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Pseudoactinomycotic Radiate Granules (PAMRAGs) in the Extensor Tendon of Hand

Rifat Sahin1

  • 1Department of Orthopaedia and Traumatology, Faculty of Medicine, Recep Tayyip Erdogan University, Turkey.

Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
|November 19, 2021
PubMed

Insights

Pseudoactinomycotic radiate granules (PAMRAGs) mimic infectious actinomycotic granules but are not infectious. This case report details PAMRAGs in a hand, emphasizing the importance of accurate diagnosis to avoid unnecessary antibiotic treatment.

Area of Science:

  • Pathology
  • Dermatology
  • Infectious Diseases

Background:

  • Pseudoactinomycotic radiate granules (PAMRAGs) are typically found in female genitalia and resemble infectious actinomycotic granules.
  • Unlike actinomycosis, PAMRAGs are non-infectious and do not require specific treatment.

Observation:

  • A case of PAMRAGs in the hand of a 56-year-old woman is presented.
  • The lesion, located on the dorsal aspect of the right hand within the extensor digitorum communis, presented as a soft mass.
  • Histopathological examination revealed granules with a radial arrangement and club-like eosinophilic character, but PAS staining was negative for actinomyces.

Findings:

  • Histopathology ruled out actinomycosis, leading to a diagnosis of PAMRAGs.
  • The characteristic features included refractile granules with a thick, irregular, eosinophilic, club-like appearance and no central core.
  • The absence of positive PAS staining further supported the differentiation from true actinomycosis.

Implications:

  • Accurate differentiation between PAMRAGs and actinomycosis is critical for appropriate patient management.
  • Familiarity with PAMRAGs' appearance is essential for pathologists to prevent misdiagnosis.
  • Avoiding misdiagnosis can prevent unnecessary antibiotic therapy, improving patient outcomes and reducing healthcare costs.

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