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Difference between revisions of "Talk:Dermatologic neoplasms"
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Talk:Dermatologic neoplasms (view source)
Revision as of 19:52, 28 September 2011
, 19:52, 28 September 2011→Microscopic: more
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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). | ||
| Line 32: | Line 32: | ||
Actinic keratosis.<br> | Actinic keratosis.<br> | ||
Solar elastosis.<br> | Solar elastosis.<br> | ||
== PUS/AFX == | |||
===Microscopic=== | |||
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=== | |||
Forearm lesion, left, re-excision:<br> | |||
-PLEOMORPHIC UNDIFFERENTIATED SARCOMA OF THE SKIN (MALIGNANT FIBROUS HISTIOCYTOMA) WITH DEEP MARGIN FOCALLY POSITIVE, RE-EXCISION IS SUGGESTED.<br> | |||
-DERMAL SCAR. | |||
== DFSP == | |||
===Microscopic description=== | |||
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 stains show that the lesion is strongly CD34 positive and negative for factor XIIIa. | |||
===Final diagnosis=== | |||
Skin, left abdomen, re-excision:<br> | |||
-DERMATOFIBROSARCOMA PROTUBERANS WITH POSITIVE DEEP MARGIN, RE-EXCISION SUGGESTED.<br> | |||
-DERMAL SCAR. | |||