Histology
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Elderly patient with histological lesions similar to "necrobiosis lipoidica". 
For the diagnosis look at bottom of the last picture.
Clinical pictures click here   Link zu den dazugehörigen klinischen Bildern (1756 Byte)

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Histopathology

fig.1 hohe Auflösung  (107 KB)
H&E

fig.2 hohe Auflösung  (132 KB)
H&E

fig.3 hohe Auflösung  (123 KB)
H&E

fig.4 hohe Auflösung  (138 KB)
H&E

fig.5 hohe Auflösung  (154 KB)
H&E

fig.6 hohe Auflösung  (154 KB)
H&E

fig.7 hohe Auflösung  (143 KB)
H&E

fig.8 hohe Auflösung  (139 KB)
H&E

       

 

Histological clue for NXG: this looks like a "caricature of necrobiosis lipoidica": there is more of everything: more necrosis, more cholesterol clefts, and much more foam cells.

NXG: look for FOAM cells + CHOLESTEROL clefts (even in very superficial biopsies which at first glance may not be representative for "classical" NXG).

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fig. 1   Superficial biopsy of NXG: Foam cells + cholesterol clefts 
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fig. 2   Foam cells + cholesterol clefts
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fig. 3 
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fig. 4   Excessive degeneration of collagen
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fig. 5   Abundant foam cells
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fig. 6
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fig. 7   Clue for NXG:  Cholesterol clefts + foam cells
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fig. 8       

     Colbar0.gif (1095 Byte)

Diagnosis: 
NECROBIOTIC  XANTHOGRANULOMA  WITH  PARAPROTEINEMIA

Colbar0.gif (1095 Byte)

 

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18.01.2008 18:30