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'''Dermatologic cancer''' can be deadly.  Collectively, they are the most common forms of cancer.
This article deals with '''dermatologic neoplasms''', also known as '''skin tumours'''.  It includes '''dermatologic cancer''', which can be deadly.  Collectively, dermatologic cancers are the most common form of cancer.


==Squamous cell carcinoma==
An introduction to dermatopathy is found in the ''[[dermatopathology]]'' article. Non-malignant disease is covered in the ''[[non-malignant skin disease]]'' article.
Precursor:<ref>TN07 D6.</ref>
*Actinic keratosis (solar keratosis).
**Clinical: yellow-brown scaly, patches, sandpaper sensation.
*Keratocathoma - see ''[[non-malignant skin disease]]''.
**Some don't believe this entity exists.
***These people sign this entity as ''low grade squamous cell carcinoma, keratoacanthoma type''.<ref>RS. 17 May 2010.</ref>


=The Big Three malignant=
==Basal cell carcinoma==
==Basal cell carcinoma==
{{Main|Basal cell carcinoma}}
==Squamous cell carcinoma of the skin==
*Abbreviated ''skin SCC'', ''SCC of the skin'', and ''SCC of skin''.
{{Main|Squamous cell carcinoma of the skin}}
==Melanoma==
{{Main|Malignant melanoma}}
*Known as the great mimicker in pathology; it may look like many things.
=Less common malignant=
==Dermatofibrosarcoma protuberans==
*Abbreviated ''DFSP''.
{{Main|Dermatofibrosarcoma protuberans}}
==Cutaneous B-cell lymphoma==
*Abbreviated CBCL.
===General===
===General===
*Very common.
*CBCL is less common than cutaneous T-cell lymphoma (CTCL).<ref>URL: [http://emedicine.medscape.com/article/1099540-overview http://emedicine.medscape.com/article/1099540-overview]. Accessed on: 24 August 2010.</ref>
*Sun exposed skin.
 
*Very rarely metastasizes - so rare... some don't think this is really a malignancy.
===Microscopic===
Features:
*Dermal lymphoid infiltrate.
*"Grenz zone" - space between the epidermis and the dermal infiltrate - '''key feature'''.
 
===IHC===
*B cell and T cell markers.  
 
==Cutaneous T-cell lymphoma==
*Abbreviated CTCL.
{{Main|Cutaneous T-cell lymphoma}}


===Clinical===
==Merkel cell carcinoma==
*Telangiectasias.
{{Main|Merkel cell carcinoma}}
*Raised pearly nodule.


====As part of a syndrome====
==Eccrine carcinoma==
*Nevoid basal cell carcinoma syndrome (NBCCS), AKA ''Gorlin syndrome''.
===General===
*Bazex syndrome (X-linked).<ref>URL: [http://emedicine.medscape.com/article/1101146-diagnosis http://emedicine.medscape.com/article/1101146-diagnosis]. Accessed on: 6 May 2010.</ref>
*Arises from the proximal sweat duct.


===Microscopic===
===Microscopic===
Features:<ref>NEED REF.</ref>
Features:
*Artefactual separation of basal cell layer from underlying stroma.
*Pleomorphic nuclei with nucleoli.
*Palisading hyperchromatic cells.
*Duct-like structures - '''key feature'''.
*Extends from dermis into epidermis (follows path of a benign sweat duct).


Notes:
Notes:
*There are various subtypes: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970110-3 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970110-3].
*May resemble [[Extramammary Paget's disease]]/[[Paget's disease of the breast]].
 
==Kaposi sarcoma==
:See ''[[Kaposi sarcoma]]''.
 
==Sebaceous carcinoma==
{{Main|Sebaceous carcinoma}}
 
==Microcystic adnexal carcinoma==
{{Main|Microcystic adnexal carcinoma}}
 
==Trichilemmal carcinoma==
{{Main|Trichilemmal carcinoma}}
 
==Lymphomatoid papulosis==
===General===
*Rare.
*Benign behaviour.
 
===Microscopic===
Features:
*Dermal lymphocytosis.
**No epidermal lymphocytes.
*Focal nuclear atypia.
 
DDx:
*[[CTCL]].
*Cutaneous [[ALCL]].
 
===IHC===
*CD30 +ve.<ref>URL: [http://path.upmc.edu/cases/case513/dx.html http://path.upmc.edu/cases/case513/dx.html]. Accessed on: 25 January 2012.</ref>
 
=Rare malignant=
==Basosquamous carcinoma==
:Should '''not''' be confused with ''basaloid [[squamous cell carcinoma]]'' ([[AKA]] ''squamous cell carcinoma, basaloid variant'').
===General===
*Very rare.
**Largest case series, as of 2000, 35 cases.<ref name=pmid10717618>{{Cite journal  | last1 = Martin | first1 = RC. | last2 = Edwards | first2 = MJ. | last3 = Cawte | first3 = TG. | last4 = Sewell | first4 = CL. | last5 = McMasters | first5 = KM. | title = Basosquamous carcinoma: analysis of prognostic factors influencing recurrence. | journal = Cancer | volume = 88 | issue = 6 | pages = 1365-9 | month = Mar | year = 2000 | doi =  | PMID = 10717618 }}
</ref>
*May be considered an aggressive variant of [[basal cell carcinoma]].<ref name=pmid10717618/>
*Aggressive behaviour.<ref name=pmid12859383>{{Cite journal  | last1 = Bowman | first1 = PH. | last2 = Ratz | first2 = JL. | last3 = Knoepp | first3 = TG. | last4 = Barnes | first4 = CJ. | last5 = Finley | first5 = EM. | title = Basosquamous carcinoma. | journal = Dermatol Surg | volume = 29 | issue = 8 | pages = 830-2; discussion 833 | month = Aug | year = 2003 | doi =  | PMID = 12859383 }}.</ref>
 
===Microscopic===
Features:
*Has features of both [[basal cell carcinoma]] and [[squamous cell carcinoma of the skin|squamous cell carcinoma]].<ref name=pmid12859383/>
**BCC component usually predominant.<ref name=Ref_Derm397>{{Ref Derm|397}}</ref>
 
Note:
*''Busam'' notes that there is disagreement about what defines this tumour;<ref name=Ref_Derm372>{{Ref Derm|372}}</ref> however, he goes on the describe it as a ''[[collision tumour]]''.<ref name=Ref_Derm397>{{Ref Derm|397}}</ref>
 
DDx:
*Basaloid [[squamous cell carcinoma]].
*[[Basal cell carcinoma]] with squamous differentiation.
 
=Intermediate=
==Atypical fibroxanthoma==
*Abbreviated ''AFX''.
{{Main|Atypical fibroxanthoma}}
 
=Benign=
==Syringoma==
===General===
*Benign sweat duct tumour.
*Eccrine differentiation.
*Usually close to lower [[eyelid]].<ref>{{Ref PBoD8|1177}}</ref>
 
===Microscopic===
Features:<ref>URL: [http://emedicine.medscape.com/article/1059871-diagnosis http://emedicine.medscape.com/article/1059871-diagnosis]. Accessed on: 12 May 2010.</ref>
*Proliferation of benign ducts with lined by a bilayer (as in normal sweat ducts) with abnormal architecture:
**Tadpole like appearing ducts.


DDx:
DDx:
*Trichoepithelioma.
*Syringomatous adenomas of nipple (AKA syringoma of the nipple).<ref name=pmid22355740>{{Cite journal  | last1 = Boecker | first1 = W. | last2 = Junkers | first2 = T. | last3 = Reusch | first3 = M. | last4 = Buerger | first4 = H. | last5 = Korsching | first5 = E. | last6 = Metze | first6 = D. | last7 = Decker | first7 = T. | last8 = Loening | first8 = T. | last9 = Lange | first9 = A. | title = Origin and differentiation of breast nipple syringoma. | journal = Sci Rep | volume = 2 | issue =  | pages = 226 | month =  | year = 2012 | doi = 10.1038/srep00226 | PMID = 22355740 |URL = http://www.nature.com/srep/2012/120117/srep00226/full/srep00226.html }}</ref>
*[[Chondroid syringoma]]. (???)
 
Images:
*[http://www.flickr.com/photos/euthman/2329061316/ Syringoma (flickr.com)].
*[http://dermatology.cdlib.org/144/tumors/axillary_syringoma/2.jpg Syringoma (dermatology.cdlib.org)].<ref>{{Cite journal  | last1 = Nosrati | first1 = N. | last2 = Coleman | first2 = NM. | last3 = Hsu | first3 = S. | title = Axillary syringomas. | journal = Dermatol Online J | volume = 14 | issue = 4 | pages = 13 | month =  | year = 2008 | doi =  | PMID = 18627735 |URL = http://dermatology.cdlib.org/144/tumors/axillary_syringoma/hsu.html}}</ref>
 
==Chondroid syringoma==
*Used to be called ''mixed tumour of skin''.<ref name=pmid19693940>{{Cite journal  | last1 = Kumar | first1 = B. | title = Chondroid syringoma diagnosed by fine needle aspiration cytology. | journal = Diagn Cytopathol | volume = 38 | issue = 1 | pages = 38-40 | month = Jan | year = 2010 | doi = 10.1002/dc.21159 | PMID = 19693940 }}</ref>
 
===General===
*Mixed apocrine & eccrine tumour of skin, usually in the head & neck<ref name=pmid19693940/>, especially nose and cheek.<ref name=pmid19633639/>
*May be in major and minor salivary glands.<ref name=pmid19633639>{{Cite journal  | last1 = Rauso | first1 = R. | last2 = Santagata | first2 = M. | last3 = Tartaro | first3 = G. | last4 = Filipi | first4 = M. | last5 = Colella | first5 = G. | title = Chondroid syringoma: a rare tumor of orofacial region. | journal = Minerva Stomatol | volume = 58 | issue = 7-8 | pages = 383-8 | month =  | year =  | doi =  | PMID = 19633639 }}</ref>


==Melanoma==
===Microscopic===
*[[AKA]] ''Malignant melanoma''.
Features:
*Main DDx: [[melanocytic lesions]] - especially if pigmented.
*Mix tumour with:<ref name=pmid19693940/>
*Known as the great mimicker in pathology; it may look like many things.
*#Epithelial component:
*#*Nests of cells with:
*#**Moderate dull eosinophilic cytoplasm.
*#**Round/ovoid nuclei with nucleoli.
*#Mesenchymal component - '''key feature''':
*#*[[Chondromyxoid stroma]].
 
Images:
*[https://www.dermnetnz.org/topics/apocrine-mixed-tumour-pathology Chondroid syringoma  (DermnetNZ)].


===Clinical===
==Dermal cylindroma==
*''ABCD'' = asymmetric, borders (irregular), colour (black), diameter (large).
{{Main|Dermal cylindroma}}


===Histology===
==Keratoacanthoma==
*Classic appearance of melanoma:
{{Main|Keratoacanthoma}}
**Loosely cohesive; mix of small nests of cells, single cells.
 
**Mixed of spindle and ovoid cell morphology.
==Sebaceous adenoma==
**+/-Occasional large binucleated cells.
===General===
**Cytoplasm: brown pigment (melanin).
*Seen in [[Muir-Torre syndrome]] - a variant of [[Lynch syndrome]] (hereditary non-polyposis colon cancer).
**Prominent (large) red nucleoli (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'').


Notes:
Notes:
*Can look almost like anything.
*Sebaceous lesions (from benign to malignant): [[sebaceous hyperplasia]], sebaceous adenoma, sebaceoma, [[sebaceous carcinoma]].
**Like it is said that [[sarcoidosis]] is in every internal medicine DDx... melanoma is every pathologic DDx.
 
*Melanomas with:
===Microscopic===
**An epitheloid cell morphology may mimic adenocarcinoma.
Features:
**A spindle cell morphology may mimic spindle cell carcinoma (squamous cell carcinoma) or a sarcoma.
*Abnormal sebaceous glands (pale fluffy cytoplasm):
**Increased basal epithelium.
**Multiple dilated glands - opening to the surface.


===Stains===
====Images====
*''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>
<gallery>
**May be useful to differentiate melanin from other brown stuff (e.g. lipofuscin, hemosiderin).
Image:Sebaceous_adenoma_-_low_mag.jpg | Sebaceous adenoma - low mag. (WC/Nephron)
Image:Sebaceous_adenoma_-_high_mag.jpg | Sebaceous adenoma - high mag. (WC/Nephron)
</gallery>
www:
*[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=587283984 Sebaceous adenoma (jhmi.edu)].
 
==Trichilemmoma==
*May be spelled ''tricholemmoma''.
{{Main|Trichilemmoma}}


===Electron microscopy===
==Poroma==
*Melanosomes.
{{Main|Poroma}}


Image(s):
==Nodular hidradenoma==
*[http://www.nature.com/nrm/journal/v8/n10/fig_tab/nrm2258_F1.html Melanosomes (nature.com)].
*[[AKA]] ''eccrine acrospiroma''.<ref name=pmid18319032>{{Cite journal  | last1 = Punia | first1 = RP. | last2 = Garg | first2 = S. | last3 = Bal | first3 = A. | last4 = Mohan | first4 = H. | title = Pigmented nodular hidradenoma masquerading as nodular malignant melanoma. | journal = Dermatol Online J | volume = 14 | issue = 1 | pages = 15 | month =  | year = 2008 | doi =  | PMID = 18319032 |URL = http://dermatology.cdlib.org/141/case_presentations/hidradenoma/punia.html }}</ref>
{{Main|Nodular hidradenoma}}


===[[IHC]]===
==Trichoblastoma==
Standard panel:
{{Main|Trichoblastoma}}
*S-100 +ve.
*HMB-45 +ve.
*Melan A (MART-1) +ve.


Notes:
==Trichofolliculoma==
*The standard panel above is positive in other lesions also, e.g. ''cellular blue nevus''.
{{Main|Trichofolliculoma}}


==Dermatofibrosarcoma protuberans==
==Apocrine carcinoma of the skin==
===General===
===General===
*Abbreviated ''DFSP''.
*Rare.<ref name=pmid7678545>{{Cite journal  | last1 = Paties | first1 = C. | last2 = Taccagni | first2 = GL. | last3 = Papotti | first3 = M. | last4 = Valente | first4 = G. | last5 = Zangrandi | first5 = A. | last6 = Aloi | first6 = F. | title = Apocrine carcinoma of the skin. A clinicopathologic, immunocytochemical, and ultrastructural study. | journal = Cancer | volume = 71 | issue = 2 | pages = 375-81 | month = Jan | year = 1993 | doi =  | PMID = 7678545 }}</ref>
*Dermal location.
*Usually very good prognosis.<ref name=pmid7678545/>
*Destroys adnexal structures.


Treatment
===Microscopic===
*Wide excision.
Features:<ref name=pmid7678545/>
*Nests.
*Apocrine snouts - "decapitation secretion"


===Histology===
DDx:
*Spindle cell morphology.
*[[Paget disease of the breast]]/[[Extramammary Paget disease]].
*Contains adipose tissue within the tumour -- ''key feature''.
 
====Images====
<gallery>
Image:Apocrine_carcinoma_-_intermed_mag.jpg | Apocrine carcinoma - intermed. mag. (WC/Nephron)
Image:Apocrine_carcinoma_-_high_mag.jpg | Apocrine carcinoma - high mag. (WC/Nephron)
</gallery>
===Stains===
Features:<ref name=pmid7678545/>
*PAS +ve.
*PASD +ve.


===IHC===
===IHC===
Panel:<ref>AP. May 2009.</ref>
*[[GCDFP-15]] (gross cystic disease fluid protein-15) +ve.<ref name=pmid7678545/>
*CD34 +ve.
 
**Usually negative in dermatofibroma.<ref name=pmid7694515>PMID 7694515.</ref><ref name=pmid9129699>PMID 9129699.</ref>
==Dermatomyofibroma==
*Factor XIIIa -ve.
:Should ''not'' be confused with [[dermatofibroma]].
**Usually positive in dermatofibroma.<ref name=pmid7694515>PMID 7694515.</ref><ref name=pmid9129699>PMID 9129699.</ref>
*Abbreviated ''DMF''.
*S100 -ve (screen for melanoma).
===General===
*caldesmin -ve (screen for muscle differentiation).
*Uncommon.
*beta-catenin ???.
*MIB-1 (proliferation marker) -- should not be confused with ''MIB1'' a gene that regulates [[apoptosis]].


===DDx - histologic===
===Microscopic===
*Dermatofibroma - has entrapment of collagen bundles at the edge of the lesion.
Features:<ref name=Ref_Derm504>{{Ref Derm|504}}</ref>
*Poorly formed fasicles parallel to the skin surface, usu. restricted to the superficial dermis.
*Moderate cellular density - less cellular than [[DFSP]].
*Eosinophilic cytoplasm.


DDx:
*[[DFSP]].
*[[Dermatofibroma]].


==Cutaneous T cell lymphoma==
Images:
*Abbreviated CTCL.
*[http://www.dermpedia.org/node/8822 DMF - low mag. (dermpedia.org)].
*''Mycosis fungoides'' - is a subtype (???).
*[http://www.dermpedia.org/node/8824 DMF - high mag. (dermpedia.org)].


===Microscopic===
===IHC===
*Atypical lymphocytes:
Features:<ref name=Ref_Derm504>{{Ref Derm|504}}</ref>
**Have folded "cerebriform" nuclei; ''Sezary-Lutzner cells''.<ref>Klatt. AOP. P.385.</ref>
*CD10 +ve.
*Grouping:
*Vimentin +ve.
**Nests in the epidermis - known as "Pautrier microabscesses".
**Single lymphocytes in epidermis; "lymphocyte exocytosis".<ref>URL: [http://www.mdconsult.com/das/book/body/199872830-2/0/1709/I4-u1.0-B978-0-443-06694-8..50117-2--f2.fig http://www.mdconsult.com/das/book/body/199872830-2/0/1709/I4-u1.0-B978-0-443-06694-8..50117-2--f2.fig]. Accessed on: 6 May 2010.</ref>
**Short linear arrays of lymphocytes at the dermal-epidermal junction; "epidermotropism".<ref>Klatt. AOP. P.385.</ref>


Images:  
Others:<ref name=Ref_Derm504>{{Ref Derm|504}}</ref>
*[http://www.jci.org/articles/view/24826/figure/2 CTCL (jci.org)].
*CD34 -ve.
*[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)].
*Factor XIIIa -ve.
*S-100 -ve.


==Merkel cell carcinoma==
==Papillary eccrine adenoma==
*Abbreviated ''[[PEA]]''.
===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>
*Uncommon.
*Rare.
*Benign.<ref name=pmid857729>{{Cite journal  | last1 = Rulon | first1 = DB. | last2 = Helwig | first2 = EB. | title = Papillary eccrine adenoma. | journal = Arch Dermatol | volume = 113 | issue = 5 | pages = 596-8 | month = May | year = 1977 | doi = | PMID = 857729 }}</ref>
*Aggressive course/poor prognosis.
 
*Neuroendocrine-like.<ref name=pmid19395876>{{Cite journal  | last1 = Pulitzer | first1 = MP. | last2 = Amin | first2 = BD. | last3 = Busam | first3 = KJ. | title = Merkel cell carcinoma: review. | journal = Adv Anat Pathol | volume = 16 | issue = 3 | pages = 135-44 | month = May | year = 2009 | doi = 10.1097/PAP.0b013e3181a12f5a | PMID = 19395876 }}
Treatment:
</ref>
*Excision.<ref>URL: [http://archderm.jamanetwork.com/article.aspx?articleid=541159 http://archderm.jamanetwork.com/article.aspx?articleid=541159]. Accessed on: 10 December 2012.</ref>
===Gross===
*Central location.


Etiology:
Note:
*Polyomavirus (?).<ref name=pmid20418670/>
*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>
*Immunocompromised/immunosuppressed (e.g. organ transplant recipients).


===Microscopic===
===Microscopic===
Features:<ref name=Ref_WMSP491>{{Ref WMSP|491}}</ref>
Features:<ref name=pmid17642667>{{Cite journal  | last1 = Laxmisha | first1 = C. | last2 = Thappa | first2 = DM. | last3 = Jayanthi | first3 = S. | title = Papillary eccrine adenoma. | journal = Indian J Dermatol Venereol Leprol | volume = 70 | issue = 6 | pages = 370-2 | month =  | year =  | doi =  | PMID = 17642667 | URL = http://www.ijdvl.com/article.asp?issn=0378-6323;year=2004;volume=70;issue=6;spage=370;epage=372;aulast=Laxmisha }}</ref><ref name=pmid9793207/>
*Nests or sheets or trabeculae.
*Well-circumscribed lesions consisting of multiple cystic spaces lined by a bilayered epithelium with:
*Scant cytoplasm.
**Papillary projections into the lumen.
*Nuclear moulding.
**Amorphous eosinophilic material in the cystic spaces.
*Multiple small nucleoli.
**Surrounded by a fibrous stroma.<ref name=pmid9508346>{{Cite journal  | last1 = Mizuoka | first1 = H. | last2 = Senzaki | first2 = H. | last3 = Shikata | first3 = N. | last4 = Uemura | first4 = Y. | last5 = Tsubura | first5 = A. | title = Papillary eccrine adenoma: immunohistochemical study and literature review. | journal = J Cutan Pathol | volume = 25 | issue = 1 | pages = 59-64 | month = Jan | year = 1998 | doi =  | PMID = 9508346 }}</ref>
*Usually mitotically active.
 
Note:
*May appear to have more than two cell layers.
 
DDx:
*[[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>


Image:
Image:
*[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.ijdvl.com/viewimage.asp?img=ijdvl_2004_70_6_370_13482_2.jpg PEA - crappy image (ijdvl.com)].<ref name=pmid17642667/>
*[http://commons.wikimedia.org/wiki/File:Merkelcellcarcinoma_Tag.jpg Merkel cell carcinoma - nested pattern (WC)].


===IHC===
===IHC===
*CK7 -ve, CK20 +ve
Outer layer of epithelium:<ref name=pmid9508346/>
*SMA-alpha +ve.
*Keratin 14 +ve.
Inner layer of epithelium:<ref name=pmid9508346/>
*Keratin 8 +ve.
 
Other stains:<ref name=pmid9793207>{{Cite journal  | last1 = Guccion | first1 = JG. | last2 = Patterson | first2 = RH. | last3 = Nayar | first3 = R. | last4 = Saini | first4 = NB. | title = Papillary eccrine adenoma: an ultrastructural and immunohistochemical study. | journal = Ultrastruct Pathol | volume = 22 | issue = 3 | pages = 263-9 | month =  | year =  | doi =  | PMID = 9793207 }}</ref>
*Vimentin +ve.
*CEA +ve.
*[[EMA]] +ve.
*S-100 +ve.
 
===Sign out===
<pre>
SKIN LESION, LEFT PARIETAL SCALP, BIOPSY:
- PAPILLARY ECCRINE ADENOMA.
</pre>
 
====Micro====
The sections show a well-circumscribed multi-locular superficial dermal lesion with a bilayered epithelium and intracystic papillary projections. The cystic spaces contain amorphous eosinophilic material. The cystic component is surrounded by a dense fibrous stroma with a mixed inflammatory infiltrate, consisting primary of plasma cells and lymphocytes.
 
There is no significant nuclear atypia and no mitotic activity is appreciated. The overlying epidermis matures appropriately. A granular layer is present.


==See also==
=See also=
*[[Dermatopathology]].
*[[Dermatopathology]].
*[[Cytopathology]].
*[[Cytopathology]].


==References==
=References=
{{reflist|2}}
{{reflist|2}}


[[Category:Dermatopathology]]
[[Category:Dermatopathology]]
Michael
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