Necrosis

What is necrosis?

Necrosis is the death of the cells in your body tissues. Necrosis can occur due to injuries, infections or diseases. Lack of blood flow to your tissues and extreme environmental conditions can also cause necrosis. While dead body tissue can be removed, it can’t be brought back to good health.

What are the different patterns of necrosis?

When your body’s cells die of necrosis, they form different patterns and appearances. The dead cells appear one of six ways. These patterns include:

Coagulative necrosis

With coagulative necrosis, the dead cells remain firm and look normal for days after death. Lack of blood flow or oxygen to any part of your body except your brain can cause coagulative necrosis.

Liquefactive necrosis

With liquefactive necrosis, the dead cells partially or completely dissolve within hours of death. Then they transform into a thick, sticky liquid. The cells sometimes appear creamy yellow because pus is forming. Infections and lack of oxygen to your brain can cause liquefactive necrosis.

Fat necrosis

With fat necrosis, damaged cells release enzymes, causing them to turn to liquid. The liquid cells combine with calcium, creating chalky, white deposits on the cells. Acute pancreatitis is the most common cause of fat necrosis. It can also occur in breast tissue.

Caseous necrosis

With caseous necrosis, the dead cells look white and soft. They’ve been described as looking like cheese — the word caseous means “cheese-like.” Caseous necrosis is uniquely seen in the infectious lung disease tuberculosis.

Fibrinoid necrosis

With fibrinoid necrosis, the dead cells appear pink and lack structure. This is because plasma proteins (fibrins) are leaking out of your blood vessel walls. Fibrinoid necrosis occurs when an autoimmune disease or infection damage your blood vessels.

Gangrenous necrosis

With gangrenous necrosis, your skin appears black and is beginning to rot. Lack of blood flow to your legs can cause gangrenous necrosis. It can sometimes affect your arms and fingers too.

What are the different types of necrosis?

Necrosis can affect many different areas of your body, including your bones, skin and organs. The different types of necrosis include:

Avascular necrosis (osteonecrosis)

Avascular necrosis goes by many names. Osteonecrosis, aseptic necrosis and bone necrosis are all other terms for avascular necrosis. Avascular necrosis occurs when blood flow to your bone tissue is blocked. Lack of blood flow to your bones causes them to break down and eventually die. Hip necrosis is the most common form of avascular necrosis.

Osteonecrosis of the jaw

Osteonecrosis of the jaw (ONJ) is a type of avascular necrosis. ONJ is a mouth (oral) disorder that occurs when cells in your jaw bone die. Osteonecrosis of the jaw can cause severe mouth and jaw pain. In addition, pus may ooze from your mouth and jaw.

Pancreatic necrosis

Pancreatic necrosis is a serious complication that can develop due to acute pancreatitis. When the blood supply to your pancreas is cut off, it can cause your pancreatic tissue to die. When this happens, your pancreas can become infected. The infection can spread into your blood (sepsis) and cause organ failure.

Fat necrosis of the breast

Fat necrosis of the breast is a noncancerous (benign) condition that can occur when fatty breast tissue is damaged. Your body usually replaces damaged breast tissue with scar tissue. With fat necrosis, some fat cells die instead of forming scar tissue. This forms a pocket of greasy fluid called an oil cyst.

Acute tubular necrosis

Acute tubular necrosis (ATN) or tubular necrosis is a kidney disorder. When the tubule cells of your kidneys are damaged, it can lead to acute kidney failure. The tubules are the tiny ducts in your kidneys that help filter your blood when it passes through your kidneys.

Radiation necrosis

Radiation necrosis is a rare side effect of high-dose radiation to your brain, head or neck. It can result in the permanent death of brain tissue.

Renal papillary necrosis

Renal papillary necrosis is a kidney disorder that occurs when the renal papillae of your kidneys die. The renal papillae are the openings of the tubes (ducts) that enter your kidneys and pass pee (urine) into your bladder.

Skin necrosis (gangrene)

Skin necrosis (gangrene) occurs when blood flow to your body tissues or internal organs is blocked. It can also occur due to a bacterial infection. It most commonly affects your fingers, toes, hands and feet but can affect any part of your body.

Spider bite necrosis

Spider bite necrosis can occur when a recluse spider bites you. The venom from a recluse spider bite can cause a skin-decaying wound. However, necrosis from a spider bite is rare.

Pulp necrosis

Pulp necrosis happens when the soft flesh (pulp) inside your tooth dies. Inside each of your teeth is a chamber that holds small pieces of flesh. Inside each chamber are blood vessels and nerves. If a tooth is injured or decayed, the flesh can get infected and die.

What’s the difference between apoptosis and necrosis?

Apoptosis and necrosis are both ways cells die. Apoptosis is the normal, healthy way cells die. They die naturally to maintain cellular balance in your body. Apoptosis is needed for your body to function normally. Apoptosis very rarely needs treatment.

Cells die through necrosis accidentally due to internal or external factors. These factors may include diseases, infections, injuries or other conditions. These conditions lead to damage in your cell walls, which makes them unable to function normally. Necrosis generally needs treatment.

What is tumor necrosis factor?

Tumor necrosis factor (TNF) or tumor necrosis factor alpha is a protein in your body used by your immune system. If certain white blood cells detect an infection, they release TNF to alert other immune cells. Inflammation kicks in to help fight the infection. Tumor necrosis factor may also have the ability to cause necrosis in some types of tumor cells. It’s being studied in the treatment of certain cancers.

What are the signs of necrosis after filler injections?

Dermal fillers, specifically hyaluronic acid injections, are minimally invasive cosmetic procedures. They’re used to plump up your skin. These treatments are used frequently and complications are rare. However, necrosis has occurred in some cases. Signs of necrosis after having a filler injected can occur immediately or hours after the procedure. These signs include:

• More pain and discomfort than expected after treatment.
• Tenderness.
• Whitening (blanching) of your skin.
• Blotchy red skin.
• Bluish or purple skin discoloration.

A note from Cleveland Clinic

Necrosis is the medical term for the death of your body tissue. Necrosis can occur for many different reasons. The different types vary in severity and treatment. While some cases of necrosis may heal on their own, it’s important to see a healthcare provider if you develop any symptoms of necrosis. Some types of necrosis require immediate treatment. A healthcare provider can diagnose your necrosis and recommend the appropriate treatment.