CPC Case of the Month

POLYPOID XANTHOMATOUS NODULE:
A UNIQUE EXPRESSION OF VERRUCIFORM XANTHOMA?

Submitted by: Lee Thomas Zane, MD, Timothy H. McCalmont, MD., Departments of Pathology and Dermatology, University of California, San Francisco, CA

CLINICAL A 20-year-old male presented with an enlarging solitary pedunculated tumor, 3.5 cm in diameter, clinically thought to be a dermatofibrosarcoma protuberans.
HISTOLOGY The slides show a nodular infiltrate of macrophages (histiocytes) with ample vacuolated and “foamy” cytoplasm within dermal papillae and with extension into the underlying reticular dermis. An admixture of other inflammatory cells, including plasma cells, was also noted. Emperipolesis was not found.
IMPORTANT FEATURE: REASON FOR PRESENTATION Instructive case.
REFERENCES 1. Rohwedder A, Murphy M, Calrson JA. HPV in verruciform xanthoma – sensitivity and specificity of detection methods and multiplicity of HPV types affect results. J Cutan Pathol 2003;30:219-220. 2. Connolly S B, Lewis EJ, Lindholm JS, et al. Management of cutaneous verruciform xanthoma. J Am Acad Dermatol 2000;42:343-347.