#pathsky #cytosky #cytopath #liverpath #surgpath #cytology

A 70-year-old woman with two ill-defined lesions in the liver. Touch preparations and core liver biopsy shown. What are your differential diagnoses?

The basal layer and mid dermis contain large epithelioid cells with ample, delicate cytoplasm scattered in the epidermis as single cells.

The large epithelioid cells are positive for CK7.

The large epithelioid cells are negative for Melan A.

The large epithelioid cells are negative for p63.

88-year-old with vulvar lesion. Diagnosis: Extramammary Paget's disease.

88-year-old with vulvar lesion. What's your diagnosis?

This is a continuation of the case below: infant with scalp mass.

CD20

TdT

Ki-67

Diagnosis: Acute B-cell lymphoblastic leukemia/lymphoma with a KMT2A (MLL) rearrangement, aka mixed-lineage leukemia. KMT2A is seen in 10% of ALL, particularly infant leukemia. Clinical relevance: KMT2A is an important prognostic marker with poor outcomes and resistance to standard therapies.

PAX-5

CD79a

DDX of superficial pediatric small round blue cell tumors are sarcomas (Ewing family and fusion-associated); rhabdomyosarcoma; lymphomas/leukemias; neuroblastoma #dermpath #surgpath #blueskypath #blueskydermpath #blueskysurgpath #hemepath #blueskyhemepath #pathology #blueskypathology

A 3-month-old baby with an enlarging, abscess-like bump on the anterior fontanelle. Additional lumps appeared on ear and scalp, with hair loss and eroded skin. What are your differentials?
#blueskypath #blueskyderm #pathsky #dermsky #dermpath #dermpathsky #pedipath #surgpath #pathology #dermatology

Acquired Reactive Perforating Dermatosis is a Variant of Prurigo Nodularis - PubMed Patients with chronic pruritus may develop scratch-induced lesions with elevated borders and central necrosis. This so-called umbilicated type of prurigo (UP) is rare and is assumed to develop prefere...

#blueskypath #pathsky #blueskydermpath #dermpathsky #dermatopathology #surgicalpathology #dermpath #derm #dermatology #pathology #inflammatoryderm

pubmed.ncbi.nlm.nih.gov/27349279/

European academy of dermatology and venereology European prurigo project: expert consensus on the definition, classification and terminology of chronic prurigo - PubMed This new definition and terminology of CPG should be implemented in dermatology to harmonize communication in the clinical routine, clinical trials and scientific literature. Acute/subacute forms of p...

pubmed.ncbi.nlm.nih.gov/28857299/

Depressed focus of ulceration covered by parakeratosis and inflammatory debris.

Base of ulceration shows a focally intact, thinned epidermis and vertically oriented eosinophilic material disrupting the epidermis.

Trichrome-Elastic stain shows the vertically, eosinophilic material on H&E is degenerated, swollen collagen fibers. Fragmented elastic fibers are also extruded through the ulcer.

Trichrome-Elastic stain: Extrusion of collagen and elastic fibers through ulcer.

A 60-year-old man with skin lesions, DM and ESRD. Skin biopsy is from the leg.
A cup-shaped ulcer with degenerated collagen and elastic fibers extruded through the ulcer. The findings are compatible with an acquired perforating collagenosis/dermatosis or umbilicated chronic prurigo nodularis.

A 60-year-old patient with skin lesions. Skin biopsy from the leg. What is your diagnosis?

Hypercellular basophilic tumor with closely packed glandular architecture.

The closely packed "glands" contain dense eosinophilic material and are lined by monotonous cells.

PAX-8 is positive.

Thyroglobulin is positive.

Metastatic thyroid carcinoma to the scalp. #dermpath #surgicalpath #blueskypath #blueskypathology #blueskydermpath #immunohistochemistry #pathology

#pathology #dermatopathology #dermpath #histopathology #surgicalpathology #pathologist #anatomicpathology #pathologyatCooper #pathologyatCUHC

Excisional biopsy of 2.4 cm mass in left paramedian scalp. What's your diagnosis?