Korean J Dermatol.  2019 Jun;57(5):243-250.

Adult Xanthogranuloma: A Clinical, Histopathological, and Immunohistochemical Study of 19 Korean Cases

Affiliations
  • 1Department of Dermatology, Chonbuk National University Medical School, Jeonju, Korea. dermayun@jbnu.ac.kr

Abstract

BACKGROUND
Juvenile xanthogranuloma is a benign, self-limited disorder that usually occurs in infants and young children. Xanthogranuloma is rare in adults, and therefore studies reporting adult xanthogranuloma are limited.
OBJECTIVE
We investigated the clinical, histopathological, and immunohistochemical characteristics of adult xanthogranuloma.
METHODS
In this study, we evaluated 20 lesions in 19 patients with adult xanthogranuloma.
RESULTS
A male predominance was observed (male : female ratio 1.4 : 1), and the mean age of patients was 35.1±16.3 years (range 15∼66 years), with the peak incidence observed in patients in their 20s. Notably, 65.0% of the lesions developed on the head and neck. The nodular form was more common than the papular form of this condition. Histopathological examination revealed dense monomorphic histiocytic infiltration without lipidization and scattered eosinophils without multinuclear giant cells in 5 lesions (25.0%), foamy histiocytic infiltration with variations of completely developed Touton giant cells in 10 lesions (50.0%), and fibrohistiocytic proliferation in 3 lesions (15.0%). On immunohistochemical examination, histiocytes including giant cells showed positive test results with Factor XIIIa (90.9%), vimentin (100%), and CD68 (100%) and negative test results with CD1a, smooth muscle actin, and S-100 protein stains. Tumor excision was the treatment for choice.
CONCLUSION
Adult xanthogranuloma most commonly manifested as the nodular form of the disease on the head and neck of men in their late 20s. Histopathologically, the classic Touton cell-rich stage was most commonly observed, followed by the stage of early predominantly mononuclear infiltration. This was a single-center, small-sized retrospective study; however, we expect the results of this study to contribute to a better understanding of adult xanthogranuloma.

Keyword

Adult; Clinical; Histopathological; Xanthogranuloma

MeSH Terms

Actins
Adult*
Child
Coloring Agents
Eosinophils
Factor XIIIa
Female
Giant Cells
Head
Histiocytes
Humans
Incidence
Infant
Male
Muscle, Smooth
Neck
Retrospective Studies
S100 Proteins
Vimentin
Xanthogranuloma, Juvenile
Actins
Coloring Agents
Factor XIIIa
S100 Proteins
Vimentin
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