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Dermatologic neoplasms (view source)

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==Cutaneous T-cell lymphoma==
==Cutaneous T-cell lymphoma==
*Abbreviated CTCL.
*Abbreviated CTCL.
 
{{Main|Cutaneous T-cell lymphoma}}
===General===
*''Mycosis fungoides'' - is a subtype (???).
*CTCL is more common than cutaneous B-cell lymphoma (CBCL).<ref>URL: [http://emedicine.medscape.com/article/1099540-overview http://emedicine.medscape.com/article/1099540-overview]. Accessed on: 24 August 2010.</ref><ref>URL: [http://emedicine.medscape.com/article/1098342-overview http://emedicine.medscape.com/article/1098342-overview]. Accessed on: 24 August 2010.</ref>
 
Stages - like [[Kaposi sarcoma]]:
*Patch.
*Plaque.
*Nodular.
 
===Microscopic===
*Atypical lymphocytes:
**Have folded "cerebriform" nuclei; ''Sezary-Lutzner cells''.<ref name=Ref_Klatt385>{{Ref Klatt|385}}</ref>
*Grouping:
**Nests in the epidermis - known as "Pautrier microabscesses".
**Single lymphocytes in epidermis - without accompanying edema.
**Short linear arrays of lymphocytes along the basal layer of the epidermis; "epidermotropism".<ref name=Ref_Klatt385>{{Ref Klatt|385}}</ref>
 
DDx:
*[[Lymphomatoid papulosis]].
 
====Images====
<gallery>
Image:Cutaneous_T-cell_lymphoma_-_very_high_mag.jpg | CTCL - very high mag. (WC/Nephron)
Image:Cutaneous_T-cell_lymphoma_-_intermed_mag.jpg | CTCL - intermed. mag. (WC/Nephron)
</gallery>
www:
*[http://www.jci.org/articles/view/24826/figure/2 CTCL (jci.org)].
*[http://www.mdconsult.com/das/book/body/199872830-2/0/1709/I4-u1.0-B978-0-443-06694-8..50117-2--f2.fig CTCL (mdconsult.com)].
 
===IHC===
Key stain:
*CD4 +ve.<ref>{{Ref PBoD8|1185}}</ref>
 
Other stains:
*CD3 +ve.
*CD8 -ve.
*CD20 -ve (to r/o significant B cell population).
*CD30 -ve.
*CD5 +ve.
*CD7 -ve (often lost first in T cell lymphomas).
*Ki-67 high.
*CD56 -ve.


==Merkel cell carcinoma==
==Merkel cell carcinoma==
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==Trichilemmal carcinoma==
==Trichilemmal carcinoma==
===General===
{{Main|Trichilemmal carcinoma}}
*Super rare.
*Not well-described.
 
===Microscopic===
Features:<ref>{{Ref Derm|399-400}}</ref>
*Clear (glycogen-rich) cytoplasm in center of lesion.
*Peripheral palisading at edge of lesion - root sheath differentiation (hair follicle).
*Contiguous with hair follicle ''or'' assoc. with [[trichilemmoma]].
 
DDx:
*[[Squamous cell carcinoma]], clear cell variant.
*[[Basal cell carcinoma]], clear cell variant.
*[[Trichilemmoma]].


==Lymphomatoid papulosis==
==Lymphomatoid papulosis==
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*Benign sweat duct tumour.
*Benign sweat duct tumour.
*Eccrine differentiation.
*Eccrine differentiation.
*Usually close to lower eyelid.<ref>{{Ref PBoD8|1177}}</ref>
*Usually close to lower [[eyelid]].<ref>{{Ref PBoD8|1177}}</ref>


===Microscopic===
===Microscopic===
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Images:
Images:
*[http://archive.ispub.com/journal/the-internet-journal-of-dermatology/volume-7-number-1/cutaneous-mixed-tumor.article-g01.fs.jpg Chondroid syringoma - low mag. (ispub.com)].<ref name=ispub_mts>URL: [http://www.ispub.com/journal/the_internet_journal_of_dermatology/volume_7_number_2_23/article/cutaneous_mixed_tumor.html http://www.ispub.com/journal/the_internet_journal_of_dermatology/volume_7_number_2_23/article/cutaneous_mixed_tumor.html]. Access on: 21 September 2011.</ref>
*[https://www.dermnetnz.org/topics/apocrine-mixed-tumour-pathology Chondroid syringoma (DermnetNZ)].
*[http://archive.ispub.com/journal/the-internet-journal-of-dermatology/volume-7-number-1/cutaneous-mixed-tumor.article-g02.fs.jpg Chondroid syringoma - high mag. (ispub.com)].<ref name=ispub_mts>URL: [http://www.ispub.com/journal/the_internet_journal_of_dermatology/volume_7_number_2_23/article/cutaneous_mixed_tumor.html http://www.ispub.com/journal/the_internet_journal_of_dermatology/volume_7_number_2_23/article/cutaneous_mixed_tumor.html]. Access on: 21 September 2011.</ref>


==Dermal cylindroma==
==Dermal cylindroma==
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==Trichilemmoma==
==Trichilemmoma==
*May be spelled ''tricholemmoma''.
*May be spelled ''tricholemmoma''.
===General===
{{Main|Trichilemmoma}}
*Benign neoplasm with features of the pilosebaceous follicular epithelium.<ref>URL: [http://emedicine.medscape.com/article/1059940-overview http://emedicine.medscape.com/article/1059940-overview]. Accessed on: 2 September 2011.</ref>
*Associated with ''nevus sebaceous''.<ref name=pmid16503928>{{Cite journal  | last1 = Baykal | first1 = C. | last2 = Buyukbabani | first2 = N. | last3 = Yazganoglu | first3 = KD. | last4 = Saglik | first4 = E. | title = [Tumors associated with nevus sebaceous]. | journal = J Dtsch Dermatol Ges | volume = 4 | issue = 1 | pages = 28-31 | month = Jan | year = 2006 | doi = 10.1111/j.1610-0387.2006.05855.x | PMID = 16503928 }}</ref>
*Muliple trichilemmomas associated with [[Cowden syndrome]].<ref name=Ref_Derm386>{{Ref Derm|386}}</ref>
 
===Microscopic===
Features:<ref name=Ref_Derm386>{{Ref Derm|386}}</ref>
*Superficial dermal lesion contiguous with the epidermis:
**Core of lesion:
***Cuboidal cells with round nuclei, eosinophilic-clear cytoplasm.
**Periphery of lesion:
***Surrounded by hyaline band.
***Peripheral palisading.


DDx:
==Poroma==
*[[Trichilemmal carcinoma]].
{{Main|Poroma}}
*[[Basal cell carcinoma]].
*[[Inverted follicular keratosis]].
 
Images:
*[http://ccr.cancer.gov/staff/images/9033_12822_Lee_1520.jpg Trichilemmoma - low mag. (cancer.gov)].<ref name=lee>URL: [http://ccr.cancer.gov/staff/gallery.asp?profileid=12822 http://ccr.cancer.gov/staff/gallery.asp?profileid=12822]. Accessed on: 2 September 2011.</ref>
*[http://ccr.cancer.gov/staff/images/9033_12822_Lee_1521.jpg Trichilemmoma - high mag. (cancer.gov)].<ref name=lee/>
*[http://dermimages.med.jhmi.edu/images/trichilemmoma_1_060109.jpg Trichilemmoma (jhmi.edu)].<ref>URL: [http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=667496720 http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=667496720]. Accessed on: 2 September 2011.</ref>
*[http://www.flickr.com/photos/40981620@N04/3812019838/in/pool-1185084@N23/ Trichilemmoma - low mag. (flickr.com/Irlam)].
*[http://www.flickr.com/photos/40981620@N04/3812019930/in/pool-1185084@N23/ Trichilemmoma - intermed. mag. (flickr.com/Irlam)].
*[http://www.flickr.com/photos/40981620@N04/3811204517/in/pool-1185084@N23/ Trichilemmoma - high mag. (flickr.com/Irlam)].
 
==Eccrine poroma==
===General===
*Benign tumour arising from the distal sweat duct.
*Erythematous - gross.
 
===Microscopic===
Features:<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70190-5 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70190-5]. Accessed on: 2 July 2010.</ref>
*Broad sheets of basaloid cells - attached to the epidermis - containing ductal structures - '''key feature'''.
*Biphasic stroma:
*#Edematous stroma.
*#Sclerotic stroma.
*Moderate nuclear pleomorphism.
*+/-Occasional mitoses.
 
Notes:
*Area above gland appears crusted.
 
DDx:
*[[Trichilemmoma]].
*[[Nodular hidradenoma]].
 
Images:
*[http://www.flickr.com/photos/40981620@N04/3808316834/in/photostream/ Eccrine poroma - low mag. (flickr.com)]
*[http://www.flickr.com/photos/40981620@N04/3807502071/in/photostream Eccrine poroma - intermed. mag. (flickr.com)].


==Nodular hidradenoma==
==Nodular hidradenoma==
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==Trichofolliculoma==
==Trichofolliculoma==
===General===
{{Main|Trichofolliculoma}}
*Benign.
 
===Microscopic===
Features:<ref name=Ref_Derm382>{{Ref Derm|382}}</ref>
*Irregular hair follicle (basilar nest of cells with an acellular hair shaft) with:
**Smaller satellites (follicles) consisting of well-circumscribed basilar cells.
 
Note:
*Lack artificial clefting between the (basilar) nests and stroma (seen in [[BCC]]).
*Surrounding stroma does not have a basophilic tingle (seen in [[BCC]]).
 
DDx:
*[[Trichoblastoma]].
*[[Basal cell carcinoma]].
*[[Pilar sheath acanthoma]].
 
====Images====
www:
*[http://www.dermatopathonline.com/trichofolliculoma2.html Trichofolliculoma - several images (dermatopathonline.com)].
<gallery>
Image:SkinTumors-P6190340.JPG | Trichofolliculoma. (WC)
</gallery>


==Apocrine carcinoma of the skin==
==Apocrine carcinoma of the skin==
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Note:
Note:
*The ''digital papillary adenoma'' is considered malignant; the AFIP says these are best classified as ''adenocarcinomas'', i.e. ''digital papillary adenocarcinoma''.<ref name=pmid10843279>{{Cite journal  | last1 = Duke | first1 = WH. | last2 = Sherrod | first2 = TT. | last3 = Lupton | first3 = GP. | title = Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). | journal = Am J Surg Pathol | volume = 24 | issue = 6 | pages = 775-84 | month = Jun | year = 2000 | doi =  | PMID = 10843279 }}</ref>
*The ''digital papillary adenoma'' is considered malignant; the AFIP says these are best classified as ''adenocarcinomas'', i.e. ''[[digital papillary adenocarcinoma]]''.<ref name=pmid10843279>{{Cite journal  | last1 = Duke | first1 = WH. | last2 = Sherrod | first2 = TT. | last3 = Lupton | first3 = GP. | title = Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). | journal = Am J Surg Pathol | volume = 24 | issue = 6 | pages = 775-84 | month = Jun | year = 2000 | doi =  | PMID = 10843279 }}</ref>


===Microscopic===
===Microscopic===
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DDx:
DDx:
*Digital papillary adenocarcinoma - location important.
*[[Digital papillary adenocarcinoma]] - location important.
*[[Tubular apocrine adenoma]] (tubulopapillary hidradenoma<ref name=pmid1566975>{{Cite journal  | last1 = Fox | first1 = SB. | last2 = Cotton | first2 = DW. | title = Tubular apocrine adenoma and papillary eccrine adenoma. Entities or unity? | journal = Am J Dermatopathol | volume = 14 | issue = 2 | pages = 149-54 | month = Apr | year = 1992 | doi =  | PMID = 1566975 }}</ref>) - a related tumour.<ref name=pmid8238787>{{Cite journal  | last1 = Ishiko | first1 = A. | last2 = Shimizu | first2 = H. | last3 = Inamoto | first3 = N. | last4 = Nakmura | first4 = K. | title = Is tubular apocrine adenoma a distinct clinical entity? | journal = Am J Dermatopathol | volume = 15 | issue = 5 | pages = 482-7 | month = Oct | year = 1993 | doi =  | PMID = 8238787 }}</ref>
*[[Tubular apocrine adenoma]] (tubulopapillary hidradenoma<ref name=pmid1566975>{{Cite journal  | last1 = Fox | first1 = SB. | last2 = Cotton | first2 = DW. | title = Tubular apocrine adenoma and papillary eccrine adenoma. Entities or unity? | journal = Am J Dermatopathol | volume = 14 | issue = 2 | pages = 149-54 | month = Apr | year = 1992 | doi =  | PMID = 1566975 }}</ref>) - a related tumour.<ref name=pmid8238787>{{Cite journal  | last1 = Ishiko | first1 = A. | last2 = Shimizu | first2 = H. | last3 = Inamoto | first3 = N. | last4 = Nakmura | first4 = K. | title = Is tubular apocrine adenoma a distinct clinical entity? | journal = Am J Dermatopathol | volume = 15 | issue = 5 | pages = 482-7 | month = Oct | year = 1993 | doi =  | PMID = 8238787 }}</ref>


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*Vimentin +ve.
*Vimentin +ve.
*CEA +ve.
*CEA +ve.
*EMA +ve.
*[[EMA]] +ve.
*S-100 +ve.
*S-100 +ve.


Michael
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