By Bruce R. Smoller
Dermal Tumors: The Basics serves as an efficient and effective instruction manual for the scholar of dermatopathology, and as a realistic bench reference for the practising diagnostician who wishes swift entry to standards which are worthy in differentiating histologically related entities. The chapters include crucial bullet issues prepared in geared up outlines taking into consideration easy accessibility and direct comparability among entities. the flowery pictorial documentation also will permit the e-book to function an atlas of the most typical dermatologic disorders.
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Dermal Tumors: the fundamentals serves as a good and effective guide for the scholar of dermatopathology, and as a realistic bench reference for the working towards diagnostician who wants quick entry to standards which are helpful in differentiating histologically related entities. The chapters include crucial bullet issues prepared in equipped outlines bearing in mind easy accessibility and direct comparability among entities.
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There is often an epidermal collarette. 17 Angiolymphoid hyperplasia with eosinophilia demonstrates a marked inflammatory infiltrate at lowest magnification. 18 At high magnification, swollen endothelial cells may make vessels appear to be small granulomas in angiolymphoid hyperplasia with eosinophilia. The percentage of eosinophils present in the infiltrate is highly variable. Original magnification 400× Fig. 19 In some cases of angiolymphoid hyperplasia with eosinophilia, there are many eosinophils surrounding the thickened blood vessels.
25 This case of follicle center lymphoma shows a mixture of small and large centrocyte-like cells with scattered centroblast-like cells that show large nuclei and prominent nucleoli (arrows) 1 An Overview of Cutaneous Lymphomas 29 –– Immunologic features °° Predominance of CD20+ or CD79a + cells in infiltrate with scattered reactive CD3/CD43+ lymphocytes °° Either kappa or lambda restriction in many cases °° Bcl-2 expression uncommon in primary cutaneous FCC lymphomas (common in nodal based lymphomas) °° Bcl-6 expression helpful in confirming follicular nature of cells °° CD10 expression seen only in follicular pattern, not in diffuse growth pattern lymphomas °° CD5 and CD43 are negative –– Molecular features °° Clonality can be established in most cases, but t(14;18) is not seen in primary cutaneous FCC lymphoma –– Treatment protocols °° °° °° °° Orthovolt radiation therapy to local lesions Surgical excision has been used (less desirable) Radiation also effective for recurrent lesions Chemotherapy indicated only when noncontiguous regions are affected –– Prognosis °° Local relapses present in 25% of cases (disease-free interval was 27 months (mean)) °° Systemic spread of disease in <5% of cases °° 5-year survival >95% independent of growth pattern (nodular vs.
15) °° Vascular spaces lined by plump endothelial cells with °° °° papillary projections into lumen Abundant hemosiderin deposits, especially laterally Poorly circumscribed and infiltrative growth pattern at periphery 48 2 Vascular Tumors Fig. 14 Targetoid hemosiderotic hemangioma demonstrates thin vessels with prominent endothelial cells and surrounding hemosiderin. Original magnification 200× Fig. 15 Targetoid hemosiderotic hemangioma (hobnail hemangioma) demonstrates prominent endothelial cell protrusion into the lumen in a hobnail-like pattern.