Fat necrosis: A consultant’s conundrum

Abstract

Fat necrosis of the breast is a benign non-suppurative inflammation of the adipose tissue and often mimics breast cancers, posing a diagnostic challenge for the clinician and radiologist. It has a myriad of appearances on different imaging techniques, ranging from the pathognomic oil cyst and benign dystrophic calcifications to indeterminate focal asymmetries, architectural distortions, and masses. A combination of different modalities can assist a radiologist in reaching a logical conclusion to avoid unnecessary interventions. The aim of this review article was to provide a comprehensive literature on the various imaging appearances of fat necrosis in the breast. Although a purely benign entity, the imaging appearances on mammography, contrast-enhanced mammography, ultrasound, and magnetic resonance imaging can be quite misleading, especially in post-therapy breasts. The purpose is to provide a comprehensive and all-inclusive review on fat necrosis with a proposed algorithm allowing a systematic approach to diagnosis.

Membranous fat necrosis of gall bladder, a case report and literature review

“…However, the greater the ischemia, the greater the damage and necrosis will be. Hence, fibrosis and calcification are reported in cases of breast membranous fat necrosis [ [10] , [11] , [12] ].…”

“…Enzymic fat necrosis, also known as intra-abdominal fat necrosis, is the characteristic diagnosis of pancreatic disorders [ [3] , [4] , [5] , [6] ]. Furthermore, there are some reports of microcytic MFN in appendix epiploica manifested by calcified fibrous nodules on the colon surface or in the abdominal cavity [ 11 ]. Nonetheless, MFN or lipo-membranous fat necrosis is commonly reported in subcutaneous and connective tissue such as dermal lesions, breast lumps, and osteodysplastic disorders [ 6 , 7 , 11 ].…”

“…Subsequently, such inflammatory response ends in fibrosis and hemorrhage in the affected organ, naming gall bladder [ 1 ]. Nevertheless, MFN in abdominal organs has no considerable clinical or imaging presentation and it is diagnosed by histological investigations [ 3 , 10 , 11 ].…”

“…Immunohistochemically, CD 68 is positive in the cytoplasm of giant cells in contrast to being negative in membranous substances. So, positive SSB, D-PAS, LFB, and Z -N are diagnostic for membranous fat necrosis [ 1 , 10 , 11 , 13 , 14 ].…”