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Breast-nonmalignant
Inflammatory / infectious
Fat necrosis of breast
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 26 September 2012, 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
Necrotic adipocytes and calcification
With metaplastic squamous epithelium Irregular fatty spaces and
and keratin whorls (AFIP) foamy macrophages
Giant cells Giant cells engulfing lipid
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 images
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Various stages of fat necrosis
Pap stain (inset Giemsa)
End of Breast-nonmalignant > Inflammatory / infectious > Fat necrosis
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