Blue Ball in the Dermis

  • Rebecca S. ThornhillEmail author
  • Nicole Asher


A 77-year-old man with a history of nodular basal cell carcinoma excised from the scalp 5 years prior presented with complaints of scalp tenderness for the past three weeks. Examination yielded a well-healed scar with surface scale. The initial stage showed a parakeratotic epithelium (Fig. 30.1) subtended by a deep dermal scar and a basophilic-staining subcutaneous nodule (Fig. 30.2). The nodule is vaguely rounded and partially surrounded by an eosinophilic capsule (Fig. 30.3). The cells are densely chromatic, lack palisading, and are admixed with vacuolated cells (Fig. 30.4). The correct diagnosis is:
  1. (a)

    Lymph node

  2. (b)

    Basal cell carcinoma

  3. (c)

    Benign follicular hamartoma

  4. (d)




Lymph node Vascular ectasia 


  1. 1.
    Marks R, Harcourt-Webster JN. Histopathology of rosacea. Arch Dermatol. 1969;100:683–91.CrossRefPubMedCentralPubMedGoogle Scholar
  2. 2.
    Callen J. Cutaneous lupus erythematosus. Arch Dermatol. 1982;118:412–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Mills S. Lymph node histology. In: Mills S, editor. Histology for pathologists. New York: Lippincott Williams; 1997. p. 765–9.Google Scholar
  4. 4.
    Morgan MB. Lymphoid pathology. In: Morgan MB, editor. Atlas of Mohs and frozen section cutaneous pathology. New York: Springer; 2009. p. 174–6.Google Scholar

Copyright information

© Springer Science+Business Media LLC 2018

Authors and Affiliations

  1. 1.Greenville Health SystemUniversity of South CarolinaGreenvilleUSA
  2. 2.American University of the Caribbean School of MedicineClermontUSA

Personalised recommendations