da mama, através de mensuraçao clínica e ecigráfica pré-operatória, comparando-os ao tamanho da peça cirúrgica. Através da análise das médias, observou-se que ambas as medidas subestimaram o tamanho da peça cirúrgica, porém, a mensuraçao ecográfica foi mais próxima da cirúrgica que a clínica. Realizando-se regressao linear, observou-se uma maior correlaçao entre o tamanho da peça e o exográfico (r=0,82) que entre a mensuraçao na peça com a clínica (r=0,62). Para os casos de tumores abaixo de 5 cm, apesar de ter diminuído a correlaçao tamanho peça/ecografia, ela, ainda assim, foi superior à correlaçao peça/clínica. Conclui-se que, para nódulos sólidos benígnos da mama. a mensuraçao ecográfica é superior à clínica, devendo, portanto, ser instituída nos casos em que se planeje a proservaçao e acompanhamento da lesao.
Subject(s)
Humans , Female , Adolescent , Adult , Middle Aged , Breast Neoplasms/pathology , Fibrocystic Breast Disease/pathology , Fat Necrosis/pathology , Fibroadenoma/pathology , Breast Neoplasms , Fibrocystic Breast Disease , Fat Necrosis , Fibroadenoma , Retrospective Studies , Ultrasonography, MammaryABSTRACT
Os autores descrevem um caso de Adipo Necrose ou Necros e Gordurosa do Subcutaneo do RN ocorrido no bercario do Hospital Maternidade Sao Luiz. Fazem uma breve revisao da literatura e identificam pacientes de risco como sendo RN a termo que experimentam asfixia perinatal. Chamam a atencao para a hipercalcemia que normalmente acompanha esse quadro e discutem aspectos relacionados a sua sintomatologia, etiologia e tratamento. Finalmente, enfatizam a importancia para que todos os RN portadores da Adipo Necrose sejam acompanhados de perto ate aproximadamente a l6a.semana de vida para a pronta identificacao dos sinais clinicos e laboratoriais de hipercalcemia
Subject(s)
Humans , Asphyxia Neonatorum , Fat Necrosis/etiology , Fat Necrosis/pathology , Fat Necrosis/therapy , Hypercalcemia , Infant, NewbornABSTRACT
Se presenta un caso de necrosis grasa subcutánea, asociada a pancreatitis. Se hace una revisión de los aspectos clínicos e histopatológicos, así como de los hallazgos de laboratorio
Subject(s)
Female , Humans , Aged , Fat Necrosis/etiology , Pancreatitis/complications , Skin Diseases/diagnosis , Chronic Disease , Fat Necrosis/diagnosis , Fat Necrosis/pathology , Pancreatitis/physiopathologyABSTRACT
En 246 pancreatitis agudas hemos registrado 27 complicaciones sépticas pancreáticas. Fueron clasificadas en 3 grupos: I- necrosis pancreáticas supuradas, 9 casos; II-necrosis y abscesos de páncreas, 12 casos y III-seudoquistes infectados, 6 casos. En la etapa inicial de la enfermedad -preoperatoria- la ascitis enzimática no se correlacionó con una mayor mortalidad (para X2p=0,3), pero se comprobó un incremento de la misma en relación al número de fallas orgánicas. En el postoperatorio inmediato la desaparición de las fallas orgánicas constituyó un signo de buen pronóstico. Los pacientes operados precozmente, generalmente por error diagnóstico, presentaron una mayor mortalidad que los operados tardíamente (para X2p<0,001). La mortalidad fue del 22,2 por ciento, 33,3 por ciento y 16,6 por ciento para cada grupo respectivamente. Los cultivos de las necrosis y colecciones infectadas evidenciaron un predominio de enterobacterias que orientan a una traslocación bacteriana intestinal. Hemos observado una persistencia del estado séptico en el postoperatorio de los pacientes que curaron, a pesar de no existir evidencias de enfermedad pancreática en la tomografía computada
Subject(s)
Male , Female , Humans , Acute Disease/epidemiology , Bacterial Infections/etiology , Pancreatitis/complications , Bacterial Infections/diagnosis , Bacterial Infections/mortality , Fat Necrosis/complications , Fat Necrosis/mortality , Fat Necrosis/pathology , Pancreatitis/surgeryABSTRACT
Os autores apresentan 13 casos de necrose gorgurosa da mama, fazendo correlacao clinico-patologica com as alteracoes radiologicas
Subject(s)
Humans , Female , Middle Aged , Breast Diseases/pathology , Fat Necrosis/pathology , Fat Necrosis/etiologyABSTRACT
Histopathological study of 10 cases sclerema neonatorum showed subcutaneous fibrosis with lobulation in all the cases. 8 (80 percent) cases showed non-specific chronic inflammation of dermis and thinning of epidermis with atrophy of rete pegs and hypercollgenisation of dermis was evident in 70 percent cases. Fat necrosis with crystallisation of fat content was not a conspicuous feature.