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Necrobiotic xanthogranuloma: a review of 17 cases with emphasis on clinical and pathologic correlation.
Arch Dermatol. 2009 Mar; 145(3):279-84.AD

Abstract

OBJECTIVE

To identify correlations between clinical presentation, specific histopathologic findings, and subsequent disease course in patients with necrobiotic xanthogranuloma (NXG).

DESIGN

Retrospective review of medical records and histopathologic examination of fixed tissue samples.

SETTING

Tertiary care medical center.

PATIENTS

Seventeen patients with a diagnosis of NXG established between January 1, 1994, and December 31, 2007.

MAIN OUTCOME MEASURES

Description and distribution of clinical lesions, presence of monoclonal gammopathy, multiple myeloma, and correlation with microscopic patterns of skin lesions.

RESULTS

Eleven patients (65%) showed involvement of the periorbital area, and the trunk was affected in 8 patients (47%). Twelve patients (71%) had a monoclonal gammopathy; of these, 3 (18%) had multiple myeloma. Histopathologic examination of 12 patients showed findings consistent with NXG, including a bandlike pattern of necrobiotic granulomatous inflammation, atypical giant cells, cholesterol clefts, and plasma cells. No correlations were identified between clinical presentation and specific histopathologic findings. Although most patients had a serum monoclonal gammopathy, staining with antibodies to CD3, CD20, kappa light chains, and lambda light chains showed polytypic lymphocytes and plasma cells in all cases.

CONCLUSIONS

The association between NXG and paraproteinemia is well documented and corroborated by this study. However, the skin lesions in NXG represent reactive inflammation and are not associated with the presence of monoclonal plasma cells or multiple myeloma.

Authors+Show Affiliations

Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19289757

Citation

Wood, Angela J., et al. "Necrobiotic Xanthogranuloma: a Review of 17 Cases With Emphasis On Clinical and Pathologic Correlation." Archives of Dermatology, vol. 145, no. 3, 2009, pp. 279-84.
Wood AJ, Wagner MV, Abbott JJ, et al. Necrobiotic xanthogranuloma: a review of 17 cases with emphasis on clinical and pathologic correlation. Arch Dermatol. 2009;145(3):279-84.
Wood, A. J., Wagner, M. V., Abbott, J. J., & Gibson, L. E. (2009). Necrobiotic xanthogranuloma: a review of 17 cases with emphasis on clinical and pathologic correlation. Archives of Dermatology, 145(3), 279-84. https://doi.org/10.1001/archdermatol.2008.583
Wood AJ, et al. Necrobiotic Xanthogranuloma: a Review of 17 Cases With Emphasis On Clinical and Pathologic Correlation. Arch Dermatol. 2009;145(3):279-84. PubMed PMID: 19289757.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Necrobiotic xanthogranuloma: a review of 17 cases with emphasis on clinical and pathologic correlation. AU - Wood,Angela J, AU - Wagner,M Veronica Uraga, AU - Abbott,Jared J, AU - Gibson,Lawrence E, PY - 2009/3/18/entrez PY - 2009/3/18/pubmed PY - 2009/4/11/medline SP - 279 EP - 84 JF - Archives of dermatology JO - Arch Dermatol VL - 145 IS - 3 N2 - OBJECTIVE: To identify correlations between clinical presentation, specific histopathologic findings, and subsequent disease course in patients with necrobiotic xanthogranuloma (NXG). DESIGN: Retrospective review of medical records and histopathologic examination of fixed tissue samples. SETTING: Tertiary care medical center. PATIENTS: Seventeen patients with a diagnosis of NXG established between January 1, 1994, and December 31, 2007. MAIN OUTCOME MEASURES: Description and distribution of clinical lesions, presence of monoclonal gammopathy, multiple myeloma, and correlation with microscopic patterns of skin lesions. RESULTS: Eleven patients (65%) showed involvement of the periorbital area, and the trunk was affected in 8 patients (47%). Twelve patients (71%) had a monoclonal gammopathy; of these, 3 (18%) had multiple myeloma. Histopathologic examination of 12 patients showed findings consistent with NXG, including a bandlike pattern of necrobiotic granulomatous inflammation, atypical giant cells, cholesterol clefts, and plasma cells. No correlations were identified between clinical presentation and specific histopathologic findings. Although most patients had a serum monoclonal gammopathy, staining with antibodies to CD3, CD20, kappa light chains, and lambda light chains showed polytypic lymphocytes and plasma cells in all cases. CONCLUSIONS: The association between NXG and paraproteinemia is well documented and corroborated by this study. However, the skin lesions in NXG represent reactive inflammation and are not associated with the presence of monoclonal plasma cells or multiple myeloma. SN - 1538-3652 UR - https://www.unboundmedicine.com/medline/citation/19289757/Necrobiotic_xanthogranuloma:_a_review_of_17_cases_with_emphasis_on_clinical_and_pathologic_correlation_ L2 - https://jamanetwork.com/journals/jamadermatology/fullarticle/10.1001/archdermatol.2008.583 DB - PRIME DP - Unbound Medicine ER -