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When actinic granuloma-like lesions appear in non-exposed areas, the rash is known as annular elastolytic giant cell granuloma. Though these can be easily distinguished based on histopathologic features and laboratory findings, the differential diagnosis includes tinea corporis , sarcoidosis , subacute lupus erythematosus , granuloma annulare ...
Histopathologically, an annular elastolytic giant-cell granuloma exhibits a granulomatous reaction accompanied by phagocytosis of the elastic fibers, elastolysis, and multinucleate giant cells devoid of or reduced in elastin fibers. Other hallmarks of the histopathology include the lack of mucin deposition and collagen necrobiosis. [7]
A giant cell (also known as a multinucleated giant cell, or multinucleate giant cell) is a mass formed by the union of several distinct cells (usually histiocytes), often forming a granuloma. [1] Although there is typically a focus on the pathological aspects of multinucleate giant cells (MGCs), they also play many important physiological roles.
Granulation tissue is composed of tissue matrix supporting a variety of cell types, [3] most of which can be associated with one of the following functions: formation of extracellular matrix;
Caseous necrosis in the kidney. In caseous necrosis no histological architecture is preserved (unlike with coagulative necrosis). [5] [6] On microscopic examination with H&E staining, the area is acellular, characterised by amorphous, roughly granular eosinophilic debris of now dead cells, [6] also containing interspearsed haematoxyphilic remnants of cell nucleus contents. [5]
Touton giant cells, being multinucleated giant cells, can be distinguished by the presence of several nuclei in a distinct pattern. This pattern is described as a ring-like or wreath-like in the center of a cell.
In the earlier stages of actinic elastosis, elastic fiber proliferation can be seen in the dermis. As the condition becomes more established, the collagen fibers of the papillary dermis and reticular dermis become increasingly replaced by thickened and curled fibers that form tangled masses and appear basophilic under routine haematoxylin and eosin staining.
The disease is still sometimes confused with lethal midline granuloma and lymphomatoid granulomatosis, both malignant lymphomas. [ 34 ] The full clinical picture was first presented by Friedrich Wegener (1907–1990), a German pathologist , in two reports in 1936 and 1939, leading to the eponymous name Wegener's granulomatosis or Wegener ...