SECTION EDITOR: SAMIR S. SHAH, MD, MSCE
Author Affiliations: Geisinger Medical Center, Danville, Pennsylvania.
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 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).
What is your diagnosis?
Melissa Tripoli, Nektarios Lountzis, Ashish Mahajan, Eric Hossler. Picture of the Month—Quiz Case. JAMA Pediatr. 2013;167(1):85. doi:10.1001/2013.jamapediatrics.209a