Foreign Body Granuloma
Brian J. Hall, MD
John C. Hall, MD
Key Facts
Terminology
Granulomatous inflammation as a response to traumatically introduced substances
Clinical Issues
Firm, usually colorless nodule that may or may not be painful or tender
Often freely movable and can migrate from original site of introduction
Microscopic Pathology
Giant cells, histiocytes, and lymphocytes forming granulomas surrounding foreign material
Foreign body material is in most cases easily recognizable on H&E sections
Top Differential Diagnoses
Sarcoidosis
Infectious granulomatous diseases
Ruptured cyst of follicle
 Foreign body granuloma of several months duration is shown between the toes of a tennis player A sliver of wood is the site of entry with surrounding erythema  and swelling where granulation tissue is building up. |
 High-power view shows foreign body granuloma due to a wood splinter  . Note how the skin is walling off the foreign body so that it can eventually be extruded. (Courtesy L Coleman, MD.) |
TERMINOLOGY
Abbreviations
Foreign body granuloma (FBG)
Definitions
Granulomatous inflammation as a response to traumatically introduced substances
Occurs in dermis, subcutaneous tissue, or soft tissue
ETIOLOGY/PATHOGENESIS
Environmental Exposure
Most common substances that elicit a FBG response are lipids, wood, petrolatum, paraffin, lead, ink (tattoos), silica, silicone, talc, zirconium (deodorants), insect fragments (e.g., from tick bites)
Suture (unremoved, undissolvable, or dissolvable but that fails to dissolve)
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