A 30-year-old man sustains blunt trauma to the epigastrium. CT shows a normal pancreas but histology of omental fat deposits reveals shadowy outlines of necrotic adipocytes with basophilic calcium deposits and a neutrophilic infiltrate. Which enzyme released in this setting is responsible for the calcium deposition?
- A Trypsin activating proelastase
- B Amyloid precursor protein cleavage by secretases
- C Lipase liberating fatty acids that bind calcium ✓
- D Collagenase degrading basement membrane
Correct answer: C. Lipase liberating fatty acids that bind calcium
Explanation
This is fat necrosis with enzymatic fat saponification. Pancreatic lipase released after ductal injury digests triglycerides in adipocytes, releasing fatty acids that combine with calcium to form chalky white calcium soaps, visible microscopically as basophilic deposits. Trypsin and elastase digest proteins and vessels but do not generate calcium soaps. Collagenase and secretases have no role here. The combination of ghosted adipocytes plus basophilic mineralization is pathognomonic for saponification.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.