A 9-year-old female child was referred to the hospital by her general practitioner for an anterior abdominal nodule. On admission, clinical examination showed a painful hardened nodule not visible to the naked eye. The nodule was about 1 cm long and was localized 6 cm above the navel. The lesion appeared very similar to a linea alba hernia. The rest of the physical examination was unremarkable, as no other nodule was recovered, and no other abnormalities were shown by echography. The patient was born in the Congo and had arrived in France 1 year prior to admission. Her medical history gave no specific information.
Due to the pain and the clinical presentation, it was decided that surgical excision would be done, and the nodule was extracted. Seborrheic liquid was collected during the excision, and the removed nodule was sent to an anatomopathological laboratory, primarily due to the absence of abdominal fascia disruption. Histopathological examination of the nodule revealed a polymorphic inflammatory infiltrate containing multiple abnormal structures (Fig. 1A). These hematoxylin-eosin-safranin (HES)-colored structures measured about 1 mm on the longitudinal axis and 300 μm on the transversal axis, with a multilocular cavity inside each structure (Fig. 1B). At a higher magnification, some of these cavities were found to contain numerous substructures (Fig. 1C).
FIG 1.
(A) Hematoxylin-eosin-safranin (HES) coloration of the nodule revealed multiple abnormal structures (magnification, ×25). (B) Multilocular elements within the structures revealed by HES coloration (×200). For an explanation of the arrows, see the answer to the photo quiz. (C) Numerous structures contained in cavities (×400).
What is your diagnosis?
For answer and discussion, see https://doi.org/10.1128/JCM.01266-18 in this issue.