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Flashcards in adnexal Deck (25)
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1

sebaceous adenoma

-Distinctly circumscribed lobular tumor
- mature sebaceous cells (sebocytes >50% ) and basaloid (germinative) cells
-Minimal cytologic atypia, mitoses may be prevalent

2

Hidradenom​a papillifer​um

-Circumscribed tumor in dermis
-maze-like glandular spaces, apocrine differentiation, papillary folds
-no epidermal connection
-minimal inflammation around

3

Syringoma

-Proliferation tadpole-like eccrine ducts dermi
- No aggressive infiltration of the deeper dermis\
- Horn cysts
- Stroma fibrotic sclerotic

4

Syringocys​tadenoma papillifer​um

-Papillomatous epidermis connecting to underlying tumor ,Papillary projections into cystic space
-Cystic space within tumor opens to surface of skin
- lined by upper portion squamous epithelium
lower portion lined by sweat glandular epithelium
- Apocrine decapitation secretion
-Plasma cell infiltrate
-Nevus sebaceus

5

DFSP

-Epidermis normal, atrophic, or ulcerated
- cellular proliferation small bland spindled fibroblasts and collagen in the dermis, extending into the subcutaneous fat
-Cartwheel pattern/ storiform
- no foamy cells or multinucleated giant cells
- fascicular or honeycomb Infiltration of fat
-Cytologic atypia mild to moderate,few mitoses
L

6

DFSP STAIN

CD34+, stromelysin-3neg, factor XIIIaneg, D2-40neg (all four opposite of dermatofibroma). S-100 is negative

7

NF

- Well circumscribed non encapsulated dermal nodule
- thin fascicles spindle cells wavy nuclei
-Pale “bubblegum” pink fibrillary collagenous stroma, mucinous or myxoid
-increased Mast cells, small blood vessels

8

NF stains

-acid mucopolysaccharides( Mucinous stroma)
-+ S-100, CD34, PGP9.5, factor XIIIa,
+ Bodian, myelin basic protein

9

Nodular hidradenom​a

-Nodular tumor dermis /subcutaneous tissue
-one cell type of basaloid cells,focal connection to epidermis
-Sweat duct lumina , eccrine differentiation, Hyalinized collagen, Keratinous cysts

10

Eccrine poroma

-sharp demarcation,acanthotic epidermis
-Tumor basaloid “poroid” cells(- clear :glycogen accumulation (PAS positive, diastase labile)
-extending into dermis
- Small sweat ducts usually present within tumor

11

Blue nevus

-Poorly circumscribed proliferation pigmented dendritic melanocytes within dermis
-dispersed haphazard arrangements
-melanocytes heavily laden melanin granules melanophages
Epidermis normal

12

Nevus sebaceus

-Epidermal hyperplasia ,papillomatosis
-many normal or enlarged sebaceous/ apocrine glands, unassociated with mature hair shafts.

13

Nevus sebaceus Cx

BCC, less than 5%
trichoblastoma
syringocystadenoma papilliferum
trichilemmoma

14

Leiomyoma

-Circumscribed non encapsulated tumor
-Fascicular patterm Interlacing bundles smooth muscle cells
-blunt ended cigar-shaped spindle cell nuclei and abundant pink cytoplasm ( longitudinal section), round nuclei with vacuoles( cross-section)
-Hair follicle association



15

Dermatofibroma

Poorly circumscribed dermal proliferative lesion
Merges surrounding dermis
Histiocytes fibroblasts dense interwoven collagenous network
Small blood vessel proliferation
Periphery: Xanthomatized cells, MNCGC, collagen entrapment
Epidermis hyperplastic hyperpigmented

16

Stains leiomyoma

SMA diffuse positive, trichrome Positive, immunostaining desmin

17

Pilomatricoma

-Lobular proliferation lower dermis
-2 distinct cell type
A)peripheral: basophilic matrical cells, hyperchromatic nuclei
B)central: transition eosinophilic cells ghost outlines
-calcification, foreign body granulomas

18

Spitz nevus

-Regular Symmetry, sharp circumscription
-Uniform nevus Nests no pagetoid spread, Bland cytological morphilogy, lack deep mitoses
-large epitheloid cells along DEJ smaller proportion spindle cells
-Dermal component compound raining down appearance
-Kamino bodies- amorphous eosinophilic aggregates papillary dermis

19

Dysplastic nevus


-elongated, clubbed rete ridges
-Poorly circumscribed larger irregular melanocytic nests cells fine dusty melanin granules
-Single melanocytes predominant DEJ bridging between rete ridges, Dispersed sides tips , fusion adjacent nests, shoulder phenomenon- Junctional melanocytes extend beyond dermal melanocytes at periphery
-Maturation of nests
-Lamellar papillary fibrosis variable cytological atypia
Perivascular lymphocytic infiltrate

20

Schwannoma

-Lobulated Encapsulated subcutaneous tumor
-fasciculated arrangement schwann cells
- cellular areasSpindle cells (Antoni A tissue) and/or edematous myxoid areas (Antoni B tissue)
- Antoni A nuclei arranged in pallisades/rows ,separated by areas without nuclei (Verocay bodies)
-Mucinous stroma stains positive for acid mucopolysaccharides
-Mast cells common
-Tumor may be attached to large nerve

21

Schwannoma stains

Positive staining S-100 myelin basic protein (MBP) Antoni A areas, negative neurofilaments
Bodian stain negative

22

DFSP pathogenesis

fusion of COL1A1 gene with the PDGFB gene
ring chromosomes r(17;22) or linear t(17;22)(q22;q13)

23

DFSP managememt

wide excision or Mohs surgery
tyrosine kinase inhibitor drug, imatinib,

24

Mets breast CA

Infiltrative tumor islands atypical cells with glandular differentiation within dermis
Epidermotropsim, glandular formation
Thin infiltrative cords tumor ells dissecting coklagen bundles indian filing pattern
Tumor aggregates in dilated lymphatics, BV

25

trichoepithelioma

-cribiform basaloid islands( resemble poorly dev hair follicles) with palisading without peritumoral retraction clefting but peristromal clefting
-papillary mesenchymal bodies and horn cysts
-loose stroma many fibroblasts