PMC9997608_01
Physical examination of the patient showed several painful, erythematous nodules with ulcerations and crusts in the left leg
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F1
A 63-year-old male presented to our hospital because of progressive bilateral lower limbs edema accompanied with nodule-like lesions for 1 month [Figure 1].
(a) Axial view of abdominal CT showed a huge mass in the left upper quadrant (arrows). (b) Endoscopic ultrasound showed a mass lesion, 11.9 x 7.8 cm in size, in the pancreatic tail (arrow)
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F2
Abdominal computed tomography (CT) scan with contrast showed a heterogeneous hypodense lesion, measuring 11 x 10 cm in size, with some gas bubbles inside in left upper abdomen [Figure 2a, arrows]. The mass was a mixed echoic tumor, measuring 11.9 x 7.8 cm in dimensions, originating from the pancreatic tail [Figure 2b, arrow].
(a) Histopathology of biopsy specimen from the skin showed infiltrations of histiocytes, lymphocytes, neutrophils, and lobular focal fat necrosis with saponification and "ghost" cells, in favor of lobular panniculitis (arrows, H & E staining; x40); (b) Histopathology of biopsy specimen from the pancreatic tumor showed poorly differentiated acinar cell carcinoma (H & E staining; x400)
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F3
Histopathological report of the skin biopsy specimen showed infiltrations of histiocytes, lymphocytes, neutrophils, and lobular focal fat necrosis with saponification and "ghost cells" [Figure 3, arrows, hematoxylin and eosin staining; original magnification, x40].