FOREIGN BODY GRANULOMATA IN SCAR
There is a period of time of highly variable duration following the introduction of foreign material by injury before foreign body granulomata develop. If the injury was minor, and the latent period of long duration, the patient may not even remember the injury. It is also of interest that one of the features of sarcoid that is supposed to be characteristic is the 'growth' of scars. One wonders how many of those lesions of cutaneous 'sarcoid' would contain birefringent foreign material if examined with polarized light.

An old scar located below the knee of a 54 year old male recently began to enlarge and become tender.
 
Scan power view. Nonspecific verrucoid epidermal hyperplasia is present. Full thickness scar that contains numerous granulomata is best seen in the left side of the picture. There is also superficial scar in the remainder of the picture.  Note the two vertical rips in the tissue caused by the microtome knife blade dragging grit through the section.
A high power view of one of many noncaseating granuloma found within the scar. This type of naked tubercle can be seen in a variety of conditions including sarcoid and foreign body response.
Low power view from another area. This looks almost like a palisading granuloma. Special stains were negative for acid-fast bacilli and fungi.
A very low power view using polarized light. Birefringent foreign material is seen at the arrow tips. Foreign material was easily demonstrable throughout the specimen.

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