Traumatic fat necrosis is a localized reaction of panniculus resulting from blunt trauma occurring predominantly on large pendulous breasts in elderly females and on the face in children. The facial lesions in children need no treatment and therapeutic excision is not indicated because a reasonable cosmetic result comes from spontaneous healing in a year or more. The clinicians unfamiliar with this problem may have confusion in diagnosis and management. Herein we report a case of a three-year-old girl who presented with a 3 cm sized erythematous and bullous plaque on her right cheek. The diagnosis of traumatic fat necrosis was made following clinical and pathological findings.
Aged ; Breast ; Cheek ; Child* ; Diagnosis ; Fat Necrosis* ; Female ; Humans

Inflammatory and reactive lesions of the breast are relatively uncommon among benign breast lesions and can be the source of an abnormality on imaging. Such lesions can simulate a malignant process, based on both clinical and radiographic findings, and core biopsy is often performed to rule out malignancy. Furthermore, some inflammatory processes can mimic carcinoma or other malignancy microscopically, and vice versa. Diagnostic difficulty may arise due to the small and fragmented sample of a core biopsy. This review will focus on the pertinent clinical, radiographic, and histopathologic features of the more commonly encountered inflammatory lesions of the breast that can be characterized in a core biopsy sample. These include fat necrosis, mammary duct ectasia, granulomatous lobular mastitis, diabetic mastopathy, and abscess. The microscopic differential diagnoses for these lesions when seen in a core biopsy sample will be discussed.
Abscess ; Biopsy* ; Breast* ; Diagnosis* ; Diagnosis, Differential ; Dilatation, Pathologic ; Fat Necrosis ; Female ; Mastitis

Subcutaneous fat necrosis of newborn is an uncommon disorder characterized by firm subcutaneous plaques and nodules usually appearing shortly after birth. A female newborn with brain death developed diffuse hardening of trunk, extremity, cheek and buttock in the first 5 weeks of the life. A clinical diagnosis of sclerema neonatorum was made. But histologic examination revealed patchy areas of fat necrosis with crystallization, infiltration of histologic cells and several multinucleated giant cells containing needle-shaped clefts. Calcium deposits were also demonstrated within the necrotic area. So, we diagnosed this case as subcutaneous fat necrosis of newborn with generalized hardening of the skin.
Brain Death ; Buttocks ; Calcium ; Cheek ; Crystallization ; Diagnosis ; Extremities ; Fat Necrosis ; Female ; Giant Cells ; Humans ; Infant, Newborn* ; Necrosis* ; Parturition ; Sclerema Neonatorum ; Skin ; Subcutaneous Fat*

PURPOSE: The aim of this study was to evaluate the CT findings of pulmonary fat embolism syndrome that was induced by triolein and oleic acid, along with its pathologic correlation. MATERIALS AND METHODS: 16 rabbits were included in this study. The rabbits in group I (n=8) were embolized with 0.2 mL triolein and the rabbits of group II (n=8) were embolized with 0.2 mL oleic acid through ear veins. HRCT scans were done prior to embolization and at 0.5, 4, 24, 48 and 72 hours post-embolization. The pathologic correlations were determined at 0.5, 24, 48 and 72 hours. RESULTS: At 24 hours, one group I rabbit showed abnormal CT findings that were composed of several 2-3 mm nodules and multiple ill-defined peripheral ground glass opacities. The pathologic finding of this rabbit at 48 hours was mainly intraarveolar edema. All the group II rabbits (n=8/8) showed ill-defined bilateral and peripheral ground glass opacities with (n=6/8) or without consolidations (n=2/8) on the 0.5 hour CT. All the rabbits (n=7/7) showed that the new ground glass opacities and ground glass opacities noted on the 0.5 hour CT were changed into consolidation. The margins of the ground glass opacities and consolidations were more sharpened on the 24 hours CT. All 6 rabbits (n=6/6) showed consolidations without ground glass opacities and the margins of the consolidations were more sharpened on the 48 hours CT. There was no significant interval change on the 72 hours CT. The pathologic findings of ground glass opacities were interstitial edema or mild intraalveolar edema. The pathologic findings of consolidation were intraalveolar edema, hemorrhage and coagulation necrosis. CONCLUSION: The CT findings after fat embolization using triolein and oleic acid were ill-defined peripheral ground glass opacities with/without consolidations. These findings occurred in only one triolein group with the time lag, but these findings were immediately and extensively seen in all group II rabbits. These CT findings may be important for making a diagnosis of pulmonary fat embolism syndrome.
Diagnosis ; Ear ; Edema ; Embolism, Fat* ; Glass ; Hemorrhage ; Necrosis ; Oleic Acid* ; Pulmonary Embolism ; Rabbits* ; Triolein* ; Veins

Epipericardial fat necrosis (EPFN) is an uncommon benign condition of unknown etiology. It presents as an unexplained acute severe pleuritic chest pain that is associated with the presence of a well-defined juxtacardiac mass usually located in or near the cardiophrenic angle. Although its typical clinical manifestations and chest computed tomography findings might lead to successful diagnosis of this rare disease, an unusual mass location such as the anterosuperior mediastinum should be considered and biopsies should be performed. We herein report a case of thymic carcinoma that was suspected initially to be EPFN.
Biopsy ; Chest Pain ; Diagnosis ; Fat Necrosis* ; Mediastinum ; Pericardium ; Rare Diseases ; Thorax ; Thymoma* ; Thymus Gland

The discovery of a breast lump is one of the most anxiety-provoking occurrences in a woman's life. The initial purpose of a surgical consultation is to determine whether a true mass exists. The majority of breast masses are self-discovered or are identified by a primary care provider. Once a breast mass has been identified, the first determination to be made is whether it is benign or malignant by using breast imaging techniques or pathologic examination. Once a breast lesion has been shown to be benign on pathologic examination, the most improtant clinical consideration is the risk of subsequent breast cancer associated with that lesion. The diagnosis of a fibroadenoma can be made using excisional biopsy or the combined modalities of CBE, ultrasound, and FNA. A true intraductal papilloma develops in one of the major subareolar ducts and is the most common lesion causing a serous or serosanguinous discharge. A mass may be felt on examination in as many as one-third of cases. The treatment of choice is microdochectomy. Hamartomas can produce a classic mammographic image that is virtually diagnostic. Because the clinical and radiologic characteristics of fat necrosis resemble those of carcimoma in the majority of cases, a needle localization or excisional biopsy is required.
Biopsy ; Breast Neoplasms ; Breast* ; Diagnosis ; Fat Necrosis ; Fibroadenoma ; Hamartoma ; Needles ; Papilloma, Intraductal ; Primary Health Care ; Ultrasonography

Pericardial fat necrosis is an infrequent cause of acute chest pain and this can mimic acute myocardial infarction and acute pericarditis. We describe here a patient with the magnetic resonance imaging (MRI) findings of pericardial fat necrosis and this was correlated with the computed tomography (CT) findings. The MRI findings may be helpful for distinguishing pericardial fat necrosis from other causes of acute chest pain and from the fat-containing tumors in the cardiophrenic space of the anterior mediastinum.
Adult ; Contrast Media/diagnostic use ; Diagnosis, Differential ; Fat Necrosis/*diagnosis ; Humans ; Magnetic Resonance Imaging/*methods ; Male ; Pericardium/*pathology

PURPOSE: To evaluate CT findings which may help differentiate benign from malignant parotid tumors. MATERIALS AND METHODS: The CT findings of seventy-one cases with surgically-proven parotid tumors were retrospectively analysed for size, location, margin, internal density, adjacent tissue plane and lymphadenopathy. RESULTS: The margin of the mass was smooth and sharp in most benign tumors (89.5%), and irregular or indistinct in twelve which were malignant (75%, p<0.01). With regard to internal density, 70.2% of benign tumors were homogeneous (similar to muscle) and 81.3% of malignant tumors were heterogeneous (p<0.01). When analysing low density patterns within the mass, focal low densities in benign tumors (11/17) and diffuse or scattered multifocal low densities in those which were maligant (8/13) were frequently seen. Three malignant tumors invaded adjacent muscles, the parapharyngeal space, and bones, each in one case, and twelve malignant and one benign tumor infiltrated the adjacent fascia or subcutaneous fat layer. In five patients with a malignant tumor, obliteration by the mass of the fat plane between the mastoid tip and styloid process was noted, suggesting facial nerve invasion, while in three cases of malignancy, lymphadenopathy greater than 1cm was seen. CONCLUSION: In differentiating malignant and benign parotid tumors, the presence of irregular or indistinct margin of the mass, and invasion of adjacent structures, are important. Lymph node enlargement greater than 1cm and diffuse internal low densities, which may suggest necrosis or cystic change were also helpful in differential diagnosis.
Diagnosis, Differential* ; Facial Nerve ; Fascia ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Mastoid ; Muscles ; Necrosis ; Retrospective Studies ; Subcutaneous Fat

PURPOSE: Since there are few studies involving acute pancreatitis in children, we reviewed our experience with this medical condition to describe the clinical features. METHODS: A retrospective analysis was conducted by reviewing the medical records of 41 patients with AP who were admitted to the Department of Pediatrics of Pusan National University Hospital between January 1996 and June 2007. RESULTS: Twenty males and 21 females (mean age, 8.7+/-4.5 years) were included. In 22 patients (53.7%), no definitive causes were found. The most common etiologies were choledochal cysts (22.0%). Necrotizing pancreatitis was diagnosed in 5 patients (12.2%), and recurrent acute pancreatitis in 4 patients (9.8%). CT findings included pancreatic swelling (43.9%), peripancreatic fluid collection (29.3%), ascites (24.4%), and peripancreatic fat necrosis (12.2%). Serum amylase and lipase levels at diagnosis were 535.3+/-553.2 and 766.2+/-723.6 U/L, respectively, and were normalized within 1 week in 22 and 14 patients, respectively. On the basis of the Balthazar scale, 2 patients were diagnosed with severe AP. In 4 patients (9.8%), a surgical procedure was indicated. Major complications included ascites (32.3%), sepsis (16.1%), and pseudocyst and renal impairments (12.9%). Two patients died from multi-organ failure. CONCLUSION: The etiologies of AP in children are varied. Most children have a single episode and a self-limited course. However, AP of childhood still carries significant morbidity and mortality. Early diagnosis, appropriate treatment according to disease severity, and management of complications are important.
Amylases ; Ascites ; Child ; Choledochal Cyst ; Early Diagnosis ; Fat Necrosis ; Female ; Humans ; Lipase ; Male ; Medical Records ; Pancreatitis ; Pediatrics ; Retrospective Studies ; Sepsis

Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue ; Calcaneus ; Diagnosis ; Fat Necrosis ; Female ; Fibrosis ; Humans ; Ilium ; Lipoma* ; Male ; Middle Aged ; Osteogenesis ; Tibia ; X-Ray Film