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Breast-nonmalignant
Inflammatory / infectious
Fat necrosis of breast
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 2 April 2010, last major update March 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Partially necrotic adipose tissue with foamy macrophages, multinucleated giant cells and chronic inflammatory cells
● Simulates carcinoma clinically and mammographically (AJR Am J Roentgenol 2009;192:815)
Terminology
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Epidemiology
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Sites
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Etiology
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Clinical features
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● May be associated with duct ectasia, fibrocystic change, trauma (including surgery), brachytherapy (Int J Radiat Oncol Biol Phys 2007;69:724), injections of Depixol (J BUON 2002;7:281), low molecular weight heparin (Age Ageing 2005;34:193), methylene blue dye (Int Semin Surg Oncol 2005;2:26), radiotherapy (25% of patients, Radiother Oncol 2010 Mar 11 [Epub ahead of print]), reconstructive surgery (35% of patients, Plast Reconstr Surg 2009;124:1754)
● Frozen sections are difficult to obtain due to high fat content of specimen
Case reports
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Treatment
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Clinical images
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Skin and fat necrosis due to methylene blue Due to coumadin
Gross description (Macroscopy)
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● Opaque, bright yellow
Gross images
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Images: hemorrhagic fat necrosis
Micro description (Histopathology)
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● Partially necrotic adipose tissue with foamy macrophages, multinucleated giant cells and chronic inflammatory cells
● Often hemosiderin deposits, fibrosis and calcification
● Occasional metaplastic squamous epithelium
Micro images
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Various images
Giant cells and microcalcification Necrotic adipocytes and calcification
With metaplastic squamous epithelium Irregular fatty spaces and
and keratin whorls (AFIP) foamy macrophages
Giant cells Giant cells engulfing lipid
Various stages of fat necrosis
Pap stain (inset Giemsa)
Other images: foamy macrophages and calcifications #1; #2; #3; #4
Virtual Slides
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Traumatic fat necrosis
Videos
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Cytology description
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Cytology images
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Fat necrosis
Positive stains
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Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● (link to topic)
Additional references
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End of Breast-nonmalignant > Inflammatory / infectious > Fat necrosis
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