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 © 2001-2009, DermAtlas | Image Name: | vulva_nevus_2_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, GENITAL / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | vulva (labia) | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The melanocytic nests are large and expansile. They are located at all positions along the retia. There is the appearance of loss of cellular cohesion within the nests. Individual melanocytes are enlarged. Mitotic activity is not appreciated. | ||||
| Comments: | This 10 year old female presented with a pigmented papule on her vulva. A subset of genital nevi look unremarkable clinically but have atypical histologic features. This is well-described in the literature. Genital nevi include those on the labia, mons, perineum, penis and scrotum. The histologic features may mimic nodular melanoma. Often times, these nevi have large expansile nests, located at all positions along the retia. There is typically loss of cellular cohesion. There may be cytologic atypia, both epidermally and dermally. Rare mitoses may even be observed. Because it is rare for premenapausal women to develop vulvar melanoma, these features should be heavily scrutinized and the lesion excised if in doubt [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | vulva_nevus_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | vulva_nevus_1_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, GENITAL / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | vulva (labia) | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | At low power, the epidermis is acanthotic and papillomatous. Thre is a cellular nevomelanocytic lesion, involving the epidermis and dermis. There is overall symmetry. | ||||
| Comments: | This 10 year old female presented with a pigmented papule on her vulva. A subset of genital nevi look unremarkable clinically but have atypical histologic features. This is well-described in the literature. Genital nevi include those on the labia, mons, perineum, penis and scrotum. The histologic features may mimic nodular melanoma. Often times, these nevi have large expansile nests, located at all positions along the retia. There is typically loss of cellular cohesion. There may be cytologic atypia, both epidermally and dermally. Rare mitoses may even be observed. Because it is rare for premenapausal women to develop vulvar melanoma, these features should be heavily scrutinized and the lesion excised if in doubt [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | vulva_nevus_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichoblastoma_2_090401 | File Type: | jpg | |
| Diagnosis: | TRICHOBLASTOMA / NEVUS SEBACEUS | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | scalp | Age: | 54 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | At higher power, these basaloid collections form primitive structures, with finger- or floret-like projections into the hypercellular stroma. There are scattered suggestions of papillary mesenchymal bodies, where the stroma sweeps into the basaoild structures. There is no signficant peritumoral clefting, atypia or mitotic activity. The cells are monomorphous and bland. | ||||
| Comments: | This 54 year old woman presented with a solitary plaque on her scalp. Clinically, there was a nevus sebaceus (not seen on the biopsy) with a prominent papule, which was biopsied. Trichoblastomas and other basaloid proliferations are commonly observed in association with nevus sebaceus. Some authors consider trichoblastomas to have low-grade malignant potential like a basal cell carcinoma, but the majority, if not all, are benign with a more hamartomatous quality. This is a typical example of a trichoblastoma, mimicking a BCC at low power. Trichoblastomas tend to have organoid or primitive follicular differentiation with a hypercellular and condensed stroma, and lack of peritumor clefting or significant atypia. Pigmentation is common, as in this case. | ||||
| Related Images: | trichoblastoma_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichilemmoma_1_090401 | File Type: | jpg | |
| Diagnosis: | TRICHILEMMOMA | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | lip | Age: | 79 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | There is a single disrete warty papule on the lip. It is flesh colored. | ||||
| Comments: | This 79 year old man developed a single warty papule on his upper cutaneous lip. This is a typical clinical and histologic appearance of a trichilemmoma. One can see how it can be mistaken for a verruca, but to date, no virus has definitively been associated with a trichilemmoma. This is thought to be derived from the outer root sheath of the follicle, highlighted by the clear cell morphology of the lesion. Multiple trichilemmomas have an association with Cowden disease. | ||||
| Related Images: | All related Images trichilemmoma_3_090401 trichilemmoma_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichilemmoma_2_090401 | File Type: | jpg | |
| Diagnosis: | TRICHILEMMOMA | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | lip | Age: | 79 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | The epidermis is acanthotic and papillomatous. There is coarsening of the granular layer, accentuated in the divots of the papillations. There is an epithelial lesion with a smooth base and clear cell morphology. | ||||
| Comments: | This 79 year old man developed a single warty papule on his upper cutaneous lip. This is a typical clinical and histologic appearance of a trichilemmoma. One can see how it can be mistaken for a verruca, but to date, no virus has definitively been associated with a trichilemmoma. This is thought to be derived from the outer root sheath of the follicle, highlighted by the clear cell morphology of the lesion. Multiple trichilemmomas have an association with Cowden disease. | ||||
| Related Images: | All related Images trichilemmoma_3_090401 trichilemmoma_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | trichilemmoma_3_090401 | File Type: | jpg | |
| Diagnosis: | TRICHILEMMOMA | Category: | neoplasm, adnexal, follicular / neoplasm, benign | ||
| Body Site: | lip | Age: | 79 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | At higher power, there is peripheral palisading of a basaloid layer. The adjacent epithelium has clear cell change. The cells are monomorphic, without atypia or mitotic activity. | ||||
| Comments: | This 79 year old man developed a single warty papule on his upper cutaneous lip. This is a typical clinical and histologic appearance of a trichilemmoma. One can see how it can be mistaken for a verruca, but to date, no virus has definitively been associated with a trichilemmoma. This is thought to be derived from the outer root sheath of the follicle, highlighted by the clear cell morphology of the lesion. Multiple trichilemmomas have an association with Cowden disease. | ||||
| Related Images: | All related Images trichilemmoma_2_090401 trichilemmoma_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | calcinosis_cutis_1_090401 | File Type: | jpg | |
| Diagnosis: | CALCINOSIS CUTIS | Category: | deposition disorders / Metabolic disorders | ||
| Body Site: | elbow | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | Several white rock-hard papules are present on the extensor surface of one elbow. There were no other clinical findings. | ||||
| Comments: | This 10 year old girl presented with several rock-hard papules on the elbow region. These developed over months to years and were asymptomatic. She has no other medical problems. Calcinosis cutis is often dystrophic calcification, and in this location, likely secondary to trauma. Systemic disorders, such as dermatomyositis, in a child, may present with calcinosis cutis. Systemic hypercalcemia is a rare cause of calcinosis cutis in a child. | ||||
| Related Images: | calcinosis_cutis_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | calcinosis_cutis_2_090401 | File Type: | jpg | |
| Diagnosis: | CALCINOSIS CUTIS | Category: | deposition disorders / Metabolic disorders | ||
| Body Site: | elbow | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There are collections of basaloid granular material in the superficial dermis, with overlying epidermal hyperplasia. The material is basophilic and refractile, consistent with calcium (pyrophosphate). | ||||
| Comments: | This 10 year old girl presented with several rock-hard papules on the elbow region. These developed over months to years and were asymptomatic. She has no other medical problems. Calcinosis cutis is often dystrophic calcification, and in this location, likely secondary to trauma. Systemic disorders, such as dermatomyositis, in a child, may present with calcinosis cutis. Systemic hypercalcemia is a rare cause of calcinosis cutis in a child. | ||||
| Related Images: | calcinosis_cutis_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | mucocele_1_090401 | File Type: | jpg | |
| Diagnosis: | MUCOCELE | Category: | mucous membrane disorders | ||
| Body Site: | lip | Age: | 10 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | There is a single soft papule on the lower mucosal lip. It is cystic and freely mobile. | ||||
| Comments: | This young man developed a cystic but mildly firm papule on the mucosal surface of his lower lip. Mucoceles can result from blockage of a minor salivary duct, casing ductular dilitation or may rupture, as in this case, resulting in an inflammatory process. | ||||
| Related Images: | mucocele_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | mucocele_2_090401 | File Type: | jpg | |
| Diagnosis: | MUCOCELE | Category: | mucous membrane disorders | ||
| Body Site: | lip | Age: | 10 years | ||
| Contributors: | Greg Hosler, MD, PhD Patrick Keehan, D.O. | ||||
| Description: | This biopsy is of mucosa. There is a mixed inflammatory infiltrate in the submucosa, comprised of lymphocytes, histiocytes, neutrophils and abundant extravasated mucin. | ||||
| Comments: | This young man developed a cystic but mildly firm papule on the mucosal surface of his lower lip. Mucoceles can result from blockage of a minor salivary duct, casing ductular dilitation or may rupture, as in this case, resulting in an inflammatory process. | ||||
| Related Images: | mucocele_1_090401 | ||||
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