Dermatopathology Cases

Deep Penetrating Nevus Visit: Dermatopathology Site Visit: Deep Penetrating Nevus Abstract: Deep penetrating nevus: a review.Arch Pathol Lab Med. 2011 Mar;135(3):321-6. CONTEXT: Deep penetrating nevus is a distinctive melanocytic lesion that may simulate melanoma both clinically and histologically. OBJECTIVE: To review clinical and histologic features of deep penetrating nevi and discuss their differential diagnosis, especially regarding melanoma. DATA SOURCES: The literature on deep penetrating nevi is reviewed and supplemented by our experiences with deep penetrating nevi. CONCLUSIONS: One or more disturbing histologic features may frequently be found in deep penetrating nevi, including asymmetry, plump but fairly regular nests of melanocytes in the dermis, cytologic atypia with some nuclear pleomorphism, a small to medium-sized eosinophilic nucleolus, absence of maturation, occasional presence of normal dermal mitoses, and a patchy mononuclear inflammatory cell infiltrate. Although ...

Image1 Image2 Image3 Image4 Image5 Case 114 A dark pigmented papule on the neck of a 25 year old female. Diagnosis

Extramammary Paget's Disease Visit: Dermatopathology Site Visit: Pathology of Extramammary Paget's Disease Abstract: Extramammary Paget's disease: Evaluation of the histopathological patterns of Paget cell proliferation in the epidermis.J Dermatol. 2011 Nov;38(11):1054-7. doi: 10.1111/j.1346-8138.2011.01268.x. Epub 2011 Sep 23. Extramammary Paget's disease (EMPD) is a rare malignant skin neoplasm. The prototypical pattern of tumor cell proliferation in the epidermis includes single cells and/or nest arrangements, mainly in the lower epidermis. Although other patterns have been recognized, they have not previously been investigated in detail. We aimed to examine the patterns of tumor cell proliferation in the epidermis. Surgical specimens were obtained from 38 patients with primary EMPD. We defined six patterns, in addition to the prototypical one: (i) glandular; (ii) acantholysis-like; (iii) upper nest; (iv) tall nest; (v) budding; and (vi) sheet-like. There were 26 mal...

Image1 Image2 Image3 Image4 Image5 Case 113 A 54 year old woman with a thickened plaque on the vulva. The lesion is crusted with scale covering its surface. Diagnosis

Pleomorphic Fibroma Visit: Dermatopathology Site Abstract: Pleomorphic fibroma of the skin: a benign neoplasm with cytologic atypia. A clinicopathologic study of eight cases.Am J Surg Pathol. 1989 Feb;13(2):107-13. A clinicopathologic study of eight examples of polypoid and dome-shaped cutaneous fibrous lesions with sparse cellularity but striking nuclear atypia and rare mitotic figures is presented. Positive immunohistochemical staining for vimentin and actin supported the fibroblastic nature of these lesions. All eight cases were adults whose ages ranged from 33 to 67 years (mean 52 years). Five were women and three were men. Five lesions were located on extremities, two on the trunk, and one on the face and they measured from 4 to 16 mm in greatest dimension. The lesions were clinically followed from 4 months to 5 years. They all showed benign clinical behavior, with only one local recurrence in a lesion that had been incompletely removed. The nuclear atypia seen in these fibrous le...

Image1 Image2 Image4 Case 112 A 51 year old female with a polypoid cutaneous lesion on the left extremity. Diagnosis