Possible origin of pancreatic fat necrosis as a septal panniculitis

We describe pancreatic subcutaneous fat necrosis in a man with alcoholism and pancreatitis. The initial specimen, from a 2-day-old lesion, showed a septal inflammatory infiltrate in the subcutis. A second specimen, from a 5-day-old lesion, showed the lobular pattern of enzymatic fat necrosis diagnostic for pancreatic panniculitis. We suggest that the histologic appearance of subcutaneous pancreatic fat necrosis evolves from an early septal reaction to a fully developed lobular panniculitis.