Case Number : CT0045 Adam_Bates

Bandlike necrobiotic granulomatous inflammation, giants cells, cholesterol clefts and plasma cells: necrobiotic xanthogranuloma.
 

Annular elastolytic giant cell granuloma ( actinic granuloma previously) needs elastic tissue stain to d.d from granuloma annulare
 

Cholesterol clefts within necrobiotic zones points to NXG...
 

Necrobiotic xanthogranuloma.
 

Necrobiotic xanthogranuloma. Is there a history of multiple myeloma?
 

he presence of foamy histiocytes in palisaded array around extensive collagen degeneration and many cholesterol clefts is indicative of necrobiotic xanthogranuloma. Facial site is likely to be the periorbital region. Patient should be screened for paraproteinemia, bearing in mind that necrobiotic xanthogranuloma may precede detectable serum paraprotein.

I also think this is necrobiotic xanthogranuloma.