A case of nodular cystic
fat necrosis with systemic lupus erythematosus presenting the multiple subcutaneous nodules on the extremities.
This leads to crystal formation,
fat necrosis, and inflammation when the fat is subjected to such stresses as vascular compromise or trauma.
Some of these entities include radial scar, sclerosing adenosis, fibroadenoma,
fat necrosis, and pseudoangiomatous stromal hyperplasia.
A single case of
fat necrosis was reported in 50 yrs.
The predominant finding was
fat necrosis with wide variety of benign appearance on imaging.
However, in patients with
fat necrosis, localized abscesses or foreign body granulomas, the most common finding on sonography was localized masses with coarse margins and showed avascularity or low blood supply.
As a result of
fat necrosis, such abscesses may manifest as numerous pockets with multiple, interconnected foci.
Postoperative complications included bleeding 0.5% (liver bed n=1 omentum n=1) biliary peritonitis due to cystic duct leak 0.25% (n=1) intra-abdominal collection/abscess 0.5% (biloma n=1 subphrenic abscess n=1) subcutaneous
fat necrosis right flank around drain site 0.25% (n=1) umbilical trocar site infection 2% (n=8) keloid at umbilical port site 0.25% (n=1) and incisional hernia at umbilicus 0.25% (n=1) as shown in fig.
Histologic examination demonstrated extensive
fat necrosis with granulomatous inflammation, characterized by cords of necrotic fat surrounded by multinucleated giant cells and epithelioid macrophages with scattered lymphocytes and plasma cells and rare heterophils.
Subcutaneous
fat necrosis of the newborn (SCFN) is a rare, benign, and self-limiting panniculitis of neonates that presents in the first few weeks of life.
(4)
Fat necrosis is rare and secondary to injury or trauma.
The false positive results occur because of some benign diseases with hypercellularity like cellular fibroadenoma, proliferative fibrocystic disease, phyllodes tumor, lactational changes, sclerosing adenosis, and so forth, and in lesions with atypia like postradiation,
fat necrosis, and radial scar [9].