This is a 46 year old man with a long standing history of chronic joint pain. He presents with a subcutaneous nodule over the left elbow.
|Sections show palisading granulomas surrounding an amorphous eosinophilic to amphophilic staining debris.|
|Higher power reveals a fine crystals present within the eosinophilic center surrounded by epithelioid histiocytes and rare giant cells.|
|In other sections of the same biopsy, palisading necrobiotic granulomas are noted.|
On higher power, the eosinophilic center reveals areas of necrobiosis with rare nuclear dust and no evidence of crystals. No atypia of the epithelioid histiocytes is noted.
What is your diagnosis?
Last Updated 1/21/2003
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