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Journal of Cutaneous Pathology

L Held, A Ruetten, H Kutzner, G Palmedo, B John, T Mentzel
BACKGROUND: Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare low-grade primary cutaneous sweat gland carcinoma with predilection for the periorbital skin in elderly female patients. METHODS: We describe eleven cases of EMPSGC using a broad panel of immunohistochemical markers including BerEP4, cytokeratin 7, CAM 5.2; synaptophysin, chromogranin, cytokeratin 20, Ki67, progesterone receptor, and estrogen receptor. Calponin (1A4) and p63 were used to detect surrounding myoepithelial cells...
June 7, 2018: Journal of Cutaneous Pathology
Vanessa Szablewski, Valérie Costes-Martineau, Céline René, Aurélie Croci-Torti, Jean-Marie Joujoux
Composite lymphoma (CL) is a rare disease defined by the occurrence of 2 distinct lymphomas within a single tissue at the same time. We present the case of an 89-year-old male with a clinical history of immunoglobulin M monoclonal gammapathy of undetermined significance (IgM MGUS). The patient presented cutaneous eruption of nodules on the right bottom and arm. An excisional biopsy revealed cutaneous infiltration composed of 2 components. The first one consisted of large B-cell with CD20+/MUM1+/BCL2+ phenotype whereas the second one involved the subcutaneous fat in a panniculitis manner, was CD3+/CD8+/GranzymeB+/TCRβF1+...
May 30, 2018: Journal of Cutaneous Pathology
Natalia Buchely, Rami Al-Rohil, Phyu P Aung, George Jour, Carlos Torres-Cabala, Victor G Prieto, Doina Ivan
Mycosis fungoides (MF) is the most common variant of cutaneous T-cell lymphomas (CTCL). Large cell transformation of MF has been associated with disease progression and overall poor outcome. The expression of CD30, which defines anaplastic large cell lymphoma (ALCL) and lymphomatoid papulosis (LyP), might also occur in a subset of patients with MF, with or without large cell transformation. Brentuximab vedotin is an anti-CD30 monoclonal antibody which has been proven to be a safe and effective therapeutic agent in the treatment of CD30-positive lymphomas, such as Hodgkin lymphoma and ALCL...
May 27, 2018: Journal of Cutaneous Pathology
T M Lim, J Weir, L Fearfield
Poromas are a group of benign growths of poroid differentiation derived from cells of the terminal duct and connected to the epidermis, normally presenting as solitary papules, plaques or nodules. Rarely they can be eruptive in nature and as such are described as poromatosis. We report an unusual case of widespread poromatosis occurring in a woman with metastatic breast cancer who had recently completed chemo-radiotherapy. This article is protected by copyright. All rights reserved.
May 24, 2018: Journal of Cutaneous Pathology
Michael Noparstak, Michael Zaycosky, Sadia Saeed
Epithelial sheath neuroma (ESN) was first described in 2000 by Requena et al (1) as a neoplasm that clinically presents as an erythematous papule or nodule on the mid-to-upper back of middle-aged to elderly adults. ESN has been reported to be asymptomatic in some cases, while exhibiting pruritus or pain in others. (2) Histologically, ESN is described to occur in the superficial dermis and is categorized by squamous epithelium surrounding enlarged peripheral nerve fiber proliferations. This article is protected by copyright...
May 24, 2018: Journal of Cutaneous Pathology
Kristen N Ruby, April C Deng, Jingwei Zhang, Robert E LeBlanc, Konstantinos D Linos, Shaofeng Yan
Xanthogranuloma (XG) is a benign idiopathic skin disease that belongs to the spectrum of non-Langerhans cell histiocytoses. The disease has a predilection for the head, neck, and upper extremities of infants and young children, and is therefore most often referred to as juvenile xanthogranuloma (JXG). The two most common manifestations are solitary pink nodules and scattered red-brown papules on the upper body. This article is protected by copyright. All rights reserved.
May 24, 2018: Journal of Cutaneous Pathology
R M Miller, E I Leremia, J B Birch, J C Chan
Poroid hidradenoma (PH) is a rare, benign neoplasm of the skin appendages of either eccrine or apocrine derivation. It typically presents as an isolated, well-circumscribed, painless nodule most commonly in the head and neck region and limbs. It is described as a tumour with the architecture of a hidradenoma and cytological features of poroma 1 . This article is protected by copyright. All rights reserved.
May 20, 2018: Journal of Cutaneous Pathology
Jasmine Saleh, Michael L Wang, Paul W Harms, Rajiv M Patel, Douglas R Fullen
Osteocartilaginous differentiation in malignant melanoma is rare and can pose a diagnostic challenge. In previously reported cases, melanomas were predominantly located on acral and mucosal sites with osteocartilaginous differentiation present in either primary or recurrent lesions. We report a case of a 52-year-old female with malignant melanoma located on the right upper back exhibiting osteosarcomatous differentiation only in the axillary lymph node metastasis. This case serves to highlight that the divergent differentiation can occur in lymph node metastases while being absent in the primary lesion...
May 20, 2018: Journal of Cutaneous Pathology
Sarina Jain, Sibasish Patro, Bhushan Darkase, Atul M Dongre, Uday S Khopkar
Smooth muscle hamartoma (SMH) is a benign hamartomatous condition that consists of a dermal proliferation of smooth muscle cells. We hereby report a case of multiple, acquired smooth muscle hamartomas on scalp. A 25-year old male had a 6-year history of multiple, asymptomatic, hyperpigmented plaques on scalp which have been progressively increasing in number and size. Histopathological examination revealed large thick walled blood vessels, in addition to the haphazardly arranged discrete smooth muscle bundles in the reticular dermis...
May 17, 2018: Journal of Cutaneous Pathology
Adam I Rubin, Michael Hitchcock
In this issue of the Journal of Cutaneous Pathology(1), the ASDP Appropriate Use Criteria (AUC) Task Force releases a landmark series of recommendations on AUC from the American Society of Dermatopathology. This is the first set of AUC in dermatopathology and, indeed, in pathology overall. These recommendations were developed as part of the work of the ASDP AUC Task Force, created in 2015. This publication provides strong, evidence-based recommendations that will improve the delivery and utilization of care for our patients, just as AUC for Mohs surgery have elevated the discourse on that procedure for the benefit of patients and society as a whole(2)...
May 17, 2018: Journal of Cutaneous Pathology
Christina Mitteldorf, Mar Llamas-Velasco, Hans-Joachim Schulze, Kai-Martin Thoms, Thomas Mentzel, Michael Tronnier, Heinz Kutzner
BACKGROUND: We investigated two cases of deceptively bland cutaneous angiosarcoma, which showed a uniform clinical presentation with a rapidly growing tumor on the nose. It remains unclear whether this was a primary cutaneous manifestation or a metastasis. Both tumors initially presented a high histologic overlap with a benign vascular tumor. The diagnosis was primarily based on the rapidly progressing clinical course and on the results of the staging procedures. METHODS: Immunohistochemical stains were performed for cytokeratin (AE1/AE3 and MNF116), CD31, ERG, CD34(HPCA1/my10), D2-40/podoplanin, LYVE-1, Ki67, PHH3, αSMA(1A4), MYC, FOS-B, CAMTA-1, TFE-3, WT1, nestin, VEGFR-2(KDR), VEGFR-3(FLT4), HHV8...
May 15, 2018: Journal of Cutaneous Pathology
Jessica Luana Dos Santos, Rander Moreira Macedo, Luciana Yamamoto Almeida, Rodrigo Neves Silva, Alfredo Ribeiro-Silva, Jorge Esquiche León
No abstract text is available yet for this article.
May 12, 2018: Journal of Cutaneous Pathology
Ikko Muto, Fumi Kuwahara, Takako Shintani, Hiroshi Saruta, Takekuni Nakama, Chika Ohata
Adenodermatofibroma is a newly recognized variant of dermatofibroma. It is characterized by dense proliferation of fibroblasts and histiocytes admixed with dilated glandular structures showing apocrine secretion. Only 5 cases of adenodermatofibroma have been reported to date. We report an additional case of adenodermatofibroma on the back of a 67-year-old female. In addition to the dilated glandular structures, non-dilated eccrine units were present at the upper periphery of the lesion, above which the normal eccrine glands reside...
May 12, 2018: Journal of Cutaneous Pathology
Andrew S Fischer, Whitney A High
BACKGROUND: BAP1 negative melanocytic tumors were unrecognized in the medical literature until 2011. While the clinical significance of these tumors is poorly understood, there is concern such lesions represent processes in transition, and malignant degeneration is a concern. We investigated use of a 23-gene expression profiling (23-GEP) test for distinction from melanoma with the aim of better characterizing the biologic potential of such tumors. METHODS: Twenty BAP1 negative melanocytic tumors, subjected to 23-GEP (Myriad Genetic Laboratories, Inc...
May 12, 2018: Journal of Cutaneous Pathology
Patrick Tran, Michael McLemore
Cellular neurothekeomas (CNTs) are rare, benign cutaneous tumors that arise primarily on the head and neck, with a slight female predominance. CNTs with atypical features have been described, including those with an infiltrative growth pattern. Although CNTs with atypical features are benign, recognition of this entity can pose diagnostic challenges. Here, we report a case of CNT with an unusual clinical presentation on the left second digit, and with atypical histological features including an infiltrative growth pattern, which could have been mistaken for features of malignancy...
May 9, 2018: Journal of Cutaneous Pathology
Gabriela Nagata, Thalita Santana, Aline Queiroz, Renata Helena Caramez, Marília Trierveiler
BACKGROUND: We analyzed the different grades of dysplasia in the epithelium adjacent to lip squamous cell carcinoma (LSCC), as a parallel to actinic cheilitis (AC) that suffered malignant transformation. METHODS: Forty samples of epithelium adjacent to LSCC were histologically graded according to the World Health Organization (WHO) and the binary systems. The expression of mutated p53 was evaluated through immunohistochemistry. RESULTS: According to WHO system, 37...
May 8, 2018: Journal of Cutaneous Pathology
B Joel Tjarks, Amy M Kerkvliet, Ali D Jassim, Jonathan S Bleeker
Checkpoint inhibitors have emerged as beneficial therapies in many different types of malignancy and their use has increased dramatically in clinical practice over the past number of years. The most common and concerning toxicities of checkpoint inhibitors are immune related adverse events (irAEs). As clinical experience with these agents increases, more irAEs have been described. We report a case of scleroderma-like skin changes induced by checkpoint inhibitor therapy, namely nivolumab.
May 8, 2018: Journal of Cutaneous Pathology
Ana Ortins-Pina, Luís Soares-de-Almeida, Arno Rütten
Primary smooth muscle malignancies in the skin account for approximately 2-3% of all soft tissue sarcomas1,2 . We read with interest a recent JCP report on a vascular leiomyosarcoma arising from vena saphena magna3 . We report herein a case of primary cutaneous vascular leiomyosarcoma arising from a small-caliber dermal vein.
May 8, 2018: Journal of Cutaneous Pathology
Justin D Richey, April C Deng, Karen Dresser, Patrick O'Donnell, Kristine M Cornejo
BACKGROUND: Distinguishing an irritated seborrheic keratosis (ISK) from a squamous cell carcinoma in situ (SCCIS) can occasionally be challenging, both histologically and clinically. The purpose of this study was to determine if an immunohistochemical profile of select markers can aid in differentiating these two entities. METHODS: We randomly selected and stained 103 ISK and 111 SCCIS for EGFR, IMP3 and BCL-2. IMP3 staining was scored as negative or 0 (0% positive), 1+ (1-25% positive), 2+ (26-50% positive) and 3+ (>50% positive)...
May 3, 2018: Journal of Cutaneous Pathology
L Taylor, K Hood, L Reisch, J Elmore, M Piepkorn, R Barnhill, S Knezevich, A Radick, D Elder
BACKGROUND: Melanoma staging has depended on depth of invasion (Breslow thickness, BT), mitotic rate (MR) and ulceration. In anticipation of the AJCC's 8th edition, variability in pathologists' assessment of these factors and consequently in tumor staging was assessed. METHODS: 115 cases of invasive melanoma, established by a consensus panel, were assessed by 187 pathologists. Variation was studied in BT, the detection of mitoses, and ulceration. The sources of this variation and its effect on tumor staging are considered...
May 2, 2018: Journal of Cutaneous Pathology
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