A 21-year-old female presented with complaints of insidious onset, gradually progressive asymptomatic swelling over the back of the left thigh for past five years. She first noticed a pea-sized swelling when she was 16 years old. The swelling gradually increased in size over 3 years to the present size and has remained static since then. General physical and systemic examination was unremarkable. Dermatological examination revealed a solitary well-defined dome-shaped pedunculated growth measuring 5 × 5 cm over the posterior aspect of the left upper thigh [Figure 1]. The lesion was firm in consistency, nontender, and there was no noticeable surface change.
Figure 1.
Solitary pedunculated growth on the left thigh
Excisional biopsy of the lesion was done. Histopathology revealed keratinized stratified squamous epithelium. Subepithelium showed fibrocollagenous tissue along with scattered adipose tissue within reticular dermis [Figures 2 and 3]. Scant mononuclear inflammatory infiltrate was also seen. No hyperpigmentation of basal layer, foamy histiocytes, giant cells, or grenz zone was seen. No atypical cells or evidence of malignancy was noted.
Figure 2.
Histopathology of growth revealing keratinized stratified squamous epithelium with dermis showing fibrocollagenous tissue along with pockets of adipose tissue (H and E, ×10)
Figure 3.
High power view of the same (H and E, ×40)
Question
What is your diagnosis?
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This round will be closed on 30th March 2014. The results will be declared online on 1st April 2014.
Diagnosis of IJD® QUIZ issue 1
Answer
Cutaneous Lymphoid Hyperplasia
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The Winners of this Quiz are:
Geeti Khullar, PGIMER Chandigarh
Laxmisha Chandrasekhar, JIPMER Puduchhery
Himanshu Gupta, ESIC-PGIMSR, New Delhi
Other than above three names who have responded correctly are:
Vinay Keshavmurthy, Urmi Khanna, Vishal Chugh, Tirthankar Gayen, Aniket B. Bhole, Nirmal B., Mrinal Gupta, Suneil Pravin Gandhi, Meghana Phiske, S. Murugan, Anjali Pal, Hari Kishan Kumar Y., Shreyans Mutha, Neetu Bhari, Dipti Das, Mugdha Jhamwar, Aancha Panth, Sonia Mangal, Priyanka C. Patil
