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| ==Cutaneous T-cell lymphoma== | | ==Cutaneous T-cell lymphoma== |
| *Abbreviated CTCL. | | *Abbreviated CTCL. |
| | | {{Main|Cutaneous T-cell lymphoma}} |
| ===General===
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| *''Mycosis fungoides'' - is a subtype (???).
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| *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>
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| Stages - like [[Kaposi sarcoma]]:
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| *Patch.
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| *Plaque.
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| *Nodular.
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| ===Microscopic===
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| *Atypical lymphocytes:
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| **Have folded "cerebriform" nuclei; ''Sezary-Lutzner cells''.<ref name=Ref_Klatt385>{{Ref Klatt|385}}</ref>
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| *Grouping:
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| **Nests in the epidermis - known as "Pautrier microabscesses".
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| **Single lymphocytes in epidermis - without accompanying edema.
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| **Short linear arrays of lymphocytes along the basal layer of the epidermis; "epidermotropism".<ref name=Ref_Klatt385>{{Ref Klatt|385}}</ref>
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| DDx:
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| *[[Lymphomatoid papulosis]].
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| ====Images====
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| <gallery>
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| Image:Cutaneous_T-cell_lymphoma_-_very_high_mag.jpg | CTCL - very high mag. (WC/Nephron)
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| Image:Cutaneous_T-cell_lymphoma_-_intermed_mag.jpg | CTCL - intermed. mag. (WC/Nephron)
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| </gallery>
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| www:
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| *[http://www.jci.org/articles/view/24826/figure/2 CTCL (jci.org)].
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| *[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)].
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| ===IHC===
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| Key stain:
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| *CD4 +ve.<ref>{{Ref PBoD8|1185}}</ref>
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| Other stains:
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| *CD3 +ve.
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| *CD8 -ve.
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| *CD20 -ve (to r/o significant B cell population).
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| *CD30 -ve.
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| *CD5 +ve.
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| *CD7 -ve (often lost first in T cell lymphomas).
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| *Ki-67 high.
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| *CD56 -ve.
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| ==Merkel cell carcinoma== | | ==Merkel cell carcinoma== |
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| ==Trichilemmal carcinoma== | | ==Trichilemmal carcinoma== |
| ===General===
| | {{Main|Trichilemmal carcinoma}} |
| *Super rare.
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| *Not well-described.
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| ===Microscopic===
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| Features:<ref>{{Ref Derm|399-400}}</ref>
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| *Clear (glycogen-rich) cytoplasm in center of lesion.
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| *Peripheral palisading at edge of lesion - root sheath differentiation (hair follicle).
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| *Contiguous with hair follicle ''or'' assoc. with [[trichilemmoma]].
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| DDx:
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| *[[Squamous cell carcinoma]], clear cell variant.
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| *[[Basal cell carcinoma]], clear cell variant.
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| *[[Trichilemmoma]].
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| ==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> |
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| ===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>
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| ==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>
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| *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>
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| *Muliple trichilemmomas associated with [[Cowden syndrome]].<ref name=Ref_Derm386>{{Ref Derm|386}}</ref>
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| ===Microscopic===
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| Features:<ref name=Ref_Derm386>{{Ref Derm|386}}</ref>
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| *Superficial dermal lesion contiguous with the epidermis:
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| **Core of lesion:
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| ***Cuboidal cells with round nuclei, eosinophilic-clear cytoplasm.
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| **Periphery of lesion:
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| ***Surrounded by hyaline band.
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| ***Peripheral palisading.
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| DDx:
| | ==Poroma== |
| *[[Trichilemmal carcinoma]].
| | {{Main|Poroma}} |
| *[[Basal cell carcinoma]].
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| *[[Inverted follicular keratosis]].
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| Images:
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| *[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>
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| *[http://ccr.cancer.gov/staff/images/9033_12822_Lee_1521.jpg Trichilemmoma - high mag. (cancer.gov)].<ref name=lee/>
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| *[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>
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| *[http://www.flickr.com/photos/40981620@N04/3812019838/in/pool-1185084@N23/ Trichilemmoma - low mag. (flickr.com/Irlam)].
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| *[http://www.flickr.com/photos/40981620@N04/3812019930/in/pool-1185084@N23/ Trichilemmoma - intermed. mag. (flickr.com/Irlam)].
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| *[http://www.flickr.com/photos/40981620@N04/3811204517/in/pool-1185084@N23/ Trichilemmoma - high mag. (flickr.com/Irlam)].
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| ==Eccrine poroma==
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| ===General=== | |
| *Benign tumour arising from the distal sweat duct.
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| *Erythematous - gross.
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| ===Microscopic===
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| 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>
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| *Broad sheets of basaloid cells - attached to the epidermis - containing ductal structures - '''key feature'''.
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| *Biphasic stroma:
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| *#Edematous stroma.
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| *#Sclerotic stroma.
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| *Moderate nuclear pleomorphism.
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| *+/-Occasional mitoses.
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| Notes:
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| *Area above gland appears crusted.
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| DDx:
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| *[[Trichilemmoma]].
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| *[[Nodular hidradenoma]].
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| Images:
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| *[http://www.flickr.com/photos/40981620@N04/3808316834/in/photostream/ Eccrine poroma - low mag. (flickr.com)]
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| *[http://www.flickr.com/photos/40981620@N04/3807502071/in/photostream Eccrine poroma - intermed. mag. (flickr.com)].
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| ==Nodular hidradenoma== | | ==Nodular hidradenoma== |
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| ==Trichofolliculoma== | | ==Trichofolliculoma== |
| ===General===
| | {{Main|Trichofolliculoma}} |
| *Benign.
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| ===Microscopic===
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| Features:<ref name=Ref_Derm382>{{Ref Derm|382}}</ref>
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| *Irregular hair follicle (basilar nest of cells with an acellular hair shaft) with:
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| **Smaller satellites (follicles) consisting of well-circumscribed basilar cells.
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| Note:
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| *Lack artificial clefting between the (basilar) nests and stroma (seen in [[BCC]]).
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| *Surrounding stroma does not have a basophilic tingle (seen in [[BCC]]).
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| DDx:
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| *[[Trichoblastoma]].
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| *[[Basal cell carcinoma]].
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| *[[Pilar sheath acanthoma]].
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| ====Images====
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| www:
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| *[http://www.dermatopathonline.com/trichofolliculoma2.html Trichofolliculoma - several images (dermatopathonline.com)].
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| <gallery>
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| Image:SkinTumors-P6190340.JPG | Trichofolliculoma. (WC)
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| </gallery>
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| ==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> |
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| ===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. |
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