Pancreatic Panniculitis and Associated Syndromes
Summary
Pancreatic panniculitis is an uncommon inflammatory condition of the subcutaneous fat, arising from the systemic release of pancreatic enzymes such as lipase and amylase. Clinically, it presents as tender, erythematous nodules or plaques, predominantly on the lower extremities, which may ulcerate and discharge oily material. Histologically, it is characterised by lobular fat necrosis with anuclear adipocytes (ghost cells) and mixed inflammatory infiltrates. While most frequently linked to acute or chronic pancreatitis and pancreatic acinar cell carcinoma, it can also herald other neoplastic or extrapancreatic enzyme-secreting lesions. Associated syndromes include polyarthritis, polyserositis and, rarely, intraosseous fat necrosis manifesting as osteolytic lesions. Early recognition is important because cutaneous findings may precede abdominal symptoms, offering a window for diagnosis and timely management of underlying pancreatic pathology. Globally, this entity underscores the interplay between dermatology, oncology and gastroenterology and emphasises the need for multidisciplinary assessment and targeted therapy to improve patient outcomes.
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Pancreatic Panniculitis and Associated Syndromes publication trend
The graph below shows the total number of articles in pancreatic panniculitis and associated syndromes across all publications each year (not limited to Nature Index journals).
Technical terms
Pancreatic panniculitis: lobular inflammation of subcutaneous fat caused by circulating pancreatic enzymes, presenting as tender, ulcerating nodules.
Acinar cell carcinoma: a malignant tumour of pancreatic exocrine cells characterised by elevated enzyme secretion and frequent paraneoplastic fat necrosis.
Ghost cells: anucleate adipocytes with preserved cellular outlines seen in necrotic fat lobules, indicative of enzymatic lipolysis.
Intraosseous fat necrosis: rare deposition of necrotic fat within bone marrow, leading to osteolytic lesions and bone pain in the context of pancreatic disorders.
References
- Pancreatic panniculitis in a patient with pancreatic-type acinar cell carcinoma of the liver – case report and review of literature. BMC Cancer (2016).
- Pancreatic panniculitis: the “bright” side of the moon in solid cancer patients. BMC Gastroenterology (2018).
- Subcutaneous and Intraosseous Fat Necrosis Associated with Chronic Pancreatitis. Medicina (2022).
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