Starvation

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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.

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:[1]

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

Gross

Features:[1]

  • 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:

Images

IHC

Features:[3]

  • S-100 +ve (key stain).
  • AE1/AE3 -ve (key stain).
  • CD68 -ve.

See also

References

  1. 1.0 1.1 Munfus DL, Menke DM (July 2009). "Case of severe serous fat atrophy". Mayo Clin. Proc. 84 (7): 570. doi:10.4065/84.7.570. PMC 2704126. PMID 19567708. http://www.mayoclinicproceedings.com/content/84/7/570.full.
  2. Clarke, BE.; Brown, DJ.; Xipell, JM. (Jan 1983). "Gelatinous transformation of the bone marrow.". Pathology 15 (1): 85-8. PMID 6222282.
  3. van Haeringen B, Francis L, Olive E, James D (2021). "Adipocyte Atrophy Mimicking Signet Ring Cell Carcinoma of the Gallbladder". Case Rep Pathol 2021: 4676885. doi:10.1155/2021/4676885. PMC 8572618. PMID 34754523. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8572618/.