Talk:Dermatologic neoplasms - Revision history

Michael: /* Microscopic */ more

2011-09-28T19:52:54Z

Microscopic: more

← Older revision		Revision as of 19:52, 28 September 2011
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	==Basal cell carcinoma==		==Basal cell carcinoma==
	===Microscopic===		===Microscopic===
	The sections show nests of basaloid cells in the superficial dermis with peripheral palisading of the nuclei. The nests demonstrate focal clefting with the surrounding myxoid stroma.		The sections show nests of basaloid cells in the superficial dermis with peripheral palisading of the nuclei, and abundant mitoses. The nests demonstrate focal clefting with the surrounding myxoid stroma.

	Dense superficial dermal collagen bundles running parallel to the dermal-epidermal junction are seen in association with loss of the rete ridges and mononuclear, perivascular inflammatory cells (dermal scar). The tumour is present in one of the tips (block A1).		Dense superficial dermal collagen bundles running parallel to the dermal-epidermal junction are seen in association with loss of the rete ridges and mononuclear, perivascular inflammatory cells (dermal scar). The tumour is present in one of the tips (block A1).

Michael: /* PUS */

2011-09-16T16:01:23Z

PUS

← Older revision		Revision as of 16:01, 16 September 2011
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	Solar elastosis.<br>		Solar elastosis.<br>

	== PUS ==		== PUS/AFX ==

	===Microscopic===		===Microscopic===
	The sections ~~shows~~ an atypical spindle cell ~~lesions~~ in the deep dermis, with a storiform and fascicular pattern, marked nuclear pleomorphism and very high mitotic activity (129 mitoses / 10 HPF, field diameter 0.55 mm). The spindle cells have moderate-to-abundant partially ~~vaculated~~ eosinophilic-to-amphophilic cytoplasm, ellipsoid-to-ovoid nuclei with coarse, irregular chromatin and, focally, nucleoli visible with the 10x objective. ~~Malignant~~ multinucleated-cells are identified focally with abundant pale gray cytoplasm. Suture material and reactive foreign body giant cells are seen.		The sections show an atypical spindle cell lesion in the deep dermis, with a storiform and fascicular pattern, marked nuclear pleomorphism and very high mitotic activity (129 mitoses / 10 HPF, field diameter 0.55 mm). The spindle cells have moderate-to-abundant partially vacuolated eosinophilic-to-amphophilic cytoplasm, ellipsoid-to-ovoid nuclei with coarse, irregular chromatin and, focally, nucleoli visible with the 10x objective. Atypical (malignant) multinucleated-cells are identified focally with abundant pale gray cytoplasm.

			Benign dense thick collagen bundles are seen in the superficial dermis with associated loss of the rete ridges (dermal scar). Suture material and (reactive) foreign body-type giant cells are also seen.

			Immunohistochemical staining show:
			-Positive staining of the tumour with: factor XIIIa (cytoplasmic), SMA (cytoplasmic - focal), WT1 (granular cytoplasmic - focal), CD10 (membranous/cytoplasmic), CD68 (cytoplasmic).
			-Negative staining of the tumour with: S100, p63, CD34, LMWK, CK5/6.


	===Final diagnosis===		===Final diagnosis===
	Forearm lesion, left, re-excision:<br>		Forearm lesion, left, re-excision:<br>
	~~Pleomorphic undifferentiated sarcoma~~ (~~malignant fibrous histiocytoma~~) ~~with deep margin focally positive~~.<br>		-PLEOMORPHIC UNDIFFERENTIATED SARCOMA OF THE SKIN (MALIGNANT FIBROUS HISTIOCYTOMA) WITH DEEP MARGIN FOCALLY POSITIVE, RE-EXCISION IS SUGGESTED.<br>
	~~Dermal scar~~.		-DERMAL SCAR.

	== DFSP ==		== DFSP ==

Michael: /* DFSP */

2011-09-15T16:19:11Z

DFSP

← Older revision		Revision as of 16:19, 15 September 2011
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	The sections show thick collagen bundles in the dermis covered by a flat epidermis with basal hyperpigmentation (dermal scar). This is surrounded by a cellular, poorly demarcated, dermal-based spindle cell lesion with a storiform pattern. There is no significant atypia or mitotic activity. The lesion extends, focally, to the deep margin (block A5) and contains adipose tissue within it (honeycomb pattern).		The sections show thick collagen bundles in the dermis covered by a flat epidermis with basal hyperpigmentation (dermal scar). This is surrounded by a cellular, poorly demarcated, dermal-based spindle cell lesion with a storiform pattern. There is no significant atypia or mitotic activity. The lesion extends, focally, to the deep margin (block A5) and contains adipose tissue within it (honeycomb pattern).

	Immunohistochemical ~~staining~~ show that the lesion is strongly CD34 positive and negative for factor XIIIa.		Immunohistochemical stains show that the lesion is strongly CD34 positive and negative for factor XIIIa.

Michael at 16:17, 15 September 2011

2011-09-15T16:17:33Z

← Older revision		Revision as of 16:17, 15 September 2011
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	===Microscopic description===		===Microscopic description===
	The sections show a thick collagen bundles in the dermis covered by a flat epidermis with basal hyperpigmentation (dermal scar). This is surrounded by a cellular, poorly demarcated, dermal-based spindle cell lesion with a storiform pattern. There is no significant atypia or mitotic activity. The lesion extends to the deep margin (block A5) and~~, focally,~~ contains adipose tissue within it.		The sections show thick collagen bundles in the dermis covered by a flat epidermis with basal hyperpigmentation (dermal scar). This is surrounded by a cellular, poorly demarcated, dermal-based spindle cell lesion with a storiform pattern. There is no significant atypia or mitotic activity. The lesion extends, focally, to the deep margin (block A5) and contains adipose tissue within it (honeycomb pattern).

			Immunohistochemical staining show that the lesion is strongly CD34 positive and negative for factor XIIIa.

	~~Immunohistochemical staining show that the lesion is CD34 strongly positive and weakly for factor XIIIa~~

	===Final diagnosis===		===Final diagnosis===
	Skin, left abdomen, re-excision:<br>		Skin, left abdomen, re-excision:<br>
	DERMATOFIBROSARCOMA PROTUBERANS WITH POSITIVE DEEP MARGIN.<br>		-DERMATOFIBROSARCOMA PROTUBERANS WITH POSITIVE DEEP MARGIN, RE-EXCISION SUGGESTED.<br>
	DERMAL SCAR.		-DERMAL SCAR.

Michael: /* DFSP */ new section

2011-09-14T20:26:37Z

DFSP: new section

← Older revision		Revision as of 20:26, 14 September 2011
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	Pleomorphic undifferentiated sarcoma (malignant fibrous histiocytoma) with deep margin focally positive.<br>		Pleomorphic undifferentiated sarcoma (malignant fibrous histiocytoma) with deep margin focally positive.<br>
	Dermal scar.		Dermal scar.

			== DFSP ==

			===Microscopic description===
			The sections show a thick collagen bundles in the dermis covered by a flat epidermis with basal hyperpigmentation (dermal scar). This is surrounded by a cellular, poorly demarcated, dermal-based spindle cell lesion with a storiform pattern. There is no significant atypia or mitotic activity. The lesion extends to the deep margin (block A5) and, focally, contains adipose tissue within it.

			Immunohistochemical staining show that the lesion is CD34 strongly positive and weakly for factor XIIIa

			===Final diagnosis===
			Skin, left abdomen, re-excision:<br>
			DERMATOFIBROSARCOMA PROTUBERANS WITH POSITIVE DEEP MARGIN.<br>
			DERMAL SCAR.

Michael: /* PUS */ new section

2011-09-14T17:41:28Z

PUS: new section

← Older revision		Revision as of 17:41, 14 September 2011
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	Actinic keratosis.<br>		Actinic keratosis.<br>
	Solar elastosis.<br>		Solar elastosis.<br>

			== PUS ==

			===Microscopic===
			The sections shows an atypical spindle cell lesions in the deep dermis, with a storiform and fascicular pattern, marked nuclear pleomorphism and very high mitotic activity (129 mitoses / 10 HPF, field diameter 0.55 mm). The spindle cells have moderate-to-abundant partially vaculated eosinophilic-to-amphophilic cytoplasm, ellipsoid-to-ovoid nuclei with coarse, irregular chromatin and, focally, nucleoli visible with the 10x objective. Malignant multinucleated-cells are identified focally with abundant pale gray cytoplasm. Suture material and reactive foreign body giant cells are seen.

			===Final diagnosis===
			Forearm lesion, left, re-excision:<br>
			Pleomorphic undifferentiated sarcoma (malignant fibrous histiocytoma) with deep margin focally positive.<br>
			Dermal scar.

Michael: /* SCC in situ, actinic keratosis */ new section

2011-09-14T16:38:23Z

SCC in situ, actinic keratosis: new section

← Older revision		Revision as of 16:38, 14 September 2011
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	Comment: The tumour is present in one of the tips; thus, the lesion is at least closely excised.		Comment: The tumour is present in one of the tips; thus, the lesion is at least closely excised.

			== SCC in situ, actinic keratosis ==

			===Microscopic description===
			A. The sections show superficial skin with benign, underlying skeletal muscle.
			The skin shows full thickness nuclear atypia (including moderate-to-marked nuclear enlargement, nuclear hyperchromasia) at a site of ulceration and in a region with overlying hyperkeratosis (squamous cell carcinoma in situ). Several atypical mitoses are identified. The edge of the lesion shows nuclear changes, including hyperchromasia and nuclear enlargement, in the basal layer (actinic keratosis). Severe solar elastosis is present.

			B. The sections show superficial skin with full thickness nuclear atypia (including mild-to-moderate nuclear enlargement, nuclear hyperchromasia) in a region with overlying hyperkeratosis (squamous cell carcinoma in situ). Mitoses and dyskeratotic cells are numerous. The edge of the lesion shows nuclear changes, including hyperchromasia and nuclear enlargement, in the basal layer (actinic keratosis). Solar elastosis is present.


			===Final diagnosis===
			A. Left upper lip, lesion, excision:<br>
			Squamous cell carcinoma in situ, resection margin close.<br>
			Actinic keratosis.<br>
			Severe solar elastosis.<br>
			Focal ulceration.

			B. Right dorsal wrist, lesion, excision:<br>
			Squamous cell carcinoma in situ.<br>
			Actinic keratosis.<br>
			Solar elastosis.<br>

Michael at 16:19, 14 September 2011

2011-09-14T16:19:51Z

← Older revision		Revision as of 16:19, 14 September 2011
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	==Basal cell carcinoma==		==Basal cell carcinoma==
	===Microscopic===		===Microscopic===
	The sections show nests of basaloid cells in the superficial dermis with peripheral palisading of the nuclei. The nests demonstrate focal clefting with the surrounding myxoid stroma. Dense superficial dermal collagen bundles running parallel to the dermal-epidermal junction is seen in association with loss of the rete ridges and mononuclear, perivascular inflammatory cells (dermal scar). The tumour is present in one of the tips (block A1).		The sections show nests of basaloid cells in the superficial dermis with peripheral palisading of the nuclei. The nests demonstrate focal clefting with the surrounding myxoid stroma.

			Dense superficial dermal collagen bundles running parallel to the dermal-epidermal junction are seen in association with loss of the rete ridges and mononuclear, perivascular inflammatory cells (dermal scar). The tumour is present in one of the tips (block A1).

	===Final diagnosis===		===Final diagnosis===

Michael: +BCC

2011-09-14T16:19:03Z

+BCC

New page

==Basal cell carcinoma==
===Microscopic===
The sections show nests of basaloid cells in the superficial dermis with peripheral palisading of the nuclei. The nests demonstrate focal clefting with the surrounding myxoid stroma. Dense superficial dermal collagen bundles running parallel to the dermal-epidermal junction is seen in association with loss of the rete ridges and mononuclear, perivascular inflammatory cells (dermal scar). The tumour is present in one of the tips (block A1).

===Final diagnosis===
Skin, scalp, excisional biopsy:<br>
Basal cell carcinoma, see comment.<br>
Dermal scar.<br>

Comment: The tumour is present in one of the tips; thus, the lesion is at least closely excised.