Dermatologic neoplasms
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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.
An introduction to dermatopathy is found in the dermatopathology article. Non-malignant disease is covered in the non-malignant skin disease article.
The Big Three malignant
Basal cell carcinoma
Main article: Basal cell carcinoma
Squamous cell carcinoma of the skin
- Abbreviated skin SCC, SCC of the skin, and SCC of skin.
Main article: Squamous cell carcinoma of the skin
Melanoma
Main article: Malignant melanoma
- Known as the great mimicker in pathology; it may look like many things.
Less common malignant
Dermatofibrosarcoma protuberans
- Abbreviated DFSP.
Main article: Dermatofibrosarcoma protuberans
Cutaneous B-cell lymphoma
- Abbreviated CBCL.
General
- CBCL is less common than cutaneous T-cell lymphoma (CTCL).[1]
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 article: Cutaneous T-cell lymphoma
Merkel cell carcinoma
Main article: Merkel cell carcinoma
Eccrine carcinoma
General
- Arises from the proximal sweat duct.
Microscopic
Features:
- Pleomorphic nuclei with nucleoli.
- Duct-like structures - key feature.
- Extends from dermis into epidermis (follows path of a benign sweat duct).
Notes:
- May resemble Extramammary Paget's disease/Paget's disease of the breast.
Kaposi sarcoma
- See Kaposi sarcoma.
Sebaceous carcinoma
Main article: Sebaceous carcinoma
Microcystic adnexal carcinoma
Main article: Microcystic adnexal carcinoma
Trichilemmal carcinoma
Main article: Trichilemmal carcinoma
Lymphomatoid papulosis
General
- Rare.
- Benign behaviour.
Microscopic
Features:
- Dermal lymphocytosis.
- No epidermal lymphocytes.
- Focal nuclear atypia.
DDx:
IHC
- CD30 +ve.[2]
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.[3]
- May be considered an aggressive variant of basal cell carcinoma.[3]
- Aggressive behaviour.[4]
Microscopic
Features:
- Has features of both basal cell carcinoma and squamous cell carcinoma.[4]
- BCC component usually predominant.[5]
Note:
- Busam notes that there is disagreement about what defines this tumour;[6] however, he goes on the describe it as a collision tumour.[5]
DDx:
- Basaloid squamous cell carcinoma.
- Basal cell carcinoma with squamous differentiation.
Intermediate
Atypical fibroxanthoma
- Abbreviated AFX.
Main article: Atypical fibroxanthoma
Benign
Syringoma
Main article: Syringoma
Chondroid syringoma
- Used to be called mixed tumour of skin.[7]
General
- Mixed apocrine & eccrine tumour of skin, usually in the head & neck[7], especially nose and cheek.[8]
- May be in major and minor salivary glands.[8]
Microscopic
Features:
- Mix tumour with:[7]
- Epithelial component:
- Nests of cells with:
- Moderate dull eosinophilic cytoplasm.
- Round/ovoid nuclei with nucleoli.
- Nests of cells with:
- Mesenchymal component - key feature:
- Epithelial component:
Images:
Dermal cylindroma
Main article: Dermal cylindroma
Keratoacanthoma
Main article: Keratoacanthoma
Sebaceous adenoma
General
- Seen in Muir-Torre syndrome - a variant of Lynch syndrome (hereditary non-polyposis colon cancer).
Notes:
- Sebaceous lesions (from benign to malignant): sebaceous hyperplasia, sebaceous adenoma, sebaceoma, sebaceous carcinoma.
Microscopic
Features:
- Abnormal sebaceous glands (pale fluffy cytoplasm):
- Increased basal epithelium.
- Multiple dilated glands - opening to the surface.
Images
Sebaceous adenoma - low mag. (WC/Nephron)
Sebaceous adenoma - high mag. (WC/Nephron)
www:
Trichilemmoma
- May be spelled tricholemmoma.
Main article: Trichilemmoma
Poroma
Main article: Poroma
Nodular hidradenoma
Main article: Nodular hidradenoma
Trichoblastoma
Main article: Trichoblastoma
Trichofolliculoma
Main article: Trichofolliculoma
Apocrine carcinoma of the skin
General
Microscopic
Features:[10]
- Nests.
- Apocrine snouts - "decapitation secretion"
DDx:
Images
Apocrine carcinoma - intermed. mag. (WC/Nephron)
Apocrine carcinoma - high mag. (WC/Nephron)
Stains
Features:[10]
- PAS +ve.
- PASD +ve.
IHC
Dermatomyofibroma
- Should not be confused with dermatofibroma.
- Abbreviated DMF.
General
- Uncommon.
Microscopic
Features:[11]
- Poorly formed fasicles parallel to the skin surface, usu. restricted to the superficial dermis.
- Moderate cellular density - less cellular than DFSP.
- Eosinophilic cytoplasm.
DDx:
Images:
IHC
Features:[11]
- CD10 +ve.
- Vimentin +ve.
Others:[11]
- CD34 -ve.
- Factor XIIIa -ve.
- S-100 -ve.
Papillary eccrine adenoma
- Abbreviated PEA.
General
- Uncommon.
- Benign.[12]
Treatment:
- Excision.[13]
Gross
- Central location.
Note:
- The digital papillary adenoma is considered malignant; the AFIP says these are best classified as adenocarcinomas, i.e. digital papillary adenocarcinoma.[14]
Microscopic
- Well-circumscribed lesions consisting of multiple cystic spaces lined by a bilayered epithelium with:
- Papillary projections into the lumen.
- Amorphous eosinophilic material in the cystic spaces.
- Surrounded by a fibrous stroma.[17]
Note:
- May appear to have more than two cell layers.
DDx:
- Digital papillary adenocarcinoma - location important.
- Tubular apocrine adenoma (tubulopapillary hidradenoma[18]) - a related tumour.[19]
Image:
IHC
Outer layer of epithelium:[17]
- SMA-alpha +ve.
- Keratin 14 +ve.
Inner layer of epithelium:[17]
- Keratin 8 +ve.
Other stains:[16]
- Vimentin +ve.
- CEA +ve.
- EMA +ve.
- S-100 +ve.
Sign out
SKIN LESION, LEFT PARIETAL SCALP, BIOPSY: - PAPILLARY ECCRINE ADENOMA.
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
References
- ↑ URL: http://emedicine.medscape.com/article/1099540-overview. Accessed on: 24 August 2010.
- ↑ URL: http://path.upmc.edu/cases/case513/dx.html. Accessed on: 25 January 2012.
- ↑ 3.0 3.1 Martin, RC.; Edwards, MJ.; Cawte, TG.; Sewell, CL.; McMasters, KM. (Mar 2000). "Basosquamous carcinoma: analysis of prognostic factors influencing recurrence.". Cancer 88 (6): 1365-9. PMID 10717618.
- ↑ 4.0 4.1 Bowman, PH.; Ratz, JL.; Knoepp, TG.; Barnes, CJ.; Finley, EM. (Aug 2003). "Basosquamous carcinoma.". Dermatol Surg 29 (8): 830-2; discussion 833. PMID 12859383..
- ↑ 5.0 5.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 397. ISBN 978-0443066542.
- ↑ Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 372. ISBN 978-0443066542.
- ↑ 7.0 7.1 7.2 Kumar, B. (Jan 2010). "Chondroid syringoma diagnosed by fine needle aspiration cytology.". Diagn Cytopathol 38 (1): 38-40. doi:10.1002/dc.21159. PMID 19693940.
- ↑ 8.0 8.1 Rauso, R.; Santagata, M.; Tartaro, G.; Filipi, M.; Colella, G.. "Chondroid syringoma: a rare tumor of orofacial region.". Minerva Stomatol 58 (7-8): 383-8. PMID 19633639.
- ↑ Punia, RP.; Garg, S.; Bal, A.; Mohan, H. (2008). "Pigmented nodular hidradenoma masquerading as nodular malignant melanoma.". Dermatol Online J 14 (1): 15. PMID 18319032.
- ↑ 10.0 10.1 10.2 10.3 10.4 Paties, C.; Taccagni, GL.; Papotti, M.; Valente, G.; Zangrandi, A.; Aloi, F. (Jan 1993). "Apocrine carcinoma of the skin. A clinicopathologic, immunocytochemical, and ultrastructural study.". Cancer 71 (2): 375-81. PMID 7678545.
- ↑ 11.0 11.1 11.2 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 504. ISBN 978-0443066542.
- ↑ Rulon, DB.; Helwig, EB. (May 1977). "Papillary eccrine adenoma.". Arch Dermatol 113 (5): 596-8. PMID 857729.
- ↑ URL: http://archderm.jamanetwork.com/article.aspx?articleid=541159. Accessed on: 10 December 2012.
- ↑ Duke, WH.; Sherrod, TT.; Lupton, GP. (Jun 2000). "Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited).". Am J Surg Pathol 24 (6): 775-84. PMID 10843279.
- ↑ 15.0 15.1 Laxmisha, C.; Thappa, DM.; Jayanthi, S.. "Papillary eccrine adenoma.". Indian J Dermatol Venereol Leprol 70 (6): 370-2. PMID 17642667.
- ↑ 16.0 16.1 Guccion, JG.; Patterson, RH.; Nayar, R.; Saini, NB.. "Papillary eccrine adenoma: an ultrastructural and immunohistochemical study.". Ultrastruct Pathol 22 (3): 263-9. PMID 9793207.
- ↑ 17.0 17.1 17.2 Mizuoka, H.; Senzaki, H.; Shikata, N.; Uemura, Y.; Tsubura, A. (Jan 1998). "Papillary eccrine adenoma: immunohistochemical study and literature review.". J Cutan Pathol 25 (1): 59-64. PMID 9508346.
- ↑ Fox, SB.; Cotton, DW. (Apr 1992). "Tubular apocrine adenoma and papillary eccrine adenoma. Entities or unity?". Am J Dermatopathol 14 (2): 149-54. PMID 1566975.
- ↑ Ishiko, A.; Shimizu, H.; Inamoto, N.; Nakmura, K. (Oct 1993). "Is tubular apocrine adenoma a distinct clinical entity?". Am J Dermatopathol 15 (5): 482-7. PMID 8238787.