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Pathology for Urologists

Lipogranuloma


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  • So known as paraffinoma, sclerosing lipogranuloma, and Tancho's nodules.
  • Clinical: usually seen in men <40 years; localized mass or indurated plaque that may be tender to palpation.
    • Penile lesions are usually due to injection of paraffin, silicone, oil, or wax (purportedly for sexual gratification or penile enlargement).
    • Scrotal lesions are usually due to injection of foreign material, trauma, cold weather (?!), and topical application of ointment.
  • Histology:
    • The lesion consists of lipid vacuoles embedded in a sclerotic stroma.
    • Often accompanied by a granulomatous reaction with foreign-body giant cells.
    • Diagnosis may be confirmed by doing lipid stains.
  • Differential diagnosis: malakoplakia or signet ring carcinoma.

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