Starvation

Starvation is due to lack of food, inability or lack of desire to eat.

General

Causes of starvation:

• Psychiatric:
  • Dementia.
  • Anorexia nervosa.
  • Disorder with delusions, e.g. schizophrenia, bipolar affective disorder - belief one is being poisoned.
• Organic disease:
  • Malignancy, e.g. esophageal carcinoma.
  • Causes of malabsorption.
  • Vomiting.
• Other:
  • Poverty.
  • Young age (cannot feed themself).
  • Disability/trauma - person falls and cannot get up, help not available.

Associations - serous fat atrophy:

• Acute febrile states.
• AIDS.
• Alcoholism.
• Anorexia nervosa.
• Cachexia.
• Carcinomas.
• Chronic heart failure.
• Lymphoma.

Gross

• Very low body mass index (BMI).
• Serous fat atrophy:
  • Soft brown/myxoid material replaces fat.

Microscopic

Features - serous fat atrophy:

• Globular cells ~3-4x the size of a RBC (24-32 micrometers) with:
  • Clear cytoplasm.
  • One small peripheral nucleus without a nucleolus.

DDx:

• Signet ring cell carcinoma.

Images:

• Serous fat atrophy - intermed mag. (WC).
• Serous fat atrophy - very high mag. (WC).

See also

• Autopsy.