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'''Starvation''' is due to lack of food, inability or lack of desire to eat. | '''Starvation''' is defined as deprivation of food for a lengthy period. Generally, it is due to lack of food, inability to eat or lack of desire to eat. It may include people that can eat but cannot absorb the nutrients in their food. | ||
This article covers ''[[serous fat atrophy]]'' as it is classically seen in starvation. | |||
==Associations<ref name=pmid19567708/> | ''Cachexia'' and ''dystrophic mesenteric adipocytes'' direct here. | ||
=Starvation= | |||
===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. | |||
===Gross findings of starvation=== | |||
Features: | |||
*Very low body mass index (BMI). | |||
*Membranous-appearing (thin) [[omentum]]. | |||
*Soft brown/[[myxoid]] material replaces fat (serous fat atrophy). | |||
=Associated conditions= | |||
==Serous fat atrophy== | |||
:''Fat atrophy'' redirects to here | |||
===General=== | |||
Associations:<ref name=pmid19567708/> | |||
*Acute febrile states. | *Acute febrile states. | ||
*AIDS. | *[[AIDS]]. | ||
*Alcoholism. | *[[Alcoholism]]. | ||
*Anorexia nervosa. | *Anorexia nervosa. | ||
*Cachexia. | *Cachexia. | ||
*Carcinomas. | *Carcinomas. | ||
*Chronic heart failure. | *Chronic heart failure. | ||
*Lymphoma. | *[[Lymphoma]]. | ||
===Gross=== | |||
Features:<ref name=pmid19567708>{{cite journal |author=Munfus DL, Menke DM |title=Case of severe serous fat atrophy |journal=Mayo Clin. Proc. |volume=84 |issue=7 |pages=570 |year=2009 |month=July |pmid=19567708 |pmc=2704126 |doi=10.4065/84.7.570 |url=http://www.mayoclinicproceedings.com/content/84/7/570.full}}</ref> | |||
*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]].<ref name=pmid6222282>{{Cite journal | last1 = Clarke | first1 = BE. | last2 = Brown | first2 = DJ. | last3 = Xipell | first3 = JM. | title = Gelatinous transformation of the bone marrow. | journal = Pathology | volume = 15 | issue = 1 | pages = 85-8 | month = Jan | year = 1983 | doi = | PMID = 6222282 }}</ref> | |||
*[[Liposarcoma]]. | |||
*[[Malignant mesothelioma]]. | |||
*[[Vascular lesions]]. | |||
====Images==== | |||
<gallery> | |||
Image:Fat_atrophy_-_intermed_mag.jpg | Serous fat atrophy - intermed mag. (WC) | |||
Image:Fat_atrophy_-_high_mag.jpg | Serous fat atrophy - high mag. (WC) | |||
Image:Fat_atrophy_-_very_high_mag.jpg | Serous fat atrophy - very high mag. (WC) | |||
</gallery> | |||
===IHC=== | |||
Features:<ref>{{cite journal |authors=van Haeringen B, Francis L, Olive E, James D |title=Adipocyte Atrophy Mimicking Signet Ring Cell Carcinoma of the Gallbladder |journal=Case Rep Pathol |volume=2021 |issue= |pages=4676885 |date=2021 |pmid=34754523 |pmc=8572618 |doi=10.1155/2021/4676885 |url=}}</ref> | |||
*S-100 +ve (key stain). | |||
*AE1/AE3 -ve (key stain). | |||
*CD68 -ve. | |||
=See also= | |||
*[[Autopsy]]. | *[[Autopsy]]. | ||
*[[Signet ring cell carcinoma]]. | |||
=References= | |||
{{reflist| | {{reflist|2}} | ||
[[Category:Autopsy]] | [[Category:Autopsy]] | ||
[[Category:Weird stuff]] | [[Category:Weird stuff]] | ||
[[Category:Clinical]] | [[Category:Clinical]] | ||