Pancreatic Panniculitis

Pancreatic panniculitis clinically presents as tender, edematous, erythematous, or red-brown nodules that may spontaneously ulcerate and drain an oily material. These nodules most commonly appear on the distal lower extremities. Histologic examination of pancreatic panniculitis reveals a mixed septal-lobular panniculitis with necrosis of adipocytes. These necrotic adipocytes, known as ghost cells, have lost their nucleus and contain a granular basophilic material in the cytoplasm from calcium deposition. In calciphylaxis, granular basophilic deposits of calcium are primarily found within the media of small vessels located between adipocytes rather than within the adipocytes themselves. Similar to pancreatic panniculitis, eosinophilic panniculitis and lipodermatosclerosis also are mixed septal-lobular panniculitis.