The precise histopathological features of the xanthogranulomatous process (XP) have been defined in an extensive review of all cases from various organs available in our files. The result was that the XP has the following aspecific but characteristic findings: the presence of granular, eosinophilic, PAS positive histiocytes in the initial stages; the mixture of foamy macrophages and activated plasma cells; the presence of suppurative foci and hemorrhages. Abscess, necrosis and most of all hemorrhages play a a role in eliciting this inflammatory response. This is in accordance with the observations so far reported in the literature. A very interesting result of our study is that some unquestionable cases of XP in cutaneous soft tissue had a histopathological picture indistinguishable from xanthoma. Basing on our experience and on an extensive study of the literature we suggest that the XP mechanism may in some way play a role in several diseases where the inflammatory or reactive nature is more or less ascertained or suspected and the secondary significance of foam cell production is overtly manifest.