RESUMEN
No abstract available.
Asunto(s)
Humanos , Células Acinares , Artritis , Carcinoma de Células Acinares , PaniculitisRESUMEN
Pancreatic panniculitis is a rare type of disorder associated with pancreatic diseases. We describe here a case of 54-year-old man who was admitted to the Department of Dermatology with the diagnosis of erythema nodosum. The patient presented with a 9-month history of painful erythematous nodules on the extremities, joint pain and swelling, and weight loss. A highly elevated level of pancreatic lipase was found on the laboratory examinations. The biopsy specimens from the skin lesions showed subcutaneous fat necrosis. Abdominal computed tomography (CT) revealed a large mass with central necrosis in the body and tail of the pancreas. Distal pancreatectomy, splenectomy and partial transverse colectomy were successfully performed on day 17 of the hospitalization. The histopathologic findings supported the diagnosis of acinar cell carcinoma of the pancreas (ACCP). Postoperatively, the level of serum lipase returned to normal, and the skin lesions and joint manifestations gradually regressed. However, the swelling did not significantly resolve in the left knee. In view of the non-specific clinical presentation of this disease, clinicians should be alert and have a high index of suspicion for pancreatic panniculitis.
Asunto(s)
Humanos , Persona de Mediana Edad , Células Acinares , Artralgia , Biopsia , Carcinoma de Células Acinares , Colectomía , Dermatología , Eritema Nudoso , Extremidades , Hospitalización , Articulaciones , Rodilla , Lipasa , Necrosis , Páncreas , Pancreatectomía , Enfermedades Pancreáticas , Paniculitis , Piel , Esplenectomía , Grasa Subcutánea , Pérdida de PesoRESUMEN
We report a case of pancreatic panniculitis associated with acute pancreatitis. The patient was a 63-year-old woman who presented with multiple painful erythematous nodules on both shins and had a mild fever and chill. Histopathologic findings showed fat necrosis with anucleate "ghost-like" fat cells with a thick shadowy wall. Laboratory evaluation revealed an increase in serum blood amylase and lipase. We diagnosed as pancreatic panniculitis associated with acute pancreatitis. Past medical history included rheumatoid arthritis and chronic renal failure treated with hemodialysis. She was taking several medicines due to rheumatoid arthritis and was newly prescribed the mizoribine (Bredinin(R)), 50 mg twice daily for 50 days. We therefore considered the possibility of drug induced pancreatitis due to mizoribine.
Asunto(s)
Femenino , Humanos , Persona de Mediana Edad , Adipocitos , Amilasas , Artritis Reumatoide , Necrosis Grasa , Fiebre , Fallo Renal Crónico , Lipasa , Pancreatitis , Paniculitis , Diálisis Renal , RibonucleósidosRESUMEN
Pancreatic panniculitis is a subcutaneous fat necrosis associated with pancreatic disease. We report a case of pancreatic panniculitis associated with chronic pancreatitis. The patient was a 47-year-old man who was a severe alcoholic. He was diagnosed with chronic pancreatitis and inferior vena cava thrombosis 2 months before. He presented with multiple, tender, erythematous, subcutaneous nodules on both lower legs, and also had pitting edema with tenderness on the left ankle. Laboratory examination showed an increase in serum blood amylase and lipase. Histopathologic findings showed subcutaneous focal fat necrosis, dense neutrophil infiltration and anucleated "ghost cells". Stippled basophilic material was deposited in and around the necrotic subcutaneous fat tissue. The lesions subsided gradually with improvement of the chronic pancreatitis.