Fat necrosis

  History:
  49 year old male 100+ pounds overweight
  Meds Zestril (ace inhibitor) Interferon 3MILUnits 3 times weekly
  Cardiomyopathy 15% ejection fraction 1 year ago 45% today
  Clean plumbing, normal cholesterol, low normal BP 110-120/50-80 heart rate 80's-90's
  Hepatitis-c Viral load ZERO   liver enzymes normal no cyrhossis
  Several months ago I noticed a nodule in my abdomen(subcutaneous) Lots of people checked it out and said EHHH don't worry.
  Then they started appearing all over my thorax (front only) They weren't painful but the tissue around them was . They gathered especially around the edge of my ribcage. They have since developed in my lower back.
  Sometimes they are extremely painful. And when the pain increases so does the density of the lumps. You can almost see them through the skin. When the pain subsides the bumps shrink in size.
  I have had three punch biopsies that revealed nothing. I also had a substantial biopsy that removed 5 grams of tissue.
  Here is the analysis: 5 gram partially encapsulated 3.5 x 2.5 x 1.5 cm portion of rubbery adipose tissue. A suture designates the rubbery nodule. (see it?)
  The cut specimen reveals a zone of fat necrosis, 2 x 1 x 1 cm. The second specimen is a tan ellipse of skin 2.0 x 1.0 x 0.5 cm. The skin overlies a portion of soft lobulated unremarkable adipose tissue, 2.0 x1.0 x 0.5 cm.
  Summary of sections: A1-A2 - sections of the sutured nodule including a representative portion of skin and underlying fat.
  Microscopic Diagnosis:
  Subcutaneous nodule, left lower quadrant:
  Skin and subcutaneous adipose tissue showing fat necrosis with focal fibrosis and dystrophic calcification. No evidence of malignancy.
   Okay a pathologist has suggested it is nodular-cystic fat necrosis. Could it be pancreatitis or some othe  problem with the pancreas? And can it be stopped?? Jack
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Dear Jack,
I doubt that the fat necrosis is a manifestation of pancreatitis.  usually, patients with pancreatitis have signs of acute illness (specifically abdominal pain) several days prior to the development of the fat necrosis.  Also the fat necrosis associated with acute pancreatitis tends to be on the extremities and not the trunk.  
This information is provided for educational purposes only.  Always consult your personal physician for the answers to specific questions regarding your health.
HFHSM.D.-rf
*keywords: pancreatitis
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