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S10C9P7-1: The interstitial infiltrates are rich in histiocytes. Focally, the histiocytes are clustered in granulomatous patterns. Some of the histiocytes have multiple cytoplasmic vacuoles. The combination of
features qualifies, in part, as a xanthogranulomatous reaction. In addition, rounded vacuoles of the type seen as a response to the death of lipocytes (a phenomenon associated with the formation of
pools of lipids in the interstitial tissue) are represented among the epithelioid histiocytes. The patterns, in toto, might be characterized as a variation of lipogranulomatous, lobular panniculitis. This is
a late, non-specific reaction of fat to injury; it could represent a stage in the evolution of a process that initially was a lobular, neutrophilic or lymphohistiocytic panniculitis. Focally, the infiltrates are
composed of lymphocytes with a sprinkling of plasma cells (lupus profundus).
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