Difference between revisions of "Dermatologic neoplasms"

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Dermatologic neoplasms (view source)

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An introduction to dermatopathy is found in the ''[[dermatopathology]]'' article.  Non-malignant disease is covered in the ''[[non-malignant skin disease]]'' article.
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=
=The Big Three malignant=
==Basal cell carcinoma==
===General===
*Very common.
*Sun exposed skin.
*Very rarely metastasizes - so rare... some don't think this is really a malignancy.
 
====Clinical====
*Telangiectasias.
*Raised pearly nodule.
 
====As part of a syndrome====
*[[Nevoid basal cell carcinoma syndrome]] (NBCCS), AKA ''Gorlin syndrome''.
*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>
 
===Microscopic===
Features:<ref name=Ref_PBoD8_1180-1>{{Ref PBoD8|1180-1}}</ref>
*Nest of hyperchromatic (i.e. blue) cells (similar in appearance to basal cells) with:
**Palisading of cells at the edge of the cell nests.
**Artefactual separation of cells (forming the nests) from the underlying stroma.
 
Notes:
*Palisading = the long axes of the cells are alined and the axes are perpendicular to the interface between the (basaloid cell) nests and stroma.
*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].
 
DDx:
*[[Trichoepithelioma]] - no artefactual cleft.<ref name=Ref_PBoD8_1180-1>{{Ref PBoD8|1180-1}}</ref>
 
==Squamous cell carcinoma==
==Squamous cell carcinoma==
{{Main|Squamous carcinoma}}
{{Main|Squamous carcinoma}}
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*CK7 -ve.
*CK7 -ve.
**Toker cells CK7 +ve.<ref name=pmid19601945>{{Cite journal  | last1 = Nofech-Mozes | first1 = S. | last2 = Hanna | first2 = W. | title = Toker cells revisited. | journal = Breast J | volume = 15 | issue = 4 | pages = 394-8 | month =  | year =  | doi = 10.1111/j.1524-4741.2009.00743.x | PMID = 19601945 }}</ref>
**Toker cells CK7 +ve.<ref name=pmid19601945>{{Cite journal  | last1 = Nofech-Mozes | first1 = S. | last2 = Hanna | first2 = W. | title = Toker cells revisited. | journal = Breast J | volume = 15 | issue = 4 | pages = 394-8 | month =  | year =  | doi = 10.1111/j.1524-4741.2009.00743.x | PMID = 19601945 }}</ref>
==Basal cell carcinoma==
===General===
*Very common.
*Sun exposed skin.
*Very rarely metastasizes - so rare... some don't think this is really a malignancy.
====Clinical====
*Telangiectasias.
*Raised pearly nodule.
====As part of a syndrome====
*[[Nevoid basal cell carcinoma syndrome]] (NBCCS), AKA ''Gorlin syndrome''.
*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>
===Microscopic===
Features:<ref name=Ref_PBoD8_1180-1>{{Ref PBoD8|1180-1}}</ref>
*Nest of hyperchromatic (i.e. blue) cells (similar in appearance to basal cells) with:
**Palisading of cells at the edge of the cell nests.
**Artefactual separation of cells (forming the nests) from the underlying stroma.
Notes:
*Palisading = the long axes of the cells are alined and the axes are perpendicular to the interface between the (basaloid cell) nests and stroma.
*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].
DDx:
*[[Trichoepithelioma]] - no artefactual cleft.<ref name=Ref_PBoD8_1180-1>{{Ref PBoD8|1180-1}}</ref>


==Melanoma==
==Melanoma==
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**[[Nuclear pseudoinclusions]] (like in ''papillary thyroid carcinoma'').
**[[Nuclear pseudoinclusions]] (like in ''papillary thyroid carcinoma'').


=Malignant=
=Less common malignant=
==Merkel cell carcinoma==
==Merkel cell carcinoma==
*Abbreviated ''MCC''.
*Abbreviated ''MCC''.
Michael
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