Annular Elastolytic Giant Cell Granuloma
Cary Chisholm, MD
Key Facts
Terminology
Granulomatous infiltrate with phagocytosis and destruction of elastic fibers
Clinical Issues
Erythematous papules and plaques, which are often annular anywhere on body
Most patients > 40 years of age
Microscopic Pathology
3 zones
Central: Solar elastosis present without inflammation
Middle: Histiocytes and multinucleated giant cells (MNGCs) present with elastic fiber phagocytosis and elastolysis
Outer zone: Elastic fibers are absent
 Multiple yellow-orange annular plaques on the upper trunk of this patient clinically mimic necrobiosis lipoidica. The patient did not have diabetes and the biopsy was compatible with AEGCG. |
 Annular elastolytic giant cell granuloma is characterized by a histiocytic infiltrate with multinucleated giant cells  . Palisading  may be present. |
TERMINOLOGY
Abbreviations
Annular elastolytic giant cell granuloma (AEGCG)
Synonyms
Giant cell elastophagocytosis
Definitions
Granulomatous infiltrate with phagocytosis and destruction of elastic fibers
Typically arising in areas with minimal actinic damage
Some authors contend that AEGCG is not a unique diagnosis
AEGCG is a term for a spectrum that includes other individual diagnoses
Granuloma annulare
Actinic granuloma of O’Brien
Atypical necrobiosis lipoidica
Granuloma multiforme
Similar findings: Histiocytic infiltrate with multinucleated giant cells (MNGCs)
Phagocytosis of mucin or elastic fibers
± necrobiosis
CLINICAL ISSUES
