An asymptomatic nodule on the forearm (original) (raw)
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A slowly enlarging purple nodule on the arm
Dermatology practical & conceptual, 2016
A 50-year-old Caucasian gentleman presented with a oneyear history of a gradually enlarging pigmented lump on the right forearm. On examination there was a 1 cm blue-purple nodule, which was hard in consistency (Figure 1). A mobile dermal cystic component was palpated after lateral pressure. Further dermoscopic examination revealed a homogeneous blue-purple pigmentation surrounded by a subtle brown hyperpigmentation and a central white area with fine linear whitish structures. No pigment network was noticed (Figure 2). Histopathological examination was performed to exclude melanoma. It revealed an ill-defined nodular dermal proliferation of spindle-shaped fibroblasts and myofibroblasts arranged as short intersecting bundles. There were multiple dilated vascular channels and numerous hemosiderin-laden macrophages (Figure 3).
Orthopaedic Case of the Month: A 30-year-old Woman with a Painful Forearm Mass
Clinical Orthopaedics and Related Research®, 2010
History and Physical Examination A 30-year-old woman with a history of chronic congenital lymphedema and overgrowth of the right upper extremity presented with a visibly inflamed, reddened, nodular, palpable mass arising from the skin on the dorsal aspect of her right forearm of 9 months duration. The patient described the initial appearance as three small pimples on the skin of the forearm that coalesced and became larger. There were no fevers, weight loss, or night sweats. The patient was otherwise healthy. Eventually the mass became tender and painful, which caused her to seek medical attention. On presentation, there was an irregular, nodular, nontender, cutaneous mass that was approximately 3 9 3 cm surrounded by a 1-cm halo of erythema. Sensation and motor function were grossly intact. She had no history of malignancy or radiation treatments. Surgical history was significant for several surgical debulking procedures and liposuction of the right forearm and arm. The entire upper extremity from shoulder through the fingers was diffusely enlarged approximately four times the circumference of her contralateral normal upper extremity. It seemed to involve the skin and subcutaneous tissue. There were no palpable enlarged lymph nodes in the axilla or epitrochlear region although these areas were difficult to palpate because of the chronic lymphedema. Laboratory studies showed complete blood count, chemistries, coagulation analysis, erythrocyte sedimentation rate, and C-reactive protein were all normal. MRI was performed (Figs. 1-3). Based on the history, physical examination, and imaging studies, what is the differential diagnosis? Imaging Interpretation MRI of the right forearm showed a mass involving the skin and subcutaneous tissue along the extensor surface of the midforearm that measured approximately 2.7 9 2.4 9 1.8 cm. The mass abutted but did not penetrate the superficial fascia along the posterior compartment of the forearm. The mass was heterogeneous but predominantly intermediate signal on T1 (Fig. 1) and high signal on T2 with a thin low signal intensity rim on the T2-weighted images (Fig. 2). High Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his or her institution approved the reporting of this case report, that all investigations were conducted in conformity with ethical principles of research.
An Ulcerated Reddish Nodule of the Chest: When You See, Think …
Dermatopathology (Basel, Switzerland)
A 97-year-old man with a previous personal history of multiple nonmelanoma skin cancers presented with a fast-growing, ulcerated reddish nodule on his chest. The nodule was surgically removed, and hematoxylin and eosin stains of the specimen showed an asymmetrical, nonpigmented lesion with architectural and structural impairment, round cells with clear, whitish, foamy cytoplasm, multiple dermal mitoses and nuclear pleomorphism. Our first hypothesis was sebaceous carcinoma, a rare malignant neoplasm derived from epithelial cells showing sebaceous differentiation. A further histopathologic examination showed the presence of pigment in a few areas of the neoplasm. On immunohistochemical study, neoplastic cells were negative for wide-spectrum cytokeratin and diffusely positive for S-100, MART-1, and HMB-45 proteins. Our final diagnosis was nodular malignant melanoma (MM) with balloon epithelioid cells, a "bizarre" presentation of MM in vertical growth phase, mimicking metastat...
Enigmatic nodules on skin – a case report
Among many skin coloured solitary or multiple nodules of the skin with minimal or no symptoms, cutaneous leiomyomas are unique in its clinical presentation, histopathological features and clinically confusing the dermatologists. Though very rare, few cases of segmental cutaneous leiomyomas have been reported in the medical literature. Cutaneous leiomyomas are rare benign tumors of the skin. Leiomyomas in other regions of the body are on records. Various modalities have been used to relieve pain in such lesions. This presentation highlights the importance of biopsy in all nodular skin lesions of the skin to identify and confirm the disease, plan for the correct treatment, answer questions from the affected patients and to teach dermatology post graduates. Histopathological features of other nodular skin lesions are compared.
Asymptomatic nodule on face: Dermoscopic and histopathological clue for diagnosis
Nepal Journal of Neuroscience
Schwannomas/ neurilemmomas are benign tumors of nerve sheath arising from Schwann cells that form myelin sheath around peripheral nerves. They are usually solitary, slow growing and encapsulated lesions. Head and neck are the common sites. We report a case of a 38 years old Nepalese female who had presented with a solitary asymptomatic, slow growing nodule on the left side of the chin for the last three years. Dermoscopy of the lesion revealed arborizing vessels with brownish pigmentation overlying a whitish to pinkish background. Complete excision of the lesion was performed. Histopathological evaluation of the lesion revealed schwannoma. Though schwannomas are a rare diagnosis, they should be considered as a differential diagnosis of any unilateral, asymptomatic, slow growing nodule in the head and neck region. Dermoscopy is a useful tool which helps to differentiate schwannoma from other lesions. Histopathology is the gold standard for diagnosis and the treatment of choice is sur...
Journal of Surgical Oncology, 2000
In our experience, we document 2 cases of a rare and non-tumoral lesion of the liver misinterpreted as necrotic tumor: necrotic solitary nodule. In the first clinical case, ultrasound (US) showed a polylobated lesion (35 × 35 × 38 mm) at segment 8. Color-doppler identified a compression of celiac axis (Dunbar syndrome). Arteriography revealed a subtotal stenosis of celiac tripod soon after the emergence of the left gastric artery. FNAB-CT showed a highly cellulated tissue with a necrotic core surrounded by a fibersclerotic tissue. The patient underwent surgery: cholecystectomy and correction of Dunbar syndrome. US follow-up showed a progressive reduction in diameter of the lesion (24 × 25 × 25 mm at 24 months), suggesting in this case the role of ischemic injury in the pathogenesis of the lesion.