Lipomembranous fat necrosis: A distinctive and unique morphology (Review)

Matsukuma,Susumu; Matsunaga,Ayano; Takahashi,Oh; Ogata,Sho

doi:10.3892/etm.2022.11695

Lipomembranous fat necrosis: A distinctive and unique morphology (Review)

Authors:
- Susumu Matsukuma
- Ayano Matsunaga
- Oh Takahashi
- Sho Ogata
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Affiliations: Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama 359‑8513, Japan, Department of Laboratory Medicine, National Defense Medical College Hospital, National Defense Medical College, Tokorozawa, Saitama 359‑8513, Japan
Published online on: November 9, 2022 https://doi.org/10.3892/etm.2022.11695
Article Number: 759
Copyright: © Matsukuma et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Lipomembranous fat necrosis (LFN) is an uncommon but distinct form of fat necrosis, which is characterized by eosinophilic, crenulated and/or serpiginous membranes. LFN exhibits macrocystic, microcystic and/or crushed features. LFN is routinely detectable on hematoxylin and eosin (H&E)‑stained sections, and is present both in the acute phase and in the later or fibrous stage of necrotic fatty lesions. Smaller crushed LFN embedded within fibrous tissues may be difficult to recognize on H&E‑stained sections, but can be highlighted by some staining techniques, including Masson trichrome, periodic acid‑Schiff, orcein, long Ziehl‑Neelsen stain, silver impregnation, phosphotungstic acid‑hematoxylin and luxol fast blue staining. LFN was initially considered a specific feature of Nasu‑Hakola disease, but has since been identified in various subcutaneous or intraabdominal lesions related to ischemic conditions or venous insufficiency. In addition, LFN is detectable in intra‑articular loose bodies and aortic valves with or without dysfunction, suggesting that LFN is also associated with ischemia‑like hypoxic conditions or malnutrition. LFN is considered to be a histological hallmark of hidden ischemic or hypoxic/malnourished conditions in various diseases; however, the exact mechanisms of LFN remain poorly understood. The present review described the clinicopathological features of this interesting, but poorly characterized, condition.

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