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Fat Necrosis



Fat Necrosis (Breast)

Etiology

  • Phagocytosis of necrotic adipose cells

  • Most common cause is trauma (MVC etc.)

  • Can be seen with duct ectasia that has ruptured (may have apocrine metaplasia present)

Clinical picture

  • Trauma to breast then patient has a localized, firm area with eventual scarring & calcifications.

Histologic Findings

Histologic Findings:

  • Consists of necrotic adipocytes, fibrosis and inflammation

    • Irregular steatocytes with loss of peripheral nuclei

    • Pink amorphous necrotic material/debris

    • Inflammatory cells

      • Foamy (lipid-laden) macrophages

      • +/- Foreign body giant cells

      • Neutrophils/lymphocytes/plasma cells

      • BEWARE: Reactive fibroblasts and reactive endothelial cells can look ugly and can be confused with carcinoma!!


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