Ch. 26 - Metastatic tumors and simulators Flashcards

1
Q

What are the most common adenocarcinoma metastases to skin?

How can glandular differentiation be highlighted?

What IHC suggests primary cutaneous adnexal tumors over metastatic adenocarcinoma?

A

Breast or lung

Mucicarmine staining

CK5/6 and p63 positivity

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2
Q

Breast carcinoma

A

Poorly differentiated adenocarcinoma with many patterns and occasional epidermotropism. GCDFP15+, ER+, CK7+

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3
Q

Carcinoma en cuirasse

A

Woody induration of skin with dense dermal collagen and single files of hyperchromatic cells with nuclear molding. Rectangular punch!

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4
Q

Inflammatory carcinoma (carcinoma erysipeloides)

A

Tumor cells within dilated lymphatic vessels with congested capillaries

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5
Q

Alopecia neoplastica

A

Sclerotic dermis with infiltrative cords of atypical cells and loss of hair follicles.

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6
Q

Lung carcinoma

A

Most common skin met in men. Can be adeno/SqCC/SLCL….TTF1+.

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7
Q

Small cell lung carcinoma

A

Sheets of uniform round blue nuclei with little cytoplasm and nuclear molding. TTF1+ (vs Merkel cell)

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8
Q

Renal carcinoma

A

Tubules of clear glycogenated cells with prominent vascular (chicken-wire) component. CD10+, PAS+, RCC+

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9
Q

Colon carcinoma

A

Moderately-differentiatd adenocarcinoma, often mucinous. CK20+, CK7-, CDX2+

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10
Q

Ovarian carcinoma

A

Well-differentiated adenocarcinoma sometimes with papillary fronding or psammoma bodies. CK7+, CA125+

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11
Q

Signet-ring carcinoma

A

Usually gastric but sometimes breast or other GI primary. Mucin compresses nucleus to periphery. Loose stroma.

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12
Q

Thyroid carcinoma

A

Papillary or follicular. “Orphan Annie” nuclei and psammoma bodies. Thyroglobulin/TTF1+

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13
Q

Prostate carcinoma

A

Poorly differentiated adenocarcinoma infiltrating through collagen. PSA+

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14
Q

Metastatic squamous cell carcinoma

A

Deeper dermal tumor with squamous pearls and no epidermal connection. EMA/pankeratin+

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15
Q

Meningioma

A

Spindled to ovoid cells in whorls or groups. Sheet-like syncytia, psammoma bodies. EMA+

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16
Q

Endometriosis

A

Glandular spaces with loose concentric fibromyxoid stroma and large polygonal decidual cells.

17
Q

Omphalomesenteric duct polyp

A

Polypoid tumor in umbilicus with surface squamous epithelium and goblet-cell columnar epithelium with smooth muscle.

18
Q
A

Breast carcinoma

19
Q
A

Carcinoma en cuirasse

20
Q
A

Inflammatory breast carcinoma

21
Q
A

Renal cell carcinoma

22
Q
A

Colorectal carcinoma

23
Q
A

Ovarian carcinoma

24
Q
A

Papillary thyroid carcinoma

25
Q
A

Follicular thyroid carcinoma

26
Q
A

Metastatic squamous carcinoma

27
Q
A

Meningioma

28
Q
A

Endometriosis

29
Q
A

Omphalomesenteric duct remnant