Totally ulcerated surface with dermal fragments infiltrated by dense mixed inflammatory infiltrate of neutrophils, lymphocytes, plasma cells, and foamy histiocytes. Extracellular anucleated keratin flakes are embedded within the reactive stroma, eliciting a prominent foreign-body granulomatous response. Numerous round, empty vacuolar spaces from lipid washout are interspersed throughout, accompanied by focal hemorrhage, fibrin, and granular necrotic debris. No intact epithelial cyst lining is identified. There is no cellular atypia or evidence of malignancy.
Right scapular area suspected sebaceous cyst.
Soft tissue piece measured 0.8x0.4x0.3 cm, totally embedded.
Skin and soft tissue, right scapular region lesion, excision: