Skin and subcutaneous tissue heavily infiltrated by a chronic suppurative and granulomatous inflammatory process. There is multiple, large, irregularly shaped, dark brown to black fungal grains (granules). These grains are composed of densely packed, thick fungal hyphae embedded within a heavily pigmented, cement-like matrix. The fungal colonies are immediately surrounded by dense aggregates of neutrophils forming microabscesses. These microabscesses are rimmed by a mixed chronic inflammatory infiltrate composed of macrophages, multinucleated giant cells, lymphocytes, and plasma cells, all set within a prominent background of reactive granulation tissue and extensive fibrosis. No evidence of mald nancy.
Rt. foot swelling.
Partially skin covered soft tissue fragment measured 2.3x2x1.5 cm, totally embedded.
Rt. foot swelling, excision biopsy: