Excisional Biopsy

Histologic examination of the H & E section revealed small clusters of a granular brownish black material deposited on delicate collagen fibers of the surrounding connective tissue, small blood vessels and skeletal muscle fibers (Figure 2 & 3). This material was surrounded by sheets of macrophages and occasional multinucleated foreign body type giant cells (Figure 3). The immunohistochemistry stain with CD68, an antibody for macrophages, was uniformly positive with some cells containing small black granules (Figure 4).

Figure 2 Low power (x100) histology shows H & E stained section with surface epithelium and underlying fibrous connective tissue containing brownish black granular material deposited on collagen fibers. and skeletal muscle bundles.


Figure 3 Higher power (x200) histology shows H & E stained section demonstrating macrophages and foreign body giant cells with black particles and one small clusters of that foreign material.

Figure 4 Higher power (x200) Immunohistochemistry stain with CD68 demonstrating positively stained macrophages and foreign body giant cells. Note the foreign material within some of these cells.