[Skip to Content]
Access to paid content on this site is currently suspended due to excessive activity being detected from your IP address 54.161.216.242. Please contact the publisher to request reinstatement.
Sign In
Individual Sign In
Create an Account
Institutional Sign In
OpenAthens Shibboleth
[Skip to Content Landing]
Views 1,269
Citations 0
Special Feature
January 2013

Picture of the Month—Quiz Case

Author Affiliations
 

SECTION EDITOR: SAMIR S. SHAH, MD, MSCE

Author Affiliations: Geisinger Medical Center, Danville, Pennsylvania.

JAMA Pediatr. 2013;167(1):85. doi:10.1001/2013.jamapediatrics.209a

A 9-year-old otherwise healthy girl presented with a lesion on the left upper lip for the past year. It was slowly growing and somewhat tender to deep palpation but was not interfering with feeding or development. No similar lesions were present on the rest of her body. Physical examination revealed a 4-mm, firm, white, nontender, mobile papule at the left upper vermilion border (Figure 1). The rest of the physical examination was unremarkable. An excisional biopsy was performed (Figure 2 and Figure 3).

Figure 1. A 4-mm, firm, white, nontender, mobile papule at the left upper vermilion border of an otherwise healthy 9-year-old girl.

Figure 1. A 4-mm, firm, white, nontender, mobile papule at the left upper vermilion border of an otherwise healthy 9-year-old girl.

Figure 2. Scanning view of the biopsy specimen, showing a well-defined dermal proliferation of large polyhedral cells (hematoxylin-eosin, original magnification ×20).

Figure 2. Scanning view of the biopsy specimen, showing a well-defined dermal proliferation of large polyhedral cells (hematoxylin-eosin, original magnification ×20).

Figure 3. Close-up of the cells shows abundant eosinophilic granular cytoplasm and centrally located vesicular nuclei. The cells were arranged in cords and surrounded by a dense collagenous stroma. No significant cellular atypia or degenerative changes were seen (hematoxylin-eosin, original magnification ×200).

Figure 3. Close-up of the cells shows abundant eosinophilic granular cytoplasm and centrally located vesicular nuclei. The cells were arranged in cords and surrounded by a dense collagenous stroma. No significant cellular atypia or degenerative changes were seen (hematoxylin-eosin, original magnification ×200).

What is your diagnosis?

×