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04:44
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Sclerotic bodies beyond nephrogenic systemic fibrosis
Jag Bhawan1, Tanya A Perez-Chua, Lynne Goldberg
1Department of Dermatology, Boston University School of Medicine, Boston, MA, USA. jbhawan@bu.edu
Journal of Cutaneous Pathology
|July 2, 2013
Summary
Sclerotic bodies, previously linked to nephrogenic systemic fibrosis (NSF), were incidentally found in a skin cancer patient with chronic kidney disease. This suggests a connection between gadolinium exposure and sclerotic body formation in renal insufficiency.
Area of Science:
- Dermatopathology
- Nephrology
- Radiology
Background:
- Sclerotic bodies are collagenous structures potentially associated with nephrogenic systemic fibrosis (NSF).
- NSF is a condition linked to gadolinium-based contrast agents in patients with renal impairment.
- Previously, sclerotic bodies were exclusively reported in NSF cases.
Observation:
- Sclerotic bodies were incidentally identified in a re-excision specimen of squamous cell carcinoma (SCC).
- The patient had a history of chronic renal failure and received gadolinium contrast in 2003-2004.
- These bodies were present in post-gadolinium exposure specimens but absent in pre-gadolinium specimens.
Findings:
- The presence of sclerotic bodies in this SCC patient suggests they are a result of gadolinium exposure in individuals with chronic renal insufficiency.
- Sclerotic bodies were observed near the surgical scar, indicating potential fibroblast activation by gadolinium or its metabolites during wound healing.
- The patient did not develop NSF, despite gadolinium exposure and chronic renal failure.
Implications:
- This finding expands the known associations of sclerotic bodies beyond NSF.
- It suggests a potential diagnostic marker for gadolinium exposure in patients with kidney disease.
- Further research is needed to understand the mechanism of fibroblast activation and the absence of NSF in this case.
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