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Journal of the American Academy of Dermatology
Volume 38, n° 6
pages 967-970 (juin 1998)
Doi : 10.1016/S0190-9622(98)70161-6
Asteroid bodies and other cytoplasmic inclusions in necrobiotic xanthogranuloma with paraproteinemia

R.K. Winkelmann, MD*, Patrick M. Dahl, MDa, Charles Perniciaro, MDb
Scottsdale, Arizona, Rochester, Minnesota, and Jacksonville, Florida 
From the Department of Dermatology, Mayo Clinic and Mayo Foundation, Rochester, Minnesota ,a and the Department of Dermatology, Mayo Clinic Jacksonville, Jacksonville. b 
* Emeritus member, Mayo Clinic Scottsdale, Scottsdale, Ariz 


Background: Necrobiotic xanthogranuloma (NXG) with paraproteinemia is a distinctive palisading granuloma of the skin. Extracutaneous lesions are rarely present. Objective: The purpose of this study was to confirm the presence and significance of giant cell asteroid bodies and other cytoplasmic inclusions in NXG with paraproteinemia. Methods: Skin biopsy specimens from 24 patients with NXG with paraproteinemia were reviewed; autopsy and lung biopsy specimens from two patients were stained for iron, calcium, and polysaccharide. Results: Giant cell asteroid bodies were observed in skin biopsy specimens of 8 (33%) of the 24 patients. In addition, large acidophilic polygonal cytoplasmic inclusions were observed in myocardial tissue of one of the autopsy cases. Iron and calcium were not found. Conclusion: Asteroid bodies and other inclusions can be present in the giant cells of NXG with paraproteinemia. They are as frequent as, or more frequent than, in other granulomatous diseases and should be considered in the diagnosis of NXG with paraproteinemia.(J Am Acad Dermatol 1998;38:967-70.)

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 Reprint requests: Charles Perniciaro, MD, 4500 San Pablo Rd., Jacksonville, FL 32224.
 0190-9622/98/$5.00 + 0  16/1/89380

© 1998  American Academy of Dermatology, Inc. Published by Elsevier Masson SAS@@#104157@@