Zabel Morgan L, Evans Tyler, Sutton Adam V, Stephany Matthew
College of Medicine, University of Nebraska Medical Center, Omaha, USA.
Dermatology, University of Nebraska Medical Center, Omaha, USA.
Cureus. 2022 Aug 10;14(8):e27845. doi: 10.7759/cureus.27845. eCollection 2022 Aug.
Granuloma annulare (GA) is a common benign granulomatous inflammatory disorder of the dermis or subcutis with classic morphologic and histologic presentation. Common clinical subtypes of granuloma annulare include localized, generalized, subcutaneous, perforating, and patch types. A biopsy is critical in cases of granuloma annulare with atypical features. We present a case of a 58-year-old male who presented with an annular scaly erythematous plaque on the right dorsal hand. Shave biopsy demonstrated irregular nests of mildly atypical squamous epithelium present within the superficial dermis, with abundant histiocytes and multinucleated giant cells arranged in palisades peripherally. These findings were consistent with invasive well-differentiated squamous cell carcinoma (SCC) with surrounding granuloma annulare. This case highlights a unique presentation in which clinicopathologic correlation is critical prior to arriving at a correct diagnosis.
环状肉芽肿（GA）是一种常见的真皮或皮下组织良性肉芽肿性炎症性疾病，具有典型的形态学和组织学表现。环状肉芽肿的常见临床亚型包括局限性、全身性、皮下型、穿通型和斑块型。对于具有非典型特征的环状肉芽肿病例，活检至关重要。我们报告一例58岁男性，其右手背出现环形鳞屑性红斑斑块。削除活检显示浅表真皮内有不规则巢状轻度非典型鳞状上皮，周围有丰富的组织细胞和多核巨细胞呈栅栏状排列。这些发现符合侵袭性高分化鳞状细胞癌（SCC）伴周围环状肉芽肿。该病例突出了一种独特的表现，即在做出正确诊断之前，临床病理相关性至关重要。
