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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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Traumatic fat necrosis


Cytology images

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      Figure 3   Figure 4

 

           
Various stages of fat necrosis

 

 

Pap stain (inset Giemsa)

 

End of Breast-nonmalignant > Inflammatory / infectious > Fat necrosis

 

 

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