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2017:83:6;736-739
doi: 10.4103/ijdvl.IJDVL_564_16
PMID: 28566561

A protruding nodule on the upper lip

Hyun Ji Kang, Sung Eun Chang, Mi Woo Lee, Woo Jin Lee
 Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

Correspondence Address:
Woo Jin Lee
Department of Dermatology, University of Ulsan College of Medicine, Asan Medical Center, 88 Olympic-ro 43 gil, Songpa-gu, Seoul 05505
Republic of Korea
Published: 31-May-2017
How to cite this article:
Kang HJ, Chang SE, Lee MW, Lee WJ. A protruding nodule on the upper lip. Indian J Dermatol Venereol Leprol 2017;83:736-739
Copyright: (C)2017 Indian Journal of Dermatology, Venereology, and Leprology

A 52-year-old woman presented with a 12-mm sized protruding nodule on the upper lip that had enlarged over the last 1 year and complained of occasional pain. Physical examination indicated a slightly erythematous nodule with disruption of the vermilion border of the upper lip [Figure - 1]. Examination of her medical history yielded nonspecific findings, including a negative human immunodeficiency virus serostatus. A skin biopsy was performed on her upper lip.

Figure 1: Solitary ill-defined erythematous to purplish nodule on the upper lip

The histopathologic examination showed that the lesion was a poorly circumscribed nodule involving the superficial and deep dermis. The nodule comprised the round or cuboidal cells with intracytoplasmic vacuolization [Figure 2a] and [Figure 2b]. However, human herpesvirus 8 immunohistochemical staining yielded negative results, and hence, a second excisional biopsy was attempted to confirm the diagnosis. Spindle cells with nests and cords of epithelioid cells were noted [Figure 3a]. Immunohistochemical staining with CD31 and CD34 showed positive results, whereas immunophenotyping for human herpesvirus 8 still yielded negative results [Figure 3b], [Figure 3c], [Figure 3d]. Additional immunohistochemical staining for vimentin yielded positive results, and that for S-100 and CD68 yielded negative results.

Figure 2a: Poorly circumscribed nodule involving the superficial and deep dermis (H and E, ×40)
Figure 2b: The nodule is comprised of round and cuboidal cells, with intracytoplasmic vacuolization (small arrows) and many mitotic figures (big arrows) (H and E, ×400)
Figure 3a: Spindle cell proliferation and pleomorphic features (H and E, ×100)
Figure 3b: Positive immunohistochemical staining with CD31 (×400)
Figure 3c: Positive immunohistochemical staining with CD34 (×400)
Figure 3d: Negative immunohistochemical staining with human herpesvirus 8 (×400)

Question

What is your diagnosis?



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