Rheumatoid nodules are the most common extra-articular manifestation of rheumatoid arthritis. Intraarticular rheumatoid nodules are very rare and usually associated with clinical symptoms. Case reports of intra-articular rheumatoid nodules in the knee joint, wrist joint, ankle joint, and sacrococcygeal joint are reported. However, an intra-articular rheumatoid nodule in the elbow joint has not been reported in the literature. Herein, we report a unique and rare case of a symptomatic intra-articular rheumatoid nodule in the elbow joint of a 49-year-old female with a 15-year history of rheumatoid arthritis. The symptoms resolved after surgical excision of the nodule.
<p class="abstract">Xanthogranuloma is a relatively rare histiocytic cutaneous disorder that typically affects the pediatric age group. Its occurrence in adulthood is still rarer with only a handful of cases on the record. The present case report describes a case of adult-onset xanthogranuloma in a 49 years old lady who presented to the otorhinolaryngology clinic with a 6 months history of a nodule on the left side of the columella. There was no history of associated pain or bleeding from the site. Local examination revealed a 0.6×0.6 cm, non-tender, soft-to-firm, pinkish dome-shaped lesion with rounded edges. No similar lesions were found elsewhere. Excisional biopsy of the lesion was performed and microscopy showed a dermal lesion comprising of sheets of histiocytes admixed with lymphoplasmacytic infiltrate, touton giant cells and few spindle cells. A diagnosis of xanthogranuloma was rendered. A number of lympho-histiocytic lesions comes in the differential diagnosis of xanthogranuloma and hence it is important to be aware of such unusual presentations in order to make correct histological diagnosis.</p>
Nevus lipomatosus cutaneous superficialis (NLCS) is a rare cutaneous hamartomatous lesion, histopathologically characterized by the presence of ectopic dermal adipocytes. Herein, reported is the clinicopathological aspect of six cases of NLCS, consisting of three males and three females, with age at presentation ranging from 18 to 47 years and duration of lesion ranging from 2 to 18 years. Out of the six cases, five were of solitary NLCS, who presented with nodules or polypoidal masses of variable sizes and duration. The lone case of classical NLCS presented with multiple skin-coloured cerebriform nodules over the right lower back in zosteriform distribution. The commonest location was lower back and thigh. Histopathological examination revealed lobules of mature adipocytes in the papillary and/or reticular dermis in all cases, thereby establishing the diagnosis of NLCS. Additional microscopic features encountered were surface ulceration, focal myxoid degeneration, mild perivascular lymphocytic infiltrate and attenuation of adnexal structures.
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