case_images: PMC4006551_01
case_images: A bluish tumor of 30 mm in diameter was observed on the palm of her right hand.
case_images: CRIDM2014-686489.001.jpg
case_images: PMC4006551_01_CRIDM2014-686489.001.jpg
case_images: fig1
case_images: A 67-year-old woman was referred to our department for evaluation of a bluish nodule on the palm of her right hand (Figure 1, arrow).
case_images: Contrast-enhanced CT showing a linear radiopaque structure of 8 mm long with a mass on its distal end.
case_images: CRIDM2014-686489.002.jpg
case_images: PMC4006551_01_CRIDM2014-686489.002.jpg
case_images: fig2
case_images: Computed tomography (CT) of the lesion revealed a linear radiopaque structure of 8 mm long with a mass on its distal end (Figure 2, arrow).
case_images: A black-pigmented fragment of 28 x 30 mm along with a lead was removed.
case_images: CRIDM2014-686489.003.jpg
case_images: PMC4006551_01_CRIDM2014-686489.003.jpg
case_images: fig3
case_images: The total excision of the tumor was performed, revealing a bluish muddy mass that contained a piece of material that resembled pencil lead (Figure 3).
case_images: HE stain of the specimen revealed degenerative tissue with calcification and granulomas associated with histiocytes laden with fragments of black graphite (Hematoxylin eosin stain, x100).
case_images: CRIDM2014-686489.004.jpg
case_images: PMC4006551_01_CRIDM2014-686489.004.jpg
case_images: fig4
case_images: Histiocytes laden with fragments of black graphite were also observed at the peripheral of the degenerative tissue (Figure 4).