S12C22P12-Necrobiotic Xanthogranuloma

S12C22P12-1: In this area of a lesion of necrobiotic xanthogranuloma, histiocytes form palisades about acellular zones. The angulated clefts in the acelluar matrix are of a type sometimes classified as cholesterol clefts. They represent sites in which cholesterol crystals have been removed during the processing of tissue.

S12C22P12-2: The acellular zone usually is characterized as a zone of necrobiosis. From a different perspective, this pattern qualifies as a palisaded granuloma of storage type (i.e., a metabolic dump). The vacuolization of the cytoplasm of the neighboring histiocytes provides a xanthomatous quality. The patient had an abnormal serum protein (paraproteinemia) and would be considered at risk for the development of myeloma.

S12C22P12-3: A portion of the zone of palisaded histiocytes is represented in the left lower margin of the field. The cholesterol clefts are well-defined in this field. Histiocytes at the margin of the zone of necrobiosis have finely vacuolated cytoplasm.

 

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