Back issues No.4 - 2009 / Resident Forum  

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An Intriguing Subcutaneous Nodule on Right Upper Arm
Szu-Ying Chu, Chang-Lin Chen, Ding-Dar Lee
Dermatol Sinica 27: 260-261, 2009

A 49-year-old female noticed a deep-seated nodule with rubbery consistency on right upper
arm for 2 months. Erythematous change on surface was seen (Fig. 1). She was suffered from
mild itching sensation without pain or tenderness. The lesion progressed in size gradually. She
visited our hospital for help and excisional biopsy was performed. Histologically, a well-defi ned
nodule circumscribed by eosinophilic cuticle was found in subcutaneous tissue. The wall of
nodule consisted of three layers, including eosinophilic integument, smooth muscle fi bers, and
columnar tegumental cells. Numerous basophilic calcareous bodies, excretory ducts, and smooth
muscle bundles were noted in loose stroma of parenchyma (Fig. 2). Besides, bothrium, a suction
groove, was discovered in the cephalic direction after serial sections (Fig. 3). There was no protoscolex,
suckers, or hooklets. A dense infl ammatory cell infi ltrate, containing lymphohistiocytes,
eosinophils, plasma cells and multinucleate giant cells, was present around the nodule. The laboratory
tests revealed no leukocytosis or eosinophilia.

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