These are necrobiotic
palisading granulomas, interstitial form and granuloma of sarcoidal or tuberculoid type.
After a 25-year course of necrobiotic
xanthogranuloma with paraproteinemia, this patient died of bacteremia following pancytopenia as he developed myeloma, Dr.
In particular, isolated rheumatoid nodules or necrobiotic granulomas (deep granuloma annulare) have a decided potential for this mimicry, vis-a-vis the alternative diagnosis of epithelioid sarcoma.
Histologically, epithelioid sarcoma and isolated necrobiotic granulomas may also be similar.
Adult orbital xanthogranulomatous disease presents with variable clinical features from which 4 subtypes are subclassified: adult-onset xanthogranuloma (AOX), necrobiotic xanthogranuloma (NBX), Erdheim-Chester disease (ECD), and adultonset asthma and periocular xanthogranuloma (AAPOX).
Necrobiotic xanthogranuloma is characterized by the presence of subcutaneous skin lesions that tend to ulcerate and become fibrotic.
When AOXGD presents with monoclonal gammopathy, as in cases of necrobiotic xanthogranuloma or in rare occasions, AAPOX, it needs to be differentiated from multiple myeloma with involvement of the orbit or plasmacytoma of the eye and/or of the orbit.
Small nerve units were also caught up in this scarifying process, which failed to show necrobiotic
foci, fibrinoid material, or nuclear dust.
Ulceration and necrosis are typical, with the frequent central necrosis (Figure 2), resulting in a pseudogranulomatous appearance, which can mimic benign necrobiotic
69) Colloidal iron or Alcian blue stains may reveal mucin in the central necrobiotic foci of granuloma annulare, (70) but in our experience that finding is not typical of ES.
Epithelioid sarcoma and isolated necrobiotic granuloma: a comparative immunocytochemical study.