Unusual targetoid nodule on the back
2 Department of Pathology, Facultad de Medicina, Pontificia Universidaad Católica de Chile, Santiago, Chile
Department of Dermatology, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago
|How to cite this article:
García-Huidobro I, Ábarzúa-Araya A, Downey C, González S. Unusual targetoid nodule on the back. Indian J Dermatol Venereol Leprol 2017;83:408-410
A 28-year-old woman presented with an asymptomatic recurrent nodule on her back for 6 months. The lesion was increasing in size and the patient noted variations in the nodule's color from pink to light brown. On examination, a non-tender, red to violaceous nodule with a thin pale brown margin and a peripheral ecchymotic ring measuring 1.6 cm × 1 cm was seen on the right posterior shoulder [Figure - 1]. The remainder of the dermatological examination was unremarkable.
|Figure 1: An erythemato-violaceous, non-tender, central nodule surrounded by a thin pale brown area and a peripheral ecchymotic ring measuring 1.6 cm × 1 cm on the right posterior shoulder|
An excisional biopsy showed dilated vascular channels in the papillary dermis with a lining of prominent endothelial normotypic cells. Extravasated erythrocytes and perivascular superficial mononuclear inflammatory infiltrate were also seen [Figure - 2]. Immunohistochemistry revealed intense positive reaction for the lymphatic endothelial cell marker podoplanin (D2–40) [Figure - 3]. Perl's stain was also positive [Figure - 4]. The study was negative for Wilms' tumor 1 gene.
|Figure 2: Dilated vascular channels in papillary dermis with a lining of prominent endothelial normotypic cells. Extravasated erythrocytes and perivascular superficial mononuclear inflammatory infiltrate and hemosiderophages were also found (H and E, ×100)|
|Figure 3: Immunohistochemical study showed intense positive reaction for the lymphatic endothelial cell marker podoplanin (D2– 40, ×100)|
|Figure 4: Isolated hemosiderophages around blood vessels at the periphery of the lesion (Perl's stain, ×400)|
What Is Your Diagnosis?
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