juvenile xanthogranuloma

XANTHOGRANULOMA (JUVENILE)

This is a solitary lesion from a nine year old male. Xanthogranulomas may be found in normolipemic persons, and they occur more frequently in children than in adults. They may be single or multiple, and the multiple ones are found more frequently in children. Extracutaneous sites may be involved, particularly the eye.

The nodule is composed of an infiltrate of altered histiocytes, and there may be scattered inflammatory cells including lymphocytes and eosinophilic leukocytes. The histiocytes contain vacuoles. Although the Touton giant cell is thought of as being characteristic, they may be few in number or absent. The 'background' cell is a foamy histiocyte, and the diagnosis can be made or suspected based upon the presence of these cells in the absence of Touton giant cells. Foamy cells can also occur in xanthomas related to hyperlipidemia, so clinical correlation is helpful.

Scan power view. This lesion is much larger than most members of the histiocytosis-X group of diseases.

Low power view. A few lymphocytes are scattered between foamy histiocytes.

High power view of above. A Touton giant cell is almost in the center of the field. A ring of nuclei surrounds a zone of relatively smooth cytoplasm, and there is a zone of foamy cytoplasm peripheral to the ring of nuclei.

High power view from another area. The vacuolated histiocytes that are seen in this field are often overlooked in cases where Touton giant cells are prominent. The diagnosis can be made or suspected based upon this cell population.

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	Scan power view. This lesion is much larger than most members of the histiocytosis-X group of diseases.
	Low power view. A few lymphocytes are scattered between foamy histiocytes.
	High power view of above. A Touton giant cell is almost in the center of the field. A ring of nuclei surrounds a zone of relatively smooth cytoplasm, and there is a zone of foamy cytoplasm peripheral to the ring of nuclei.
	High power view from another area. The vacuolated histiocytes that are seen in this field are often overlooked in cases where Touton giant cells are prominent. The diagnosis can be made or suspected based upon this cell population.