Talk:Dermatologic neoplasms

Basal cell carcinoma

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.

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).

Final diagnosis

Skin, scalp, excisional biopsy:
Basal cell carcinoma, see comment.
Dermal scar.

Comment: The tumour is present in one of the tips; thus, the lesion is at least closely excised.

SCC in situ, actinic keratosis

Microscopic description

A. The sections show superficial skin with benign, underlying skeletal muscle. The skin shows full thickness nuclear atypia (including moderate-to-marked nuclear enlargement, nuclear hyperchromasia) at a site of ulceration and in a region with overlying hyperkeratosis (squamous cell carcinoma in situ). Several atypical mitoses are identified. The edge of the lesion shows nuclear changes, including hyperchromasia and nuclear enlargement, in the basal layer (actinic keratosis). Severe solar elastosis is present.

B. The sections show superficial skin with full thickness nuclear atypia (including mild-to-moderate nuclear enlargement, nuclear hyperchromasia) in a region with overlying hyperkeratosis (squamous cell carcinoma in situ). Mitoses and dyskeratotic cells are numerous. The edge of the lesion shows nuclear changes, including hyperchromasia and nuclear enlargement, in the basal layer (actinic keratosis). Solar elastosis is present.

Final diagnosis

A. Left upper lip, lesion, excision:
Squamous cell carcinoma in situ, resection margin close.
Actinic keratosis.
Severe solar elastosis.
Focal ulceration.

B. Right dorsal wrist, lesion, excision:
Squamous cell carcinoma in situ.
Actinic keratosis.
Solar elastosis.