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Aluminum tattoo: a phenomenon that can resemble parasitized histiocytes
D M Elston1, W F Bergfeld, J T McMahon
1Department of Pathology, Cleveland Clinic Foundation, Ohio.
Abstract:
We present a study of aluminum tattoos that resulted from aluminum chloride cauterization of biopsy sites. The stippled macrophages were studied by light and electron microscopy and by means of X-ray energy spectroscopy (XES) analysis. The light microscopic appearance may be striking, and may mimic the appearance of parasitized histiocytes, although the particles are larger and vary in size and shape. The basophilic particles are electron dense by electron microscopy. XES analysis demonstrated distinct emission peaks corresponding to aluminum, calcium, and phosphorus. Only a minor chloride emission peak was identified. The particles may represent an inorganic precipitate or an organic compound in which aluminum, calcium, and phosphate form a complex with protein.
Insights
Aluminum tattoos from aluminum chloride cauterization create striking microscopic patterns. Analysis revealed aluminum, calcium, and phosphorus particles, potentially a complex with protein.
Area of Science:
- Pathology
- Materials Science
- Biomedical Research
Background:
- Aluminum chloride cauterization is used for biopsy site management.
- Unusual pigmentations, termed 'aluminum tattoos,' can arise post-procedure.
Purpose of the Study:
- To characterize the nature of aluminum tattoos resulting from aluminum chloride cauterization.
- To differentiate these artifacts from endogenous cellular structures.
Main Methods:
- Light microscopy for morphological assessment.
- Electron microscopy for ultrastructural details.
- X-ray energy spectroscopy (XES) for elemental composition analysis.
Main Results:
- Microscopic examination revealed stippled, basophilic, electron-dense particles within macrophages.
- XES analysis confirmed the presence of aluminum, calcium, and phosphorus, with minimal chloride.
- Particle morphology varied in size and shape, distinct from parasitic inclusions.
Conclusions:
- The observed 'aluminum tattoos' are likely inorganic precipitates or protein-aluminum-calcium-phosphate complexes.
- These findings aid in the accurate diagnosis of biopsy site artifacts.
- Understanding the composition is crucial for differentiating iatrogenic changes from disease processes.