Palisading granulomas caused by infectious diseases.
We recently encountered a palisading granuloma in which an infectious cause was not considered until special stains revealed hyphae and tissue culture revealed organisms of phaeohyphomycosis. A review of more than 2,500 cases of various granulomas revealed 11 cases of palisading-type granuloma caused by infection, including phaeohyphomycosis, nontuberculous mycobacteriosis, papulonecrotic tuberculid, tuberculoid syphiloderm, cat-scratch disease, sporotrichosis, cryptococcosis, and coccidioidomycosis. Infectious disease should be considered in the differential diagnosis of palisading granuloma. Special stains for bacteria, fungi, and acid-fast bacilli should be performed in biopsy specimens that have a palisading granuloma pattern with central necrosis, especially in immunosuppressed patients.
Su
W P
WP
Department of Dermatology, Mayo Clinic, Rochester, MN 55905.
Kuechle
M K
MK
Peters
M S
MS
Muller
S A
SA
D000368:Aged; D001424:Bacterial Infections / Q000175:diagnosis*; D003881:Dermatomycoses / Q000175:diagnosis*; D006099:Granuloma / Q000175:diagnosis / Q000382:microbiology*; D006229:Hand Dermatoses / Q000175:diagnosis / Q000382:microbiology; D006801:Humans; D016410:Lymphoma, T-Cell, Cutaneous / Q000473:pathology; D008297:Male; D003904:Mitosporic Fungi; D012874:Skin Diseases, Infectious / Q000175:diagnosis*; D012878:Skin Neoplasms / Q000473:pathology