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=Less common malignant= | =Less common malignant= | ||
==Dermatofibrosarcoma protuberans== | ==Dermatofibrosarcoma protuberans== | ||
*Abbreviated ''DFSP''. | *Abbreviated ''DFSP''. | ||
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==Merkel cell carcinoma== | ==Merkel cell carcinoma== | ||
*Abbreviated ''MCC''. | |||
===General=== | |||
*Aggressive. | |||
*Rare. | |||
*Increased risk in the immunodeficient. | |||
*Most caused by ''Merkel cell polyomavirus''.<ref name=pmid18202256>{{Cite journal | last1 = Feng | first1 = H. | last2 = Shuda | first2 = M. | last3 = Chang | first3 = Y. | last4 = Moore | first4 = PS. | title = Clonal integration of a polyomavirus in human Merkel cell carcinoma. | journal = Science | volume = 319 | issue = 5866 | pages = 1096-100 | month = Feb | year = 2008 | doi = 10.1126/science.1152586 | PMID = 18202256 }}</ref> | |||
===General=== | ===General=== | ||
Features:<ref name=pmid20418670>{{Cite journal | last1 = Calder | first1 = KB. | last2 = Smoller | first2 = BR. | title = New insights into merkel cell carcinoma. | journal = Adv Anat Pathol | volume = 17 | issue = 3 | pages = 155-61 | month = May | year = 2010 | doi = 10.1097/PAP.0b013e3181d97836 | PMID = 20418670 }}</ref> | Features:<ref name=pmid20418670>{{Cite journal | last1 = Calder | first1 = KB. | last2 = Smoller | first2 = BR. | title = New insights into merkel cell carcinoma. | journal = Adv Anat Pathol | volume = 17 | issue = 3 | pages = 155-61 | month = May | year = 2010 | doi = 10.1097/PAP.0b013e3181d97836 | PMID = 20418670 }}</ref> | ||
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===Microscopic=== | ===Microscopic=== | ||
Features:<ref name=Ref_WMSP491>{{Ref WMSP|491}}</ref> | Features:<ref name=Ref_WMSP491>{{Ref WMSP|491}}</ref> | ||
* | *Neuroendocrine nuclear features - round nucleus, small nucleoli/no nucleolus, stippled chromatin - '''key feature'''. | ||
*Typically medium size cells ~3x resting lymphocyte. | |||
**May be small or large. | |||
*Architecture: nests, sheets or trabeculae. | |||
*Scant cytoplasm. | *Scant cytoplasm. | ||
*Nuclear moulding. | *Abundant mitoses. | ||
* | *+/-Nuclear moulding. | ||
* | |||
DDx: | |||
*[[Basal cell carcinoma]] - no stippled chromatin, less mitoses active. | |||
*Cutaneous [[Ewing sarcoma]] - sorted-out with immunostains. | |||
*[[Lymphoma]]. | |||
Images: | |||
*[http://www.bccancer.bc.ca/HPI/CE/cytotechnology/cytosleuthquiz/nongyne/ng12hist.htm MCC (bccancer.bc.ca)]. | |||
*[http://www.joplink.net/prev/200403/07.html MCC (joplink.net)]. | |||
*[http://www.ispub.com/ispub/ijd/volume_5_number_2_8/concurrent_merkel_cell_carcinoma_and_bowen_s_disease_of_the_thigh/bowen-fig3.jpg Merkel cell carcinoma (ispub.com)]. | *[http://www.ispub.com/ispub/ijd/volume_5_number_2_8/concurrent_merkel_cell_carcinoma_and_bowen_s_disease_of_the_thigh/bowen-fig3.jpg Merkel cell carcinoma (ispub.com)]. | ||
*[http://commons.wikimedia.org/wiki/File:Merkelcellcarcinoma_Tag.jpg Merkel cell carcinoma - nested pattern (WC)]. | *[http://commons.wikimedia.org/wiki/File:Merkelcellcarcinoma_Tag.jpg Merkel cell carcinoma - nested pattern (WC)]. | ||
===IHC=== | ===IHC=== | ||
*CK7 -ve | Features: | ||
*CK7 -ve. | |||
*CK20 +ve. | |||
*CAM5.2 +ve (dot-like pattern). | |||
Others: | |||
*TTF-1 -ve. | |||
==Eccrine carcinoma== | ==Eccrine carcinoma== |
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