A Case for Diagnosis. Presented by Dr. E. P. Zeisler.
This woman, aged 25, has an enlargement of the index finger of the left hand which has been present for fifteen years. Numerous firm subcutaneous nodes can be palpated on the flexor surface, and the tendon sheath is palpable as a firm cord.
Histologic examination showed marked hyperkeratosis and numerous enlarged nerve endings in the corium. No tumor cells and no xanthoma cells were visible with stains for fat.
Dr. S. W. Becker: I thought I saw some hyaline degeneration in the section of the nerve itself, not a neuroma in the sense of nerve proliferation, but indication that the nerves were definitely degenerated, and that might account for the peculiar whitish appearance of the lesions on the ball of the finger. There are swelling, hyaline change and a little fibrosis in the nerve endings but no such changes