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CUTANEOUS MALIGNANCIES

Asmara Syed Click to edit Master subtitle style

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35 year-old male with 9 year history of a skin rash presented with hypopigmented patches on trunk and extremities.

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DIFFERENTIAL

DIAGNOSIS??????

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MYCOSIS

FUNGOIDES

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Most common primary cutaneous T cell lymphoma Usually elderly or other adults May arise from progression of large plaque psoriasis Usually protracted clinical course over years By definition, are negative for HIV1,
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Premycotic General

(patch) stage

Usually indolent course

Gross

description

Erythematous, scaly and pruritic skin

Microscoy

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Tumorous General

stage

Treatment:

Systemic chemotherapy

Microsopy

Dense dermal infiltrates of atypical T cells with cerebroid nuclei (with thin sections) 8/12/12

42-year-old male with a scalp mass

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DIFFERENTIAL

DIAGNOSIS??????

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ECTOPIC

MENINGIOMA

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Extra-cranial

meningiomas can occur in three settings. First, in children, they represent developmental abnormalities related to neural tube closure defects. These seem to have a similar pathogenesis as meningoceles and are associated with a good prognosis when excised. Second, they may occur as primary soft tissue meningiomas derived from arachnoid nests associated with cranial or spinal nerves.
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46-year-old

female with a skin nodule

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DIFFERENTIAL

DIAGNOSIS????

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LANGERHANS CELL HISTIOCYTOSIS

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Also

called histiocytosis X

Langerhans

cells are derived from bone marrow, circulate freely from skin to regional lymph nodes or multiple lesions (papules, nodules, plaques) infants, resembles seborrheic keratosis diffuse dermal infiltrate of Langerhans cells (large, ovoid, pale pink cytoplasm, indented bland nuclei) or clusters of Langerhans cells which 8/12/12

Solitary In

Micro:(1)

(2)

The

patient is a 51-year old female with a plaque-like tumor on the back.

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DIFFERENTIAL

DIAGNOSIS??????

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DERMATOFIBROSARCOMA

PROTUBERANS (DFSP)

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31-year-old

female with forehead lesion

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DIFFRENTAIL

DIAGNOSIS?????

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ANGIOLYMPHOID

HYPERPLASIA WITH

EOSINOPHILIA

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23-year-old

female with a lower lip

lesion.

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DIFFERENTIAL

DIAGNOSIS?????

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ANGIOMATOID

FIBROUS HISTIOCYTOMA

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68

year old male with patches on his elbows and buttocks.

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DIFFERENTIAL

DIAGNOSIS????

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LYMPHOMATOID

PAPULOSIS

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Rare,

self-healing, recurrent papular eruption Indolent clinical course, although 10% are associated with or evolve to anaplastic large cell lymphoma May be self healing benign phase of anaplastic large cell lymphoma

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Micro

description

Wedge shaped on low power with base of lymphocytes at epidermis and tip deep within reticular dermis Polymorphic superficial dermal infiltrate, usually perivascular, with thin epidermis Occasional atypical lymphoid cells resembling Reed-Sternberg cells or lumps of coal Often obscures dermoepidermal junction with variable epidermotropism
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Differential

diagnosis ======================== ======================== ======================== = Arthropod bite

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Nine

month old with a neck mass.

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DIFFERENTIAL

DIAGNOSIS????

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JUVENILE

XANTHOGRANULOMA

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This

patient had numerous pigmented skin lesions and a subcutaneous nodule. The nodule was resected.

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DIFFERENTIAL

DIAGNOSIS????

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PLEXIFORM

NEUROFIBROMA

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Definition Benign peripheral nerve sheath tumor that surrounds multiple nerve fascicles Has irregularly thickened, distorted, tortuous structure Plexiform:complex; in the form of a plexus or network Site Orbit, face, neck, back, inguinal Nodular or diffuse Diffuse cases are also known as 8/12/12 elephantiasis neurofibromatosa;

Positive

stains

S100 in scattered cells (unlike strong staining in schwannoma) Perineurial cells are EMA+ in plexiform but not in ordinary neurofibromas Diagnosis Plexiform schwannoma

Differential

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