Atlas of dermatopathology: Foreign body granulomas

+ Introduction

+ Literature

+ Support

+ Skin biopsy

+ Non-tumorous skin diseases

+ Skin tumors

+ Mesenchymal tumors

+ Cysts of the skin and subcutis

+ Soft tissue lesions

+ Some lesions of the oral cavity

+ Dermatovenerology

+ Collection of histological slides by prof. Günter Burg

+ Collection of histological slides by prof. Werner Kempf

+ Collection of histological slides of dr. Ram Chandra Adhikari

Foreign body granulomas

Clinical signs

location: areas of trauma and surgeries (face, wrists, knees etc.)
small, firm nodules, often surrounded by inflammation
color red, red brown of color of normal skin
ulcerations and fistulas are common

Pictures

Foreign body granulomas, posttraumatic, face: Foreign body granuloma, Clinical picture (741)

Granuloma around the suture material: Foreign body granuloma, Clinical picture (742)

Histology

Foreign bodies (suture material, keratin, hair, traumatic foreign material) lead to chronic inflammation with giant multinuclear histiocytes. Granulocytes are often present. Some of foreign bodies (silica, wood, suture material, glass) are birefringent and easily identifiable using polarized light.

Large lesions in surgical wounds (often with remnants of suture material) are called Schloffer's tumor.

Pictures

Granuloma and inflammation around an epidermal cyst: Epidermal cyst, inflammation, HE 20x (211)

Detail of the same case: Epidermal cyst, inflammation, HE 40x (212)

Another case of suture granuloma (ear, after basalioma resection): Foreign body granuloma, HE 40x (3593)

Another example: deep foreing body demarcated by a capsule of connective tissue: Foreign body, HE 2x (199) Foreign body, HE 5x (200)

Capsule, detail: Foreign body, capsule, HE 20x (198)

Chronic purulent inflammation around suture material: Suture material, purulent inflammation, HE 20x (278)

Granuloma around suture material: Foreign body granuloma (fibre), HE 40x (10936)

Granuloma around suture material: Granuloma near suture, HE 60x (14042)

Granuloma after surgery: Granuloma after surgery, HE 40x (72473)

Foreign body granuloma: Foreign body granuloma, HE 20x (1303)

Scar, foreign body: Scar, foreign body, HE 40x (13007)

Foreign body granuloma, ear, suture material: Foreign body granuloma (ear; suture material), HE 20x (5331)

Wooden splinter with mostly purulent inflammatory reaction: Splinter, inflammation, HE 40x (5949)

Splinter, inflammatory reaction: Splinter, HE 20x (13921)

Splinter, another case: Splinter, HE 20x (14249)

Granuloma around some plant material: Foreign body granuloma, HE 20x (2126)

Foreign body granuloma around keratin remnants in squamous cell carcinoma: Granulomatous reaction on keratin in squamous cell carcinoma, HE 20x (4325)

Encapsulated and calcified foreign body, cholesterol crystals: Foreign body granuloma, calcification, HE 20x (5147)

Foreign body of unknown origin: Foreign body, PAS 20x (13945)

Foreign body: Foreign body granuloma, HE 60x (13766)

Scar, foreign bodies: Scar, foreign bodies, HE 20x (14349)

Foreign body, fibrotic capsule, hemosiderin deposits (v.s. it was an iron splinter): Foreign body, metal splinter, hemosiderosis, HE 20x (13767) Foreign body, metal splinter, hemosiderosis, HE 20x (13768)

Foreign body, iron splinter, hemosiderin deposits: Foreign body, siderosis, HE 20x (14002) Foreign body, siderosis, HE 20x (14003) Foreign body, siderosis, HE 20x (14004)

Another case of iron splinter, hemosiderin deposits: Foreign body, siderosis, HE 20x (14633) Foreign body, siderosis, HE 20x (14634) Foreign body, siderosis, Prussian blue 20x (14631) Foreign body, siderosis, Prussian blue 20x (14632)

Granulomatous reaction after herpes zoster: Herpes zoster, granulomatous reaction, HE 20x (4326)

Sinus pilonidalis: Sinus tract containing hairs, located in the sacral area, often inflammed: (more details here) Sinus pilonidalis, inflammed, HE 20x (389)

Schloffer's tumor within the scar after Caesarean section with endometriosis: Endometriosis and Schloffer't tumor, abdominal wall, HE 40x (10725) Endometriosis and Schloffer't tumor, abdominal wall, CD10 40x (10723) Endometriosis and Schloffer't tumor, abdominal wall, Prussian blue 40x (10724)

Supraumbilical suture granuloma with endometriosis, woman 30y: Endometriosis, suture granuloma, scar above the umbilicus, HE 20x (13710)

Residual changes after vaccination: Residual vaccination, HE 60x (13959)

Silica granuloma is the chronic reaction to silica crystals, which were traumatically introduced into the dermis. Epithelioid granuloma may resemble sarcoidosis, however, polarized light will show birefringent foreign material.

Histology

Epithelioid granulomas, birefringent material, artefacts (knife dented by silica crystals)

Pictures

Silica granuloma: Silica granuloma, HE 5x (387) Silica granuloma, HE, polarizace 5x (388)

Higher magnification, normal transmitted light and polarization: Silica granuloma, HE 20x (383) Silica granuloma, HE, polarizace 20x (384)

Detail (normal transmitted light and polarization): Silica granuloma, HE 40x (385) Silica granuloma, HE, polarizace 40x (386)

Zyderm reaction (bovine collagen): Zyderm, dermal, HE 20x (5433)

Foreign body granuloma (cytoplast): Granuloma after cytoplast, HE 20x (4324)

Silicone granuloma