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Derm Flashcards

1
Q

Clark levels

A

II: Melanoma present but does not fill/expand papillary dermis
III: Fills and expands papillary dermis
IV: Invades reticular dermis
V: Invades subcutis

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2
Q

Melanoma T staging

A

a: no ulceration
b: ulceration
pT1: <0.8 cm (0.8-1.0)
pT2: 1-2.0cm
pT3: 2-4.0 cm
pT4: >4cm

C
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3
Q

Low CSD Melanoma

A

Superficial spreading
Nodular
Nevoid
Lentiginous

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4
Q

High CSD Melanoma

A

Lentigo maligna
Desmoplastic

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5
Q

Melanoma in sun shielded areas or without known UV association

A

Spitz
Acral
Mucosal
Arising in congenital nevus
Arising in blue nevus
Uveal

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6
Q

Merkle cell CA T-staging

A
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7
Q

Merkle cell CA N-staging

A

pN1: clinically undetected met
pN2: in-transit met without LN
pN3: in-transit met with LN

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8
Q

Histopathological features of lichen planus

A

Confluent orthokeratosis without parakeratosis
Wedge shaped hypergranulosis
Epidermal acanthosis with saw-toothed rete ridges
Band-like lymphocytic infiltrate in the superficial dermis
Vacuolar degen of basal keratinocytes with necrotic keratinocytes (Civatte bodies) in the epidermis and papillary dermis (colloid bodies)

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9
Q

4 histopathological variants of lichen planus

A

Bullous lichen planus
Hypertrophic lichen planus
Lichen planopilaris
Atrophic lichen planus

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10
Q

IF findings of lichen planus

A

Colloid bodies stain with IgM, occasionally with IgG, IgA, and C3
Fibrinogen deposits are present in the dermoepidermal junction

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11
Q

Types, timing, and histopathological manifestations of cutaneous GvHD

A

Acute - onset first 3 months posttransplant - vacuolar interface dermatitis
Chronic (lichenoid) - >3 months posttransplant (can follow acute) - lichenoid interface dermatitis
Chronic (sclerodermoid) - up to 18 months posttransplant - morphea-like fibrosing dermatitis

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12
Q

Grading scheme for cutaneous GvHD

A

Grade 1: basal vacuolar change
Grade 2: dyskeratotic keratinocytes
Grade 3: subepidermal cleft and microvesicle formation
Grade 4: Dermoepidermal split +/- epidermal necrosis

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13
Q

Causes of erythema multiforme

A

Variety of triggers:
Infection - HSV, mycoplasma
Drugs - NSAIDs

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14
Q

Histopathological findings in erythema multiforme

A

Early: vacuolar interface dermatitis
More advanced: bullous lesions with subepidermal vasiculation
Severe: resemble toxic epidermal necrolysis with marked epidermal necrosis

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15
Q

Variants and histopathological patterns of lupus skin disease

A

Cutaneous manifestation of active SLE
* - Superficial and deep perivascular dermatitis, vacuolar interface change
* - Subepidermal blister with neutrophils
Subacute cutaneous lupus erythemattosus
* - Superficial perivascular dermatitis, vacuolar interface change
Discoid lupus erythematosus
* - Superficial and deep perivascular dermatitis, vacuolar interface change
Tumid lupus erythematosus
* - Superficial and deep perivascular dermatitis
Lupus profundus
* - Lobular panniculitis

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16
Q

Histochemical stains with utility in diagnosis of cutaneous lupus

A

Stains for increased dermal mucin - AB, Colloida iron
Stains for BM thickening - PAS

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17
Q

Significance and diagnostic value of “lupus band” on DIF

A

Incidence of positivity related to lesion site and duration
Lupus band test has high incidence of positive in systemic SLE in both lesional and nonlesional sun-exposed skin
Lower incidence of + in SLE if nonlesional sun-protected skin sampled
May be falsely pos in chronically sun-exposed skin or normal controls

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18
Q

What to tell a clinician about to sample a pt with bullous disease

A

Lesional skin for routine sections and perilesional skin for DIF
FFPE for routine sample and saline or Miche;’s medium for IF sample
Normal saline if transport time <24h
Michel’s medium if transport time >24h
No formalin contamination for IF specimen or false neg

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19
Q

Conditions requiring lesional over perilesional tissue for DIF

A

Lupus
Vasculitis
Lichen planus

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20
Q

Classification of vesiculobullous diseases

A

Based on 3 features:
- location of split (subepi vs intraepi)
- mechanism of split (intraepi spong, acantholysis, ballooning)
- dermal inflammatory infiltrate

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21
Q

4 disorders characterized by intraepidermal acantholysis, histopath features and IF

A

**Pemphigus vulgaris ** - suprabasal acantholysis with tombstoning, mixed infiltrate, net-like or intercellular IgG +/- C3 on DIF
Hailey-Hailey - Acantholysis in dilapidated brick wall pattern, minimal dyskeratosis. No IF
Darier disease - Acantholysis with prominent dyskeratosis, neg DIF
**Grover disease **- focal acantholysis and variable dyskeratosis, neg DIF

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22
Q

6 disorders character by subepidermal blisters and histopathological findings, IF

A

Epidermolysis bullosa acquista - cell poor blister, linear IgG/C3 staining along basement mebrane zone, immune deposits to dermal side of blister (salt split skin)
Porphyria cutanea tarda - cell poor blister with projection of dermal papillae into cavity, caterpillar bodies in roof. IgG/C3 along BMZ and within thickened pap derm vessels
Bullous pemphigoid - eosinophil-rich blister and dermal infiltrate, sometimes with neuts, eosinophilic spong. DIF linear IgG/C3 along BMZ. Salt split skin to roof
Pemphigoid (herpes) gestationalis - indistinguishable from bullous pemphigoid, occurs in pregnancy
Dermatitis herpetiformis - neutrophil rich blisters and microabscesses at tips of dermal papillae, Granular IgA along BMZ, celiac association
Linear IgG dermatosis - similar to dermatitis herpetiformis, association with IBD, LPDs, drugs

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23
Q

Histopathologic features of leukocytoclasic vasculitis

A
  • Fibrinoid necrosis of small vessel walls with extravasated RBCs
  • Angiocentric neutrophilic infiltrate with nuclear dust
  • DIF: der,al vessel staining with IgG/C3/fibrinogen +/- IgM
  • Secondary changes - necrosis/ulceration or subepidermal blister formation
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24
Q

Possible causes of lekocytoclasic vasculitis

A
  1. Infection - bacterial, rickettsial, fungal, viral
  2. Autoimmunity - immune complex diseeases, ANCA-associated
  3. Drugs
  4. Malignancy
  5. Idiopathic (40%)
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25
Q

Clinical findings and histopathology of Sweet syndrome

A

Clinical
* Pts with sudden eruptions of painful plaques and papules on face/extremities, often following infection
* fever and leukocytosis
* Unknown etiology but assocation with malignancy (esp AML), autoimmunity, infection, drugs

Histopath
* Dense diffuse dermal neutrophilic infiltrate
* subepidermal edema
* Usually no true vasculitis

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26
Q

Histopathological deatures of plaque-type psoriasis

A
  • Regular acanthosis of epidermis with elongated, club-shaped rete ridges and thinned suprapap plates
  • Prominent dilated capillaries in pap dermis
  • Confluent dry parakeratosis overlying diminished granular layer
  • Kogoj microabscess - neut collection in spinous layer
  • Munro microabscess - mounds of parakeratosis with neuts
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27
Q

Patterns of cutaneous granulomatous inflammation with relevant disease associations

A

Tuberculoid: Nodular epithelioid histiocytes with central necrosis and periphera lymphocyte rim - tuberculosis, leprosy, rosacea
Sarcoidal: naked granulomata without necrosis - sarcoidosis, berylliosis, zirconium granulomas, Crohn’s disease
Foreign body: abdundant irregularly distributed forgei-body giant cells - suture granuloma, keratin, tattoo
Xanthomatous: foamy histocytes - xanthogranuloma, infections (leprosy, syph)
Suppurative and granulomatous: aggregations of neuts with interspersed histiocytes - ruptured follicular cyst/unit, deep funal infection, atypical myobacterial infection
Palisading: geographic pattern with histiocytic rims - granuloma annulare, rheumatoid nodule, necrobiosis lipoidica

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28
Q

Clinical and histopathological features of granulama annulare, rheumatoid nodule, necrobiosis lipoidica

A

GA: young adults, acral sites
* usually foca involvement of upper anf mid reticular dermis, palisading histiocyters, increased dermal mucin

RN: bony prominence of forearms, elbows, hands, feet, knees
* deep in dermis and/or subcutis
* Palisading and sometimes serpiginous granulomas surrounding fibrinoid change, lack of sig dermal mucin

NL: assocation with diabetes
* diffuse dermal involvement and extnding into superficial subcutis
* palisaded, interstitial or tiered inflammatory infiltrate with intervening sclerotic collagen (layer cake appearance)
* mixed infiltrate of histiocytes lymphs, plasma cells
* lack of sig dermal mucin

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29
Q

Histopathologic features of erythema nodosum

A

Predominantly septal panniculitis with some overflow into fat lobules
* early phase - predominance of neuts
* late phase - predominance of lymphs, eos, multinucleated giant cells
* chronic recurrent EM prominant septal fibrosis with inflammation

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30
Q

5 conditions associated with erythema nodosum

A
  1. Drug reaction (eg oral contraceptive)
  2. Infection
  3. Sarcoidosis
  4. IBD
  5. Malignancy (eg hematolymphoid)
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31
Q

5 key causes of lobular panniculitis

A
  1. Infection
  2. Nodular vasculitis
  3. Lupus profundus
  4. alpha-1 antitrypsin deficiency
  5. Pancreatic panniculitis
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32
Q

Clinical and histopathologic features of fixed drug eruption

A

Clinical
* ovoid or annular erythematous lesions in response to drug exposure and recur in same location upon reexposure
* Common sites: lipds, face, hands, genitalia

Histopath
* vacuolar interface dermatitis with superficial and deep perivascular infiltrate
* acute phase resembles EM
* pigment incontinece can be observed in quiescent phase

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33
Q

Features of pityriasis rosea

A
  • Self limited papulosquamous eruption in children and young adults
  • starts as salmon-coloured herald path on trunk developing into multiple smaller scaly papules on truck and extremities in Christmas tree pattern
  • clinically similar to secondary syph
  • Histopath - subacute spong derm w superficial perivasc lymph infiltrate with overlying mounds of parakeratotic scale
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34
Q

What is cornoid lamella and where is it found

A

Angulated pillar of parakeratosis arising from epidermal invagination with loss of granular layer and localized dyskeratosis
Seen in porokeratosis

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35
Q

Cinucal and histopathological features of morphea

A

Clinical
* localized/plaque-like, linear, or generalized
* Indurated plaques present on trunk and extremities with shiny white centres urrounding by violaceous border

Histopath
* early - superficial and deep perivasc and interstitial lymphplasmacytic infiltrate
* late - thickened dermal collagen resulting in biopsy specimen with square edges, atrophy of adnexal structures with loss of periadnexal fat, diminished inflammation
* may be associated lichen sclerosis type changes

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36
Q

DDx of “normal appearing skin biopsy”

A

Dermatophytosis
Subtyle pigmentary disorder (eg solar lentigo or vilitigo)
Cutaneous amyloidosis
Urticaria
Icthyosis

37
Q

Clinical and histopathologic features of lichen sclerosus

A

Clinica
* pruritic white plaques with wrinkled appearance most commonly in anogenital area of females

Histopath
* epidermal atrophy and hyperkeratosis with homogenized superficial dermal collagen and vacuolar degen of basal keratinocytes with associated perivasc lymphocytic infiltrate

38
Q

4 common cysts in skin and their characteristic histopathologival features

A
  1. Epidermal inclusion cyst - lining with squam epi with gran layer, cyst contents laminated keratin
  2. Trichilemma cyst - squam epi liming with trichilemmal keratinization without granular layer, cyst contents dense honogenous keratin +/- calcs
  3. Steatocystoma - lining squam epi with currogated eosinophilic lining without granular layer
    * sebaceous lobules within or near cyst wall
    * cyst appears empty due to loss of sebaceous fluid during processing
  4. Hidrocystoma - lining simple cuboidal to columnar +/- decapitation secretion, cyst appears empty
39
Q

Skin conditions with AIDs-association

A

Psoriasis
Seborrheic dermatitis
Eosinophilic folliculitis
Infections - HSV, molluscum, bacillary angiomatosis, mycobacteria, tc
Kaposi sarcoma

40
Q

Histopathologic features of stasis dermatitis

A

Superficial and deep dermis with neovascularization and lobular prolif of small vessels and mild lymphocytic perivasc infiltrate
Adjacent dermis may contain extravasated RBCs and hemosiderin
Overlying epidermis may be acanthotic and shows spong and hyperkeratosis

41
Q

Syndromes with cutaneous manifestations

A

Muir-Torre - sebaceous neoplasms, keratoacanthomas
Birt-Hogg-Dube - fibrofolliculomas, acrochordons
Cowden - trichilemmomas
Tuberous sclerosis - angiofibromas, shagreen patch, ash-leaf macles periungual fibromas

42
Q

Histopath findings of dermatophyte infection

A

May look normal
Neuts in cornified layer
Psoriasiform epidermis
Vesciular with prominent spong

43
Q

3 common skin infections and histopath findings

A

HSV/VZV - intraepidermal vesicle, grand glass MMM nuclei
HPV - acanthosis, papillomatosis, hyperkeratosis with parakeratosis overlying papillae. Large coarse keratohyalin granules in superficial keratinocytes
Molluscum contagiosum (poxvirus) - lobulated and often crateriform lesion, epidermal hyperplasia with henderson-patterson bodies

44
Q

Key variants of cutaneous viral warts and most commonly associated HPV types

A

Verruca vulgaris - 1, 2, 4
Myrmecial wart - 1
Verruca plana - 3, 5, 10
Condyloma acuminatim - 6, 11, 18
Epidermodysplasia verruciformis - 2, 3, 5, 8

45
Q

Dermatologic conditions associated with significant morbidity/mortality and require urgent recognition

A

Pancreatic panniculitis
SJS/TEN
Staph scalded skin syndrome
Acute GvHD
Calciphylaxis
Angioinvasive fungal infection
Pemphigus
Vasculitis
Hematological malignancy

46
Q

Define erythroderma and list possible causes

A

Generalized redness and scaling of the skin involving >90% of skin surface
Causes:
* psoriasis
* atopic dermatitis
* drug reaction
* Cutaneous T-cel lymphoma
* pityriasis rubra pilaris

47
Q

Conditions affecting the skin in which there are electron micoscopic findings

A

Amyloidosis - randonly arranged, nonbranching 6-10nm diameter filaments
LCH - birbeck granules
Fabry disease - lamellar inclusion bodies within endothelial cells, smooth muscle cells, fibroblasts and macrophages 2’ lipid deposition in lysosomes
Variants of epidermolysis bullosa - split at basement membrane zone
Merkle cell CA - dense core granules within cytoplasm of tumor cells
Melanoma - melanosomes

48
Q

Clinical findings suggestive for melanoma

A

Asymmetry
Borders - irregular
Colour variegation
Diameter > 6mm
Evolution of lesion

49
Q

Staging features of melanoma

A

Breslow thickness
Presence or absence of ulceration
Presence or absence of microsatellites

50
Q

How is depth of invasion in melanoma measured

A

Measure from top of granular layer to the deepst broad base of tumor (avoiding periadnexal extension)
If ulcerated epidermis, measure from base of ulcer to base of tumor

51
Q

Definition of ulceration

A

Full-thickness epidermal defect not due to trauma or previous procedure
evidence of reactive changes - fibrin deposition, neutrophils

52
Q

Define cutaneous microsatellite, satellite, in-transit metastasis

A

Microsatellite mets - microscopically determined, cutaneous and/or subQ tumor deposit adjacent or deep to primary melanoma separated by normal tissue (not fibrotic or inflammed)
Satellite met - clinicall evidence cutaneous/subQ tumor deposits within 2cm of primary melanoma
In-transit met - clinically evident cutaneous/subQ deposit >2cm from primary melanoma between primary and nearest regional LN

53
Q

Definition of sentinel LN for melanoma

A

first node to receive lymphatic drainage from primary tumor
May be more for some tumors

54
Q

Assessment of sentinel LNs for melanoma

A

Section at 2-3mm, serial sections cut for H&E and immunostains
Single melanoma cell marks it as positive
Beware capsular nevus, pigmented melanophages

55
Q

Capsular nevus vs metastatic melanoma in LN

A

Nevus - location in nodal fibrous tissue, benign cytology, no mits, weak/low HMB45 & Ki67
Melanoma - subcapsular sinus/parenchyma, malignant cytology, mits, strong/high HMB45 & Ki67

56
Q

Features of desmoplastic melanoma

A
  • Occurs in H&N of older patients, flesh coloured nodule
  • Frequently nonpigmented and looks kike scar
  • Sometimes associated with subtle junctional prolif of melanocytes
  • Presence of lymphoid aggregates at periphery of tumor
  • Frequently has PNI and deep extension
  • May be associated with elements of “conventional” melanoma
  • stains with S100/SOX10 but typically negative for other melanocytic markers
57
Q

Gene mutation most frequently associated with melanoma

A

CDKN2A (p16)
BRAF, NRAS, HRAS, CKIT also found in some

58
Q

Histopathological features of CLark nevus/dysplasic nevus

A

Lentiginous proliferation of melanocytes singly and in nests involving tips and sides of rete ridges with bridging
Shouldering
Papillary dermal fibrosis
Variable cytologic features
Perivascular lymphohistiocytic infiltrate

59
Q

Variants of melanoma that may be mistaken for nevi or other lesions

A

Nevoid melanoma
spitzoid melanoma
desmoplastic melanoma
Blue nevus-like metastatic melanoma

60
Q

Benign melanocytic lesions that may be mistaken for melanoma

A

Spitz nevus
Combined nevus
Halo nevus
Recurrent/persistent nevus after biopsy/partial resection
Irritated/traumatized nevus
Nevus in pregnancy with increased mitotic rate
Nevi of special sites

61
Q

Histopathologic features of Spitz nevus

A

Clinical context - usually young patients with a pink dome-shaped papule on the head and neck
Microscopically small, symmetrical, and circumscribed proliferation of spindled or epithelioid melanocytes arranged in nests surrounded by clefts at the dermoepidermal junction
Junctional, compound, or completely dermal
Spindle cells often vertically oriented as “hanging bananas” at tips of acanthotic rete ridges
Intraepidermal kamino bodies
Minimal pagetoid extension

62
Q

Molecular findings associated with Spitz nevus

A

HRAS
BAP1 loss
Deletions in 6p23
Fusion or translocations involving tyrosine kinases (ROS1, ALK, NTRK)

63
Q

Features of Spitzoid nevus with BAP1 loss

A

Typically dermal, lack epidermal hyperplasia and kamino bodies
Typically arise from common nevus showing a biphasic pattern with component of small melanocytes adjacent to spitzoid component.
Both components of melanocytes harbour BRAF muitations
Only spitzoid component shows BAP1 loss

64
Q

Histopathologic features of blue nevus

A

Common blue nevus: Small, wedge-shaped dermal aggregated of spindled and dendritic melanocytes in a fascicular pattern with admixed melanophages and dermal fibrosis
Cellular blue nevus: Dermal or subQ fascicles of monomorphous spindle cells without prominent pigmentation

65
Q

Histopathologic features suggestive of congenital nevus

A

Deep extesion of melanocytes into dermis +/- subQ fat
Extension of melanocytes along blood vessels and adnexal structures
Splaying of nevus cells between collagen bundles of the reticular dermis

66
Q

Clinical features of SCC that are associated with aggressive clinical course

A

Immunosuppressed patients
Lip, ear, vulva, perineum, penis location
Arising in chronic ulcer, scar, sinus

67
Q

Histopathologic variants of SCC associated with aggressive course

A

Acantholytic
Pseudovascular
Adenosquamous

68
Q

Benign lesions or conditions that can simulate SCC on histopathology

A

Pseudoepitheliomatous hyperplasia
Prurigo nodularis
Hypertrophic cutaneous lupus erythematosus
Hypertrophic lichen planus
Inverted follicualr keratosis
Desmoplasmic trichilemmoma
Modified verruca vulgaris
Proliferating pilar tumor

69
Q

Histopathologic features of keratoacanthoma

A

Exophytic and endophytic crateriform epidermal lesion with papillomatosis and abundant keratin in crater
Galssy eosinophilic keratinocytes towards center of nests and entrapment of elastic fibres at periphery
Exhibits inflammation, usually eos and neutrophilic microabscesses

70
Q

Classic clinical hx of keratoacanthoma

A

Rapidly growning nodule on sun exposed skin of elderly individuals, often with horn
Lesion that usually involutes over several months

71
Q

Factors of oncogenic important in Merkle Cell CA

A

Risk factors: advanced age, chronic sun exposure, fair skin, immunosuppression
Merkel ecll polyomavirus-mediated oncogenesis occurs in 80%
UV-mediated oncogenesis in minority of cases

72
Q

IHC for merkel cell CA

A

Synapto/chromo +
CK20/CAM5.2 paranuclear dot-like positivity
Dot-like positivity with neurofilament
Nuclear pos Merkle cell polyomavirus IHC
Neg: TTF1, S100, SOX10, melanoma markers, LCA

73
Q

Basaloid epithelial tumors on the DDx for nodular BCC

A

Basaloid SCC
Merkel cell CA
Trichoepithelioma
Trichoblastoma
Adenoid cystic CA
Sebaceous CA

74
Q

Stages of mycosis fungoides

A

Patch
Plaque
Tumor

75
Q

Clinical evolution of mycosis fungoides

A

Chronic scaly patches develop mainly on doubly clothes areas of the body, usually in adults
Disease is slowly progressive
May evolve into erythroderma
LN and other organ involvement can occur

76
Q

Histopathologic features of patch stage mycosis fungoides

A
  • Sparse lymphocytic infiltrate present in superficial dermis and extends into basal epidermis, often single file of cells
  • Increased lymphocytes within epidermis in absence of significant spong
  • Pautrier microabscesses - cluters of atypica lymphs in epidermis
  • Frank atypia uncommon, but cells may be angular with slightly enlarged hyperchromatic nuclei
  • Papillar dermal collagen has a coarse chiciken-wire pattern
77
Q

Malignant spindle cell lesions of skin

A

Melanoma
SCC
AFX/PDS
Leiomyosarcoma
DFSP
MPNST
Kaposi sarcoma
Angiosarcoma
Mets or extension of deep soft tissue tumor

78
Q

IHC for ddx of malignant spindle cell lesion of sun damaged skin

A

CK5/6, p63, p40
S100, SOX10, MelanA, HMB45
Desmin, actin, calponin
ERG, CD31, CD34
D2-40, HHV8
CD10

79
Q

DF vs DFSP

A

DFSP larger, deep extension, lace-like fat infiltration, uniform cytology with mild atypia
DF smaller, poorly circ dermal nodule with collagen trapping, associated epidermal hyperplasia. Heterogeneous cell population with multinucleated, pigmented, foamy cells
DFSP CD34+, FXIIIA-
DF CD34- FXIIIA+
DFSP COL1A1-PDGFR

80
Q

Differentiate cutaneous sebaceous neoplasms

A

Sebaceous hyperplasia - prominnet sebaceous lobules connected to common central follicular infundibulum
Sebaceous adenoma - most common sebaceous tumor of MTS. Mature sebocytes with minority of basaloid germinative cells. Circumscribed and lobulated.
Sebaceoma - Majority of tumor basaloid germinative cells, mature sebocytes are minor. Conspicuous mitoses but no atypica mits, marked pleomorphism etc
Sebaceous CA - Atypical basaloid cells with large and irregular vesicular nuclei, mild to severe nuclear atypia, mits, necrosis

81
Q

Classic clinical description of a glomus tumor

A

Painful nodule most commonly on digits, especially subungual
Derived from modified smooth muscle cells involved in thermoregulation (Sucquet-Hoyer cells)

82
Q

Painful cutaneous lesions

A

Angiolipoma
Neuroma
Glomus tumor
Eccrine spiradenoma
Leiomyoma

83
Q

Settings in which patients may develop cutaneous angiosarcoma

A
  • Elderly pts, head and neck, no predisposing condition
  • chronic lymphedema (stuart-treves syndrome)
  • Postirradiation
84
Q

2 variants of lipoma seen in skin

A

Angiolipoma: painful nodule, often on forearms, composed of mature adipose tissue with admixed blood vessels containing fibrin thrombi
Spindle cell lipoma: lesion in cape distribution of older men, composed of mature adipose tissue, CD34+ spindle cells, myxoid matrix, often with thick intervening ropey collagen and mast cells

85
Q

Mammary vs extramammary pagets

A

Mammary - Mucin+, CK7+, HER2+, often CEA+
Extramammary - less often HER2+
* staining profile similar to associated malignancy

86
Q

Histopathological features of epithelioid sarcoma

A

Multinodular proliferatio of epithelioid or spindled cells with variable atypia and mits, areas of geographic necrosis may look like palisading
Majority pos for vimentin, CK, EMA +/- CD34
Loss of INI1 expression

87
Q

Primary cutaneous lymphoma classification

A

Cutaneous T-cell and NK-cell lymphoma
* MF/Sezary syndrome
* Adult T-cell leukemia/lymphoma (HTLV-I)
* Primary cutaneous CD30+ LPDs

Cutaneous B-cell lymphomas
* MALT
* Primary cutaneous follicular centre lymphoma
* Primary cutaneous DLBCL, leg type
* Intravascular large B-cell lymphoma

Other - blastic plasmacytoid dendritic cell neoplasm

88
Q

Inflammatory conditions in which associated lymphoid infiltrate may contain CD30+ lymphocytes

A

Molluscum contagiosum
Persistent arthropod bite reaction
Drug eruption
Viral warts
HSV/VSV

RC (20 decks)

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