Difference between revisions of "Dermatologic neoplasms"

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(→‎Melanoma: trim -- split-out into malignant melanoma)
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==Melanoma==
==Melanoma==
{{Main|Malignant melanoma}}
===General===
===General===
*[[AKA]] ''Malignant melanoma''.
*Main DDx: [[melanocytic lesions]] - especially if pigmented.
*Known as the great mimicker in pathology; it may look like many things.
*Known as the great mimicker in pathology; it may look like many things.
====Clinical====
*''ABCD'' = asymmetric, borders (irregular), colour (black), diameter (large).


===Microscopic===
===Microscopic===
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**Marked nuclear pleomorphism - variation in cell size, shape & staining (like in ''serous carcinoma'' of the ovary).
**Marked nuclear pleomorphism - variation in cell size, shape & staining (like in ''serous carcinoma'' of the ovary).
**[[Nuclear pseudoinclusions]] (like in ''papillary thyroid carcinoma'').
**[[Nuclear pseudoinclusions]] (like in ''papillary thyroid carcinoma'').
Notes:
*Can look almost like anything.
**Like it is said that [[sarcoidosis]] is in every internal medicine DDx... melanoma is every pathologic DDx.
*Melanomas with:
**An epitheloid cell morphology may mimic adenocarcinoma.
**A spindle cell morphology may mimic spindle cell carcinoma (squamous cell carcinoma) or a sarcoma.
===[[Electron microscopy]]===
*Melanosomes.
Image(s):
*[http://www.nature.com/nrm/journal/v8/n10/fig_tab/nrm2258_F1.html Melanosomes (nature.com)].
===Stains===
*''Fontana-Masson stain'', stains melanin.<ref>URL: [http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exfontana.htm http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exfontana.htm]. Accessed on: 5 May 2010.</ref>
**May be useful to differentiate melanin from other brown stuff (e.g. lipofuscin, hemosiderin).
===[[IHC]]===
Standard panel:
*S-100 +ve.
*HMB-45 +ve.
*Melan A (MART-1) +ve.
Others:
*SOX10 +ve -- useful for diff. from excision scar.<ref name=pmid20653825>{{cite journal |author=Ramos-Herberth FI, Karamchandani J, Kim J, Dadras SS |title=SOX10 immunostaining distinguishes desmoplastic melanoma from excision scar |journal=J. Cutan. Pathol. |volume=37 |issue=9 |pages=944–52 |year=2010 |month=September |pmid=20653825 |doi=10.1111/j.1600-0560.2010.01568.x |url=}}</ref>
**SOX-10 = pan-schwannian and melanocytic marker.
Notes:
*The standard panel above (S-100, HMB-45, MART-1) is also positive in other lesions, e.g. ''cellular blue nevus''.


==Dermatofibrosarcoma protuberans==
==Dermatofibrosarcoma protuberans==
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