Cytological Diagnosis of Multiple Normolipemic Tuberous Xanthoma: An Unusual Occurrence

Xanthomas are lesions characterised by accumulations oflipid laden macrophages within the dermis. Tuberousxanthomas are large nodular lesions those develop inpatients with underlying hyperlipoproteinemias. A 26-yearold female presented to our hospital with multiple tuberousswellings on the extensor surface of the body since 15 years.We also incidentally detected presence of Nodular thyroidswelling while examining the patient in our lab. Routineinvestigations along with Lipid profile were within normalrange and serum protein electrophoresis showed normalpattern. FNAC from few Tuberous nodules and multiple sitesof thyroid nodule was then performed. Cytosmears in alltuberous nodules showed good number of foamy histiocytesin clusters and discretely admixed with plenty of giant cellsand collections of cholesterol crystals over a dirtyhaemorragic background. Surprisingly FNAC done fromthyroid smears shows good number of epithelioid cellclusters, group of benign follicular cells and other featuressimilar to aspiration of tuberous nodules. Thyroid functionrevealed increased TSH with low normal T3,T4. Histopathology from a single excised nodular lesionshowed attenuated epidermal lining with collection of foamymacrophages in the dermis with plenty of giant cell reactionand cholesterol crystals that confirmed our findings to beTuberous xanthoma. We present a case of normolipemictuberous xanthomas with its association with thyroid disorder(hypothyroidism), which is an uncommon occurrence.

A Case of Diffuse Normolipemic Plane Xanthoma Associated with Multiple Myeloma / 대한피부과학회지

Diffuse plane xanthoma (DPX) presents with symmetric yellow-orange plaques primarily on the neck, upper trunk, flexural folds, and the periorbital region. Based on serum lipid and lipoprotein levels, these xanthomas are classified as normolipemic or hyperlipoproteinemic DPX. Diffuse normolipemic plane xanthoma (DNPX) is a rare condition that is not well studied yet. It is associated with reticulo-endothelial diseases, particularly multiple myeloma and monoclonal gammopathy of unknown significance (MGUS). A 62-year-old woman developed yellowish hyperpigmented papules and diffuse patches in the medial canthal area of her neck. Based on a skin biopsy and laboratory analyses, she was diagnosed with DNPX associated with multiple myeloma. This diagnosis demonstrates that dermatological lesions should be carefully assessed as they may be the first manifestation of an underlying hematological disease. We report herein a rare case of diffuse plane xanthoma associated with multiple myeloma and review the relevant literature.

Xantomas eruptivos en un niño normolipémico / Eruptive xanthomas in a normolipemic child

Los xantomas eruptivos son una enfermedad cutánea poco frecuente en la infancia que pueden aparecer en el contexto de trastornos primarios o secundarios del metabolismo lipídico y en algunas ocasiones no se asocian a ninguna enfermedad de base. Presentamos el caso de un niño de tres años de edad con múltiples pápulas amarillentas en los párpados, el tronco y los miembros superiores desde los dos años de edad, sin alteraciones en su perfil lipídico, que coincidían con xantomas. Consideramos importante informar este caso y hacer una revisión del tema debido a su baja prevalencia.

Normolipemic eruptive xanthomas are a very rare skin disorder in children. They most often occur in the context of primary or secondary lipid metabolism disorders, but sometimes no systemic involvement or lipid disorder is found. We report a 3 year old boy with multiple yellowish papules on the eyelids, trunk and superior extremities since he was 2 years old, with a normal lipid profile. We consider it is important to report this case due to its low prevalence.

Diffuse Normolipemic Plane Xanthoma with Multiple Myeloma / 대한피부과학회지

Diffuse plane xanthoma (DPX) is a rare variant of plane xanthoma and DPX appears as yellow flat patches or slightly elevated plaques on the eyelids, neck, upper trunk and flexural areas. Lynch and Winkelmann divided it into two groups according to the presence of hyperlipidemia. Diffuse normolipemic plane xanthoma is often associated with reticuloendothelial proliferative disease such as multiple myeloma and monoclonal gammopathy with unknown significance (MGUS). We report here on a case of diffuse normolipemic plane xanthoma associated with multiple myeloma in a 59 year-old man.

Normolipemic Tendinous and Tuberous Xanthomatosis: One Case Report / 대한정형외과학회잡지

A xanthoma is a localized collection of tissue histiocytes containing lipid and is usually associated with hyperlipidemia. Tendinous and tuberous xanthomatosis have been found in association with familial hypercholesterolemia, Type III hyperlipidemia, beta-sitosterolemia and cerebrotendinous xanthomatosis. Tendinous and tuberous xanthomatosis without hyperlipidemia have been reported very rarely. Especially tendinous xanthomatosis without hyperlipidemia have not been reported at all in korea. We are reporting a patient with tendinous and tuberous xanthomatosis accompanied by normal plasma lipids