S12C18P8-Tick Bite Granuloma

S12C18P8-1: Lymphoid infiltrates in the dermis are perivascular and micronodular. In the micronodular components, there is an increased number of vessels per unit area. The pattern is interrupted centrally by a defect, a biopsy site. The defect contains condensed fibrin (red), and a lattice of basophilic foreign material (gel foam). This inflammatory response (beyond the biopsy site) is characteristic of the reaction to a tick bite (“tick bite granuloma”).

S12C18P8-2: Nodular infiltrates at the interface between the dermis and the fat are prominent in this reaction to a tick bite. Green arrows identify a germinal center with a mantle zone. The adjacent dermis and fat show patterns of mucinosis. The pattern is that of lymphoplasia; it is compatible with a reaction to a tick bite.

S12C18P8-3: The follicles are of reactive type (non-neoplastic). Mantle zones are represented.

S12C18P8-4: In the interstitial infiltrates of this tick bite reaction, eosinophils are sprinkled among the lymphocytes (blue arrows). Plasma cells also may be a prominent feature.

 

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