Skin-nontumor / Clinical dermatology
Other dermatoses
Necrobiotic xanthogranuloma

Author: Mowafak Hamodat, M.D., MB.CH.B, MSc., FRCPC (see Authors page)

Revised: 18 July 2016, last major update August 2011

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PubMed Search: Necrobiotic xanthogranuloma

Cite this page: Necrobiotic xanthogranuloma. PathologyOutlines.com website. http://pathologyoutlines.com/topic/skinnontumornecrobioticxanthogranuloma.html. Accessed December 7th, 2016.
Definition / General
  • Head, neck and trunk lesions similar to necrobiosis lipoidica, but associated with IgG paraproteinemia and not diabetes
Micro Description
  • Marked necrobiosis alternating with foci of xanthogranulomatous infiltration through the reticular dermis with extension into subcutaneous fat
  • Septal distribution may mimic panniculitis
  • Granulomatous infiltrate is associated with epithelioid and foamy histiocytes in addition to conspicuous giant cells, many of Touton type; also foreign body giant cells, lymphocytes and plasma cells, cholesterol clefts
  • Asteroid bodies often found in cytoplasm of giant cells
  • Granulomatous and necrobiotic process may also affect muscular arteries
Micro Images

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Necrobiotic xanthogranuloma

Positive Stains
  • Oil Red O may reveal focal lipid droplets
  • Direct immunofluorescence shows IgM, C3 and fibrinogen deposits in blood vessel wall
  • Alcian blue staining may reveal small amount of interstitial mucin
Negative Stains
  • No elastic fibers in necrobiotic areas