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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Although the effectiveness of vaccination with BCG, an attenuated strain of Mycobacterium tuberculosis, has been challenged,^1-2 the vaccine has been used in Japan since 1942. We describe a very rare case of a patient in whom BCG granuloma was identified by polymerase chain reaction (PCR)–based genomic deletion analysis more than 50 years after vaccination for BCG.

Report of a Case

A 62-year-old Japanese woman found 4 painless subcutaneous nodules on her left upper arm and 1 on her right upper arm 3 months before seeking care (Figure 1). The lesions were hard and clearly defined nodules and were 10 to 16 mm in diameter. Two nodules were fused together. She had no history of tuberculosis, immunodeficiency, or diabetes mellitus. She and her family had never engaged in farming or cattle breeding, so cattle were unlikely to be the source of the infection.

Figure appears in full text version. Figure 1. Clinical features of the patient at the . . . [Full Text of this Article]

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AUTHOR INFORMATION
Mariko Seishima, MD; Tomomi Fujisawa, MD; Shinya Yamanaka, MD; Norihisa Ishii, MD, PhD; Shuichi Mori, PhD; Kazutaka Ohashi, MD, PhD; Tatsuo Suzutani, MD, PhD