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Picture of the Month—Quiz Case FREE

Melissa Tripoli, BS; Nektarios Lountzis, MD; Ashish Mahajan, MD; Eric Hossler, MD
[+] Author Affiliations

Author Affiliations: Geisinger Medical Center, Danville, Pennsylvania.


SECTION EDITOR: SAMIR S. SHAH, MD, MSCE


JAMA Pediatr. 2013;167(1):85. doi:10.1001/2013.jamapediatrics.209a.
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A 9-year-old otherwise healthy girl presented with a lesion on the left upper lip for the past year. It was slowly growing and somewhat tender to deep palpation but was not interfering with feeding or development. No similar lesions were present on the rest of her body. Physical examination revealed a 4-mm, firm, white, nontender, mobile papule at the left upper vermilion border (Figure 1). The rest of the physical examination was unremarkable. An excisional biopsy was performed (Figure 2 and Figure 3).

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Figure 1. A 4-mm, firm, white, nontender, mobile papule at the left upper vermilion border of an otherwise healthy 9-year-old girl.

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Figure 2. Scanning view of the biopsy specimen, showing a well-defined dermal proliferation of large polyhedral cells (hematoxylin-eosin, original magnification ×20).

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Figure 3. Close-up of the cells shows abundant eosinophilic granular cytoplasm and centrally located vesicular nuclei. The cells were arranged in cords and surrounded by a dense collagenous stroma. No significant cellular atypia or degenerative changes were seen (hematoxylin-eosin, original magnification ×200).

Figures

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Graphic Jump Location

Figure 1. A 4-mm, firm, white, nontender, mobile papule at the left upper vermilion border of an otherwise healthy 9-year-old girl.

Place holder to copy figure label and caption
Graphic Jump Location

Figure 2. Scanning view of the biopsy specimen, showing a well-defined dermal proliferation of large polyhedral cells (hematoxylin-eosin, original magnification ×20).

Place holder to copy figure label and caption
Graphic Jump Location

Figure 3. Close-up of the cells shows abundant eosinophilic granular cytoplasm and centrally located vesicular nuclei. The cells were arranged in cords and surrounded by a dense collagenous stroma. No significant cellular atypia or degenerative changes were seen (hematoxylin-eosin, original magnification ×200).

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