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Histopathology Flashcards

(55 cards)

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1
Q

Atypical fibroxanthoma

A

Dermal spindle cell tumour
Stains: CD10, CD68
Deep= pleomorphic dermal sarcoma

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2
Q

Spindle cell tumours

A
  • Spindle cell melanoma
  • Spindle cell SCC
  • AFX/PDS
  • Other sarcomas:
    E.g. Leimyosarcoma (fasicular appearance); dermatofibrosarcoma protuberans; angiosarcoma
  • If benign: dermatofibroma, neurofibroma (wavy appearance; mast cells), leiomyoma (cigar cells)
  • Scar

Markers:
SCC: cytokeratin stains
Smooth muscle: SMA, desmin, caldesmon
Vascular: CD31, CD34, ERG

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3
Q

Granulomatous processes

A
  • Granuloma annulare
  • Rheumatoid nodule
  • Necrobiosis lipoidica
  • Foreign body reaction
  • Infection
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4
Q

Stains for granulomatous histo (for infection)

A
  • PAS (Periodic Acid Schiff stain) or GMS (Grocott’s methenamine silver)
  • Ziehl Neelson or Wade Fite stain
  • Gram stain
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5
Q

Stains for melanocytes

A

SOX 10 - negative in histiocytes
S100 - can also stain positive histiocytes/dendritic cells
Melan-A
PRAME
HMB-45

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6
Q

Stains for SCC

A

AE1/AE3 (PCK-pancytokeratin)
Cytokeratin MNF116
CK56
P40, P63

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7
Q

Keratin-filled cysts

A

Epidermoid cyst - keratin more laminated
Dermoid cyst
Trichilemmal (pilar) cyst (missing granular layer) - keratin more compact
Pilomatricoma
Cystic SCC
Skin adnexal tumours e.g. poroma (less cystic)
Steatocystoma - sebaceous lobules in cyst wall, wavy keratin, absent granular layer, contains sparse keratin and sebaceous material

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8
Q

Trichoepithelioma

A
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9
Q

Blue cell tumours

A

BCC
Melanoma
Merkel cell/neuroendocrine
Lymphoma
Metastasis
Basaloid SCC

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10
Q

Merkel Cell Stain

A

Perinuclear dotting staining AE1/AE3
CD56
Chromogranin
Synaptophysin
CK20 - perinuclear dottiing
Poliomavirus stain

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11
Q

Syringoma

A

Nests, cords, ductular structures (containing pink amorphous material), can be like tadpoles/comma shapes
Ddx: trichoepithelioma, BCC, microcystic adnexal carcinoma

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12
Q

Stains for DF vs DFSP

A

DF: 13A, CD10
DFSP: CD34

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13
Q

Blue naevus

A

Spindle cells
Dense pigment
Granular melanin
Well circumscribed

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14
Q

SCC in situ

A

No maturation of keratinocytes in epidermis (just as large on top as on bottom of epidermis)
Mitoses
Nuclear pleomorphism
Upper dermal lichenoid inflammation

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15
Q

Neurofibroma

A

Spindle cell tumour
Mast cells
S100 positive (patchy)
CD34 positive (swirling pattern)
SMA negative (just staining blood vessels)
Can be polypoid

Ddx:
Palisaded and encapsulated neuroma
Schwannoma

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16
Q

herpes inclusions

A

multinucleation
moulding
margination

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17
Q

Stains for BCC

A

BerEp4

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18
Q

Trichilemomma

A

Clear cells (follicular epithelial cells)
Well circumscribed, symmetrical
Associations: Cowdens (PTEN mutation, also a/w breast, thyroid, GI ca)

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19
Q

Eccrine spiradenoma

A
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20
Q

Lesions that are painful

A

Blend an egg

Blue rubber bleb
Leimyoma
Eccrine spiradenoma
Neuroma
Dermatofibroma
Angiolipoma
Neurilemomma
Endometriosis
Granular cell tumour
Glomus tumour

Schwannomas
Angiolipomas
Glomus tumours
Granular cell tumours
Tufted angiomas
Leiomyomas

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21
Q

Keratoacanthoma (wdSCC, keratoacanthoma type)

A

Invagination of epidermis with colarette
Keratin-filled crater
Atypical squamous epithelium with pale glassy appearance cytoplasm, often down to deep dermis
Neutrophil collections

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22
Q

Solar keratosis

A

Atypia along basal layer
Thinning of granular layer
Parakeratosis, hyperkeratosis

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23
Q

Amyloid stain

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A

Crystal violet (magenta, metachromatic staining)
Congo red

24
Q

Difference between sebaceoma and sebaceous adenoma

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A

Sebaceoma - >50% basaloid cells
Sebaceous adenoma - <50% basaloid cells (basaloid cells at periphery, with sebaceous cells centrally)
Sebaceous carcinoma - more invasive, atypical mitoses, pleomorphism

25
Deep penetrating naevus stain (to differentiate from blue naevus)
Beta catenin
26
Stain for PEIN
P16
27
Muir Torre Stains/Mutations
MLH1, MSH2, MSH6, PMS2 (loss of)
28
Peripheral nerve sheath tumours
SOX10, S100 positive Melan-A negative Schwanomma - encapsulated, verocay bodies Neurofibroma - circumscribed but not encapsulated
29
Ductal lumen stains
EMA CEA
30
Ddx for syringoma
Desmoplastic trichoepithelioma Microcystic adnexal carcinoma
31
Poroma
Growth of terminal duct cells Circumscribed Compact cuboidal keratinocytes, small monomorphous nuclei, scant eosinophilic cytoplasm Stain: CEA positive Ddx: seb k, porocarcinoma
32
Spiradenoma
Lobulated, circumscribed Two types of basaloid cells - smaller palisaded at peripheries; adjacent larger spaced out basaloid cells Scattered lymphoyctes Cystic change/cyst like degeneration Ddx: cylindroma, spiradenocarcinoma
33
Cylindroma
Two cell types, same as spiradenoma (smaller basaloid cells palisaded at peripheries; adjacent larger spaced out) Occasional scattered lymphocyte superimposed Duct formation Jigsaw puzzle appearance Ddx: spiradneoma
34
Hidradenoma papilliferum
Finger-like projections (papillary growth), apocrine differentiation, cuboidal columnar epithelium lining ducts, duct formation (maze-like) ddx: syringocystadenoma papilliferum (plasma cells) tubular apocrine adenoma (more simple arrangement of glands, less maze-like)
35
Hidradenoma
Clear cells, poroid cells, squamous cells, mucin Duct formation Sclerotic stroma
36
Xanthogranuloma
Spindle cells Xanthomatisation Touton giant cells Superimposed lymphocytes, eosinophils Stain: CD68 or CD163 Ddx: dermatofibroma
37
Granuloma faciale
Dense polymorphous dermal infiltrate (plasma cells, neutrophils, lymphocytes) Perivascular accentuation, sometimes vascular damage Red cell extravasation Sweeping bands fibrosis Grenz zone Ddx: EED, Sweets
38
Langherans cell stains/markers
CD1A, langerin
39
Langerhans cells
Abundant pale eosinophilic cytoplasm Footprint nucleus Can get multiple nuclei
40
Warty dyskeratoma
Grains and corp ronds Acantholysis and clefting Acanthylotic dyskeratosis Reticulated areas ddx: Acontholytic dyskeratotic acanthoma
41
Spindle cell lipoma
Sharp demarcation, well circumscribed Adipocytes No septae Mucin/myxoid change n stroma Spindle cells Scattered mast cells Ropey collagen CD34 will stain spindle cells
42
Angiolipoma
Uniform adipocytes Small closely packed vessels, particularly peripherally
43
Naevoid melanoma - stains to help differentiate naevus and melanoma
KI67 - melanocytic proliferation hmb45 (+ve in melanoma, -ve in naevi) p16 (-ve in melanoma, +ve in naevi) Beta catenin more diffusely positive in deep penetrating naevus than in melanoma
44
Glomus tumour
Basaloid cells - concentric surrounding vessels Bland monotonous benign tumour of basaloid cells Positive for smooth muscle actin Negative for desmin
45
Glomangiomyoma
Circumscribed Some spindle cells Some smooth muscle differentiation Vascular
46
Granuloma annulare
Interstitial infiltrate - histiocytes, somewhat circumscribed Stain: alcian blue or colloidal iron for mucin Ddx: NLD - less spared normal dermal collagen, more diffuse, less circumscribed, no mucin Interstitial granulomatous dermatitis - also less circumscribed, more diffuse, more neutrophils
47
Types of dermatofibroma
Aneurysmal Cellular Atypical Lipidised Fibrocollagenous Clear cell Epithelioid Haemosiderotic Deep fibrous histiocytoma
48
Stains for melanin v haemosiderin
Schmorl's stain - melanin Prussian blue - haemosiderin
49
Xanthelasma
Xanthomatised histiocytes CD68 CD163
50
Trichoblastoma
Most commonly associated with sebaceous naevus Prominent cellular stromal component Predominantly basaloid epithelial cells in nests with peripheral palisading May show cribriform, rippled or solid patterns
51
Calcium stain
Von Kossa
52
Elastin stain
Verhoeff's stain VVG
53
Elastosis perforans serpiginosa
54
Lymphoma stains
CD45 - Bs and Ts CD3 - T cells CD20 - B cells
55
Lung met
CK7 TTF1

Histopathology (1 decks)

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