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Breast-nonmalignant

Benign tumors / changes

Juvenile xanthogranuloma

 

Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)

Revised: 7 April 2012, last major update April 2010

Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.

 

Definition

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● Benign histiocytic disorder of skin, very rare in breast tissue itself

● See also topic under Soft Tissue Tumors

 

Terminology

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● Also called nevoxanthoendothelioma

 

Epidemiology

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● Benign histiocytic disorder of infants and children; 15% occur in adults (usually young)

 

Sites

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Etiology

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Clinical features

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Prognostic factors

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Case reports

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● 20 year old woman with clinical extranumerary nipple (Case of the week #5)

● 74 year old woman with prior cutaneous juvenile xanthogranulomas and breast masses (Am J Surg Pathol 2005;29:827)

● Occurring in woman within field of radiation therapy for breast cancer (J Cutan Pathol 2010 Feb 5 [Epub ahead of print])

 

Treatment

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● Conservative excision

 

Clinical images

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Gross description (Macroscopy)

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● Cutaneous lesions usually 0.1 to 2.0 cm, yellow-red and papulonodular

 

Gross images

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Micro description (Histopathology)

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● Dense dermal infiltrate of lymphocytes, histiocytes, Touton giant cells (usually), eosinophils and neutrophils, which may extend into subcutis; late - epidermis thins out and the rete ridges become elongated

● Extracutaneous lesions may lack the Touton giant cells.

● Note: histiocytic giant cells may be Touton type [ring of nuclei surrounding foamy cytoplasm with cytoplasm usually also visible around the nuclei; Langhans type [nuclei form a horseshoe arrangement, not necessary a distinct category from Touton type] or foreign-body type [haphazard nuclear arrangement]

 

Micro images

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Case of Week #5 images


Other images: #1#2

 

Virtual Slides

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Videos

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Cytology description

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Cytology images

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Positive stains

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Touton giant cells and histiocytes: CD68, HAM56, Factor XIIIa

 

Negative stains

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Touton giant cells and histiocytes: S100 and CD1a

 

Electron microscopy descriptions

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Electron microscopy images

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Molecular / cytogenetics description

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Molecular / cytogenetics images

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Differential Diagnosis

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Benign fibrous histiocytoma: related entity, usually has a storiform pattern

Langerhans cell histiocytosis: more common disorder of childhood, coffee bean nuclei / nuclear grooves, no Touton giant cells, Birbeck granules are present on EM, S100+, CD1a+, CD68-, HAM56-, Factor XIIIa-

Xanthoma: uniform collection of foam cells and variable Touton giant cells, no other inflammatory cells, often associated with hyperlipidemia

 

Additional references

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Am J Surg Pathol 2003;27:579, Am J Surg Pathol 2005;29:21

 

End of Breast-nonmalignant > Benign tumors / changes > Juvenile xanthogranuloma

 

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