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Oct 2011

Subcutaneous Nodules in an Elderly Patient —Diagnosis

Author Affiliations
 

SECTION EDITOR: MARY S. STONE, MD; ASSISTANT SECTION EDITORS: SOON BAHRAMI, MD; CARRIE ANN R. CUSACK, MD; SENAIT W. DYSON, MD; MOLLY A. HINSHAW, MD; ARNI K. KRISTJANSSON, MD

Arch Dermatol. 2011;147(10):1215-1220. doi:10.1001/archdermatol.2011.285-b

Sections (Figure 2 and Figure 3) showed an intense, superficial, and deep perivascular lymphoplasmacytic inflammatory infiltrate with some involvement of the superficial subcutaneous fat. Some plasma cells were enlarged; atypical and binucleate cells were present. Also seen were scattered giant cells, several with Touton morphologic characteristics. No cholesterol clefts were noted. In situ hybridization for immunoglobulin light chain showed an increased number of κ-restricted plasma cells. Findings were compatible with a diagnosis of granulomatous dermatitis, suggestive of necrobiotic xanthogranuloma.

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