胰腺胰腺炎——不仅仅是一种皮肤病

IF 0.1 Q4 PATHOLOGY
J. Crimmins, D. Russell, T. Samulski, Carolyn M. Ziemer, P. Googe
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引用次数: 0

摘要

摘要胰膜炎是一种罕见的胰腺疾病的后遗症,典型表现为累及下肢的柔软、红斑性皮下结节。少见的关联包括累及骨髓、腹腔内脂肪、胸腔内脂肪和临床表现为关节疼痛。我们报告一个病例,患者表现为1年的间歇性恶心、腹胀和厌食症病史,计算机断层扫描发现复杂的胰腺囊性病变,大网膜发现与癌性疾病和腹水有关。她在入院时首次发现双侧下肢有压痛、红斑和色素沉着的皮下结节。胰腺活检显示胰腺假性囊肿,入院时的实验室检查结果与胰腺炎和胰腺腹水一致。腹腔镜网膜活检显示多灶性结节性脂肪坏死和相关炎症,未发现癌。组织学上与大网膜活检相似,皮肤穿刺活检显示小叶脂肪坏死、炎症和嗜碱性钙点点,与胰膜炎一致。考虑到胰腺腹水的皮肤和大网膜的组织学表现相似,她的大网膜表现被认为是胰腺胰膜炎。本病例强调了认识到胰膜炎可以作为一种全身性疾病的重要性。我们强调胰膜炎的腹腔镜、皮肤病学、实验室和活检结果,以证明病理结果在各个受累器官是相似的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pancreatic Panniculitis—Not Just a Skin Disease
Abstract Pancreatic panniculitis is a rare sequela of pancreatic disease classically presenting with tender, erythematous subcutaneous nodules involving the lower extremities. Rarer associations include involvement of the marrow, intra-abdominal fat, intrathoracic fat, and the clinical finding of joint pain. We present the case of a patient who presented with a 1-year history of intermittent nausea, bloating, and anorexia with computed tomography scan findings of a complex pancreatic cystic lesion, omental findings concerning for carcinomatosis, and ascites. She developed tender, erythematous, and hyperpigmented subcutaneous nodules on bilateral lower extremities that were first noted on admission. Pancreatic biopsy revealed pancreatic pseudocyst and laboratory findings on admission were consistent with pancreatitis and pancreatic ascites. Laparoscopic omental biopsies revealed multifocal, nodular fat necrosis and associated inflammation with no carcinoma identified. Histologically similar to the omental biopsies, a punch biopsy of skin revealed lobular fat necrosis, inflammation, and basophilic stippling by calcium consistent with pancreatic panniculitis. Given the similar histologic findings in the skin and omentum in the setting of pancreatic ascites, her omental findings were attributed to pancreatic panniculitis. This case highlights the importance of recognizing that pancreatic panniculitis can present as a systemic disorder. We highlight the laparoscopic, dermatologic, laboratory, and biopsy findings of pancreatic panniculitis to demonstrate that the pathologic findings are similar in the various organs involved.
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