| Subcutaneous fat necrosis/panniculitis and polyarthritis associated with acinar cell carcinoma of the pancreas: a rare presentation of pancreatitis, panniculitis and polyarthritis syndrome. | |
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MedLine Citation:
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PMID: 20865849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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An 82-year-old man presented with a two-week history of three painful, inflamed nodules on his lower extremities with symmetric arthritis of multiple joints. He was under the care of hospice for end-stage acinar cell carcinoma of the pancreas. His serum amylase and lipase levels were markedly elevated. An incisional biopsy revealed lobular inflammation of subcutaneous fat, focal fat necrosis with saponification/ghost cells and scattered foreign-body type giant cells consistent with pancreatic fat necrosis/pancreatic panniculitis. This is hypothesized to be initiated by autodigestion of subcutaneous fat secondary to systemic spillage of excess digestive pancreatic enzymes. Enzymes such as amylase, lipase and trypsin are increased in the bloodstream and can affect remote tissues, such as the subcutaneous fat and articular surfaces of joints. This report, along with the patient's clinical findings, was consistent with PPP syndrome: pancreatic disease, polyarthritis and panniculitis. Although the pancreatic disease of PPP syndrome usually includes pancreatitis, this case represents a report of polyarthritis and panniculitis occurring in the presence of pancreatic carcinoma. |
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Authors:
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Jessica Borowicz; Megan Morrison; Daniel Hogan; Richard Miller |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Journal of drugs in dermatology : JDD Volume: 9 ISSN: 1545-9616 ISO Abbreviation: J Drugs Dermatol Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-27 Completed Date: 2010-10-18 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101160020 Medline TA: J Drugs Dermatol Country: United States |
Other Details:
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Languages: eng Pagination: 1145-50 Citation Subset: IM |
Affiliation:
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Nova Southeastern University College of Osteopathic Medicine, Largo Medical Center/Suncoast Hospital, Largo, FL 33774, USA. drjflowers@hotmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged, 80 and over Arthritis / complications, pathology* Biopsy Carcinoma, Acinar Cell / complications*, pathology Hospices Humans Male Necrosis Pancreatic Neoplasms / complications*, pathology Pancreatitis / complications*, pathology Panniculitis / complications, pathology* Skin / pathology* Subcutaneous Fat / pathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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