| Image |
Slide # |
Tissue |
Mag |
Feature |
 |
Case 1 |
Skin-Seborrheic keratosis |
Gross |
Verrucous, "stuck-on" brown papule |
 |
Case 1 |
Skin |
LP |
Hyperkeratosis (thickening of the stratum
corneum), horn pseudocyst, and acanthosis (thickening of the stratum spinosum |
 |
Case 2 |
Actinic keratosis |
Gross |
Whitish hyperkeratotic papules with erythema.
Usually multiple |
 |
Case 2 |
Actinic keratosis |
HP |
Hyperkeratosis and atypical hyperchromatic
keratinocytes. The underlying dermis exhibits bluish smudgy discoloration
termed solar elastosis |
 |
Case 3 |
Bowen's disease (squamous carcinoma in-situ) |
Gross |
Papulosquamous plaque with hyperkeratotic
scaling and erythema on sun-exposed skin. This image shows extensive crusting
(different image from that included in Dermpath lab cases) |
 |
Case 3 |
Bowen's disease (squamous carcinoma in-situ) |
LP |
Normal epidermis on left lower edge of
skin image. Acanthotic epidermis at lower right of image. Beneath acanthotic
region is band of lymphocytes attempting to keep atypical lymphs out of
dermis. |
 |
Case 3 |
Bowen's disease (squamous carcinoma in-situ)
|
HP |
Bizarre atypical hyperchromatic keratinocyte
in epidermis. Horn pearls are also present. |
 |
Case 4 |
Basal cell carcinoma |
Gross |
Nodular tumor with pearly raised borders
and central depression (umbilication) or ulceration. Telangiectasias may
be seen in raised borders. |
 |
Case 4 |
Basal cell carcinoma |
HP |
Tumor cell nests are composed of basaloid
cells and peripheral palisading basal cells. Note surrounding stromal retraction
away from tumor nests. |
 |
Case 5 |
Squamous cell carcinoma |
Gross |
Indurated nodule with erythema and central
ulceration. Located on cheek (sun-exposed skin) |
 |
Case 5 |
Squamous cell carcinoma |
LP |
Invasion of dermis by squamous epithelium |
 |
Case 5 |
Squamous cell carcinoma |
HP |
Bizarre hyperchromatic nuclei of keratinocytes.
Dark purple keratin pearl. |
 |
Case 6 |
Nevus sebaceus |
Gross |
Linear, verrucous and yellowish plaque
on face of child. Yellow color is secondary to lipid contained within sebaceous
glands of this lesion. |
 |
Case 6 |
Nevus sebaceus |
LP |
Hyperkeratosis, acanthosis, and papillomatosis
with underlying proliferation of sebaceous glands and apocrine glands in
underlying dermis. |
 |
Case 6 |
Nevus sebaceus |
MP |
Sebaceous glands and apocrine sweat glands. |
 |
Case 7 |
Melanocytic nevus |
Gross |
Brown papule, most consistent with compound
nevus. (Junctional nevi are usually brown macules). |
 |
Case 7 |
Melanocytic nevus |
HP |
Nevus cell nests are localized to both
the dermal/epidermal junction and within the dermis. |
 |
Case 8 |
Malignant melanoma |
Gross |
Nodular, blue-black tumor with asymmetry,
irregular border, variegation in color, and diameter greater than 6mm. |
 |
Case 8 |
Malignant melanoma |
LP |
Tumor cells extend from epidermis to invade
the dermis. Note brown melanin pigment in tumor cells. |
 |
Case 8 |
Malignant melanoma |
HP |
Pagetoid spread of tumor cells through
epidermis. There is also dermal invasion. Some tumor cells contain brown
melanin pigment. |
 |
Case 9 |
Skin tag (acrochordon) |
Gross |
Pedunculated (on a stalk) flesh-colored
papule. |
 |
Case 9 |
Skin tag (acrochordon) |
LP |
Pedunculated skin with epidermal papillomatosis
and underlying loose or edematous dermis. |
 |
Case 10 |
Epidermoid cyst (epidermal inclusion cyst) |
Gross |
Freely movable dermal subcutaneous nodule.
Cut section reveals a white, cheesy and malodorous cyst contents. |
 |
Case 10 |
Epidermoid cyst (epidermal inclusion cyst)
|
LP |
The cyst is lined by stratified squamous
epithelium which flakes off into the center of the cyst as pink keratin
"corn-flakes". |
 |
Case 11 |
Dermatofibroma |
Gross |
Frim nodule which is brown or flesh-colored
and dimples with central compression. |
 |
Case 11 |
Dermatofibroma |
LP |
The overlying epidermis is acanthotic
and hyperpigmented along the basal layer. Fibrosis is increased in the
dermis. |
 |
Case 11 |
Dermatofibroma |
HP |
Thick collagen bundles are intermixed
with spindled nuclei of fibroblasts. |
 |
Case 12 |
Keloid |
Gross |
Large, firm indurated nodule. |
 |
Case 12 |
Keloid |
LP |
Thick "hyalinized smudgy pink dermis.
Thinned epidermis with loss of rete ridges. |
 |
Case 12 |
Keloid |
HP |
Thick pink collagen bundles with interspersed
spindled nuclei of fibroblasts (much fewer in comparison than dermatofibromas). |
 |
Case 13 |
Neurofibroma |
Gross |
Flesh colored soft nodules. If multiple,
think of neurofibromatosis |
 |
Case 13 |
Neurofibroma |
MP |
Solid proliferation compressing overlying
atrophic epidermis. Pale dermis. |
 |
Case 13 |
Neurofibroma |
HP |
The stroma is pale and loose with interspersed
fibroblasts, mast cells, and Schwan cells, some of which are comma-shaped. |