Acinar pancreatic tumor with metastatic fat necrosis: report of a case and review of rheumatic manifestations.

This report deals with a pancreatic tumor associated with metastatic fat necrosis. Our patient displayed the full gamut of nodular panniculitis, polyarthritis, fever, eosinophilia, hyperlipasemia, lytic bones lesions, and marrow fat necrosis. The rheumatologic features are reviewed. Elevated serum lipase is a most helpful laboratory confirmation. The tumor in our patient presented a difficult problem in classification. Although the appearance under light microscopy was most compatible with islet cell carcinoma or islet cell carcinoid, the ultrastructural characteristics were those of acinar carcinoma.