Related Experiment Video
Updated: Aug 16, 2025
A Guide to Examining Intramuscular Fat Formation and its Cellular Origin in Skeletal Muscle
Published on: May 26, 2022
Lipomembranous fat necrosis: A distinctive and unique morphology (Review)
Susumu Matsukuma1,2, Ayano Matsunaga1, Oh Takahashi2
1Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa, Saitama 359-8513, Japan.
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.
Insights
Lipomembranous fat necrosis (LFN) is a rare condition characterized by specific membrane features in necrotic fat. It serves as a key indicator of underlying ischemic or malnourished states across various diseases.
Area of Science:
- Pathology
- Histology
- Medical Science
Background:
- Lipomembranous fat necrosis (LFN) is an uncommon form of fat necrosis.
- It presents with characteristic eosinophilic, crenulated, and/or serpiginous membranes, alongside macrocystic, microcystic, and/or crushed features.
- LFN is identifiable on standard hematoxylin and eosin (H&E) stains in both acute and later stages.
Purpose of the Study:
- To review the clinicopathological features of lipomembranous fat necrosis.
- To highlight diagnostic challenges and ancillary staining techniques for LFN.
- To discuss the association of LFN with various conditions, particularly those involving ischemia or malnutrition.
Main Methods:
- Review of existing literature on lipomembranous fat necrosis.
- Analysis of histological characteristics and staining properties of LFN.
- Correlation of LFN presence with clinical conditions and disease states.
Main Results:
- LFN exhibits distinct morphological features, including unique membrane structures and tissue alterations.
- While visible on H&E, certain LFN presentations require special stains (e.g., Masson trichrome, PAS, orcein) for optimal detection.
- LFN has been identified in diverse lesions, including subcutaneous, intra-abdominal, intra-articular, and aortic valve pathologies.
- Its presence is linked to ischemic, hypoxic, or malnourished conditions, suggesting a role as a marker for these states.
Conclusions:
- Lipomembranous fat necrosis is a significant histological finding associated with hidden ischemic or hypoxic/malnourished conditions.
- Despite its diagnostic utility, the precise mechanisms underlying LFN formation remain incompletely understood.
- Further research is warranted to elucidate the pathophysiology and clinical implications of LFN.
