Nodular-Cystic Fat Necrosis -A Review of 147 Japanese Patients

Abstract

Nodular-cystic fat necrosis, which is also called encapsulated fat necrosis, is a mobile subcutaneous nodule and histologically reveals fat necrosis encapsulated by fibrous connective tissue. In Japan, many cases have been reported, and there are some opinions that diabetes mellitus and systemic corticosteroid therapy cause this condition. The author found that out of 147 Japanese patients reported from 1982 up to 2015, 9 had the former and 23 received the latter. Systemic corticosteroid therapy may be responsible for nodular-cystic fat necrosis.

Subcutaneous, abdominal, and thoracic encapsulated fat necrosis in bowhead whales Balaena mysticetus from Alaska, USA

“…Subcutaneous encapsulated fat necrosis case reports in humans have been associated with prior trauma (Hurt & Santa Cruz 1989, Burgdorf & Hurt 2011). In the absence of prior trauma history, origin of encapsulated fat necrosis is linked to rapid vascular insufficiency and or tissue ischemia associated with underlying collagen and endocrine-metabolic disturbances (Anonymous 1926, Herzog et al 2010, Hanson et al 2014, Ban 2016. Cockrill (1951Cockrill ( , 1960 did not discuss the role of trauma in the etiology of subcutaneous encapsulated bodies in large whales, colloquially known as 'husks' among whaler men, and thought that the masses were of parasitic origin.…”

Nodular cystic fat necrosis in a patient with sarcoidosis

“…All patients of the two families met the diagnostic criteria of AI. 2 After receiving informed consent, we collected peripheral blood from all surviving members of the families. Genomic DNA was extracted to amplify c-secretase genes using published primers by polymerase chain reaction (PCR), and then Sanger sequencing was conducted.…”

“…Histological examination typically shows non-viable adipocytes surrounded by condensed fibrous tissues, along with lipomembranous changes, 1 which probably result from a consequence of inflammatory, infectious and physical processes, or an interruption of the blood supply in the subcutaneous tissues. 2 To date, only a few cases of either NCFN or lipomembranous changes have been reported in patients with sarcoidosis. 2,3 In the present case, it is unique that NCFN occurred on the previously affected sites by subcutaneous sarcoidosis a few years after resolution.…”

“…2 To date, only a few cases of either NCFN or lipomembranous changes have been reported in patients with sarcoidosis. 2,3 In the present case, it is unique that NCFN occurred on the previously affected sites by subcutaneous sarcoidosis a few years after resolution. We speculate that ischemic changes due to inflammation, tissue damage and fibrosis caused by subcutaneous sarcoidosis may mainly be relevant to the induction of NCFN.…”

“…Nodular cystic fat necrosis (NCFN; encapsulated fat necrosis) is a localized form of fat necrosis characterized by discrete fat nodules, and most commonly affects the lower extremities. Histological examination typically shows non‐viable adipocytes surrounded by condensed fibrous tissues, along with lipomembranous changes, 1 which probably result from a consequence of inflammatory, infectious and physical processes, or an interruption of the blood supply in the subcutaneous tissues 2 . To date, only a few cases of either NCFN or lipomembranous changes have been reported in patients with sarcoidosis 2,3 .…”