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 © 2001-2009, DermAtlas | Image Name: | LinearNevus_1_090828 | File Type: | jpg | |
| Diagnosis: | NEVUS, EPIDERMAL / NEVUS, LINEAR EPIDERMAL | Category: | linear eruptions / neoplasm, epidermal | ||
| Body Site: | leg | Age: | 12 years | ||
| Contributor: | Will Sorey, MD | ||||
| Description: | linear warty hyperpigmented plaque | ||||
| Comments: | This 12-year-old boy had a linear brown warty plaque on the back of his left leg at birth.The lesion was asymptomatic and unchanged since birth. This case was prepared by senior medical student at the University of Mississippi.Sarah Conerly, | ||||
 © 2001-2009, DermAtlas | Image Name: | actinic_keratosis_1_070501 | File Type: | jpg | |
| Diagnosis: | KERATOSIS, ACTINIC | Category: | neoplasm, epidermal | ||
| Body Site: | ear lobe | Age: | 86 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | At low power, there is a characteristic 'flag sign', where the abnormal parakeratin skips over adnexal units. These areas are hyperkeratotic. | ||||
| Comments: | This is a typical example of an actinic keratosis, forming on sun-exposed skin. These are dysplastic, or pre-cancerous, lesions related to ultraviolet light exposure. There is a spectrum from actinic keratosis to hypertrophic actinic keratosis to squamous cell carcinoma in situ (keratotic type) to invasive squamous cell carcinoma. Although this spectrum admittedly exists, it is best not to lump all actinic keratoses into in situ carcinomas because only a small percentage of the former lead to invasive carcinoma. The dysplasia of an actinic keratosis is different from that of Bowen's disease, which likely derives from adnexal units and shows a different, more aggressive, biologic behavior. | ||||
| Related Images: | actinic_keratosis_2_070501 | ||||
 © 2001-2009, DermAtlas | Image Name: | actinic_keratosis_2_070501 | File Type: | jpg | |
| Diagnosis: | KERATOSIS, ACTINIC | Category: | neoplasm, epidermal | ||
| Body Site: | ear lobe | Age: | 86 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | At slightly higher power, the keratinocytic dysplasia is more evident. There is nuclear crowding and hyperchromasia. It is largely confined to the lower layers of the epidermis. | ||||
| Comments: | This is a typical example of an actinic keratosis, forming on sun-exposed skin. These are dysplastic, or pre-cancerous, lesions related to ultraviolet light exposure. There is a spectrum from actinic keratosis to hypertrophic actinic keratosis to squamous cell carcinoma in situ (keratotic type) to invasive squamous cell carcinoma. Although this spectrum admittedly exists, it is best not to lump all actinic keratoses into in situ carcinomas because only a small percentage of the former lead to invasive carcinoma. The dysplasia of an actinic keratosis is different from that of Bowen's disease, which likely derives from adnexal units and shows a different, more aggressive, biologic behavior. | ||||
| Related Images: | actinic_keratosis_1_070501 | ||||
 © 2001-2009, DermAtlas | Image Name: | Pigmented_Basal_Cell_Carcinoma_5_061020 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL / CARCINOMA, BASAL CELL, PIGMENTED | Category: | neoplasm, epidermal / neoplasm, malignant | ||
| Body Site: | face / cheek | Age: | 85 years | ||
| Contributor: | Catinchi-Jaime Steven, MD | ||||
| Description: | The so called "retraction artifact" which is extremelly characteristic of basal cell carcinomas is seen with higher magnification. This is caused by the formalin fixing process and not because of the tumor cells. Also note a few normal mitotic figures which is a common finding in this tumor. | ||||
| Comments: | This 85-year-old man was evaluated by his dermatologist for a brown nodule on the right forehead.The tumor measured 0.4 x 0.4 x 0.4 cm in the greatest dimension. No ulcerated or endophytic component was observed. The lesion was removed with a 1.0 cm resection margin, and histology revealed a pigmented basal cell carcinoma. Pigmented basal cell carcinoma is an epithelial tumor wich is more common in darkly pigmented races. It is a variation of nodular basal cell carcinoma. Due to the abundant pigment this lesion is sometimes misdiagnosed as malignant melanoma. The characteristic microscopic features of pigmented basal cell carcinoma are present in this case. They include basaloid tumor cell nests budding from the epidermis into the dermis with variable atypia, retraction artifact (the stroma is separated from tumor nests due to formalin effect during fixation process), peripheral palisading of nuclei on basal layer, presence of mucin within the stroma (might be present within basaloid aggregates), variable amount of melanin and melanocytes within the tumor, variable lymphocytes, plasma cells or lymphoid follicules around the tumor in the dermis. Basal cell carcinoma almost never metastazises. Their biological behavior bears no resemblance to melanoma. Last but not least, this variant of basal cell carcinoma is not among the most aggressive basal cell carcinomas. | ||||
| Related Images: | All related Images Pigmented_Basal_Cell_Carcinoma_1_061020 Pigmented_Basal_Cell_Carcinoma_2_061020 Pigmented_Basal_Cell_Carcinoma_3_061020 Pigmented_Basal_Cell_Carcinoma_4_061020 | ||||
 © 2001-2009, DermAtlas | Image Name: | Pigmented_Basal_Cell_Carcinoma_4_061020 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL / CARCINOMA, BASAL CELL, PIGMENTED | Category: | neoplasm, epidermal / neoplasm, malignant | ||
| Body Site: | face / cheek | Age: | 85 years | ||
| Contributor: | Catinchi-Jaime Steven, MD | ||||
| Description: | Collections of melanin and melanophages are seen within the solid tumor. Note the globules containing hyaline-like material within the neoplasm. | ||||
| Comments: | This 85-year-old man was evaluated by his dermatologist for a brown nodule on the right forehead.The tumor measured 0.4 x 0.4 x 0.4 cm in the greatest dimension. No ulcerated or endophytic component was observed. The lesion was removed with a 1.0 cm resection margin, and histology revealed a pigmented basal cell carcinoma. Pigmented basal cell carcinoma is an epithelial tumor wich is more common in darkly pigmented races. It is a variation of nodular basal cell carcinoma. Due to the abundant pigment this lesion is sometimes misdiagnosed as malignant melanoma. The characteristic microscopic features of pigmented basal cell carcinoma are present in this case. They include basaloid tumor cell nests budding from the epidermis into the dermis with variable atypia, retraction artifact (the stroma is separated from tumor nests due to formalin effect during fixation process), peripheral palisading of nuclei on basal layer, presence of mucin within the stroma (might be present within basaloid aggregates), variable amount of melanin and melanocytes within the tumor, variable lymphocytes, plasma cells or lymphoid follicules around the tumor in the dermis. Basal cell carcinoma almost never metastazises. Their biological behavior bears no resemblance to melanoma. Last but not least, this variant of basal cell carcinoma is not among the most aggressive basal cell carcinomas. | ||||
| Related Images: | All related Images Pigmented_Basal_Cell_Carcinoma_1_061020 Pigmented_Basal_Cell_Carcinoma_2_061020 Pigmented_Basal_Cell_Carcinoma_3_061020 Pigmented_Basal_Cell_Carcinoma_5_061020 | ||||
 © 2001-2009, DermAtlas | Image Name: | Pigmented_Basal_Cell_Carcinoma_3_061020 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL / CARCINOMA, BASAL CELL, PIGMENTED | Category: | neoplasm, epidermal / neoplasm, malignant | ||
| Body Site: | face / cheek | Age: | 85 years | ||
| Contributor: | Catinchi-Jaime Steven, MD | ||||
| Description: | There are palisaiding cell layers separated by stroma. The melanin pigment is located within the basaloid cells. Note the "pushing effect" of the tumor on the epidermis which appears thin with orthokeratosis on the stratum corneum. | ||||
| Comments: | This 85-year-old man was evaluated by his dermatologist for a brown nodule on the right forehead.The tumor measured 0.4 x 0.4 x 0.4 cm in the greatest dimension. No ulcerated or endophytic component was observed. The lesion was removed with a 1.0 cm resection margin, and histology revealed a pigmented basal cell carcinoma. Pigmented basal cell carcinoma is an epithelial tumor wich is more common in darkly pigmented races. It is a variation of nodular basal cell carcinoma. Due to the abundant pigment this lesion is sometimes misdiagnosed as malignant melanoma. The characteristic microscopic features of pigmented basal cell carcinoma are present in this case. They include basaloid tumor cell nests budding from the epidermis into the dermis with variable atypia, retraction artifact (the stroma is separated from tumor nests due to formalin effect during fixation process), peripheral palisading of nuclei on basal layer, presence of mucin within the stroma (might be present within basaloid aggregates), variable amount of melanin and melanocytes within the tumor, variable lymphocytes, plasma cells or lymphoid follicules around the tumor in the dermis. Basal cell carcinoma almost never metastazises. Their biological behavior bears no resemblance to melanoma. Last but not least, this variant of basal cell carcinoma is not among the most aggressive basal cell carcinomas. | ||||
| Related Images: | All related Images Pigmented_Basal_Cell_Carcinoma_1_061020 Pigmented_Basal_Cell_Carcinoma_2_061020 Pigmented_Basal_Cell_Carcinoma_4_061020 Pigmented_Basal_Cell_Carcinoma_5_061020 | ||||
 © 2001-2009, DermAtlas | Image Name: | Pigmented_Basal_Cell_Carcinoma_2_061020 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL, PIGMENTED / CARCINOMA, BASAL CELL | Category: | neoplasm, epidermal / neoplasm, malignant | ||
| Body Site: | face / cheek | Age: | 85 years | ||
| Contributor: | Catinchi-Jaime Steven, MD | ||||
| Description: | There are nests of basaloid cells with palisaiding cells. Note that the nests are separated by dermal stroma. There are melanophages intermixed with basaloid cells and collections of melanin pigment in between the cell nests (dermal collagenous tissue). | ||||
| Comments: | This 85-year-old man was evaluated by his dermatologist for a brown nodule on the right forehead.The tumor measured 0.4 x 0.4 x 0.4 cm in the greatest dimension. No ulcerated or endophytic component was observed. The lesion was removed with a 1.0 cm resection margin, and histology revealed a pigmented basal cell carcinoma. Pigmented basal cell carcinoma is an epithelial tumor wich is more common in darkly pigmented races. It is a variation of nodular basal cell carcinoma. Due to the abundant pigment this lesion is sometimes misdiagnosed as malignant melanoma. The characteristic microscopic features of pigmented basal cell carcinoma are present in this case. They include basaloid tumor cell nests budding from the epidermis into the dermis with variable atypia, retraction artifact (the stroma is separated from tumor nests due to formalin effect during fixation process), peripheral palisading of nuclei on basal layer, presence of mucin within the stroma (might be present within basaloid aggregates), variable amount of melanin and melanocytes within the tumor, variable lymphocytes, plasma cells or lymphoid follicules around the tumor in the dermis. Basal cell carcinoma almost never metastazises. Their biological behavior bears no resemblance to melanoma. Last but not least, this variant of basal cell carcinoma is not among the most aggressive basal cell carcinomas. | ||||
| Related Images: | All related Images Pigmented_Basal_Cell_Carcinoma_1_061020 Pigmented_Basal_Cell_Carcinoma_3_061020 Pigmented_Basal_Cell_Carcinoma_4_061020 Pigmented_Basal_Cell_Carcinoma_5_061020 | ||||
 © 2001-2009, DermAtlas | Image Name: | Pigmented_Basal_Cell_Carcinoma_1_061020 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL / CARCINOMA, BASAL CELL, PIGMENTED | Category: | neoplasm, epidermal / neoplasm, malignant | ||
| Body Site: | face | Age: | 85 years | ||
| Contributor: | Catinchi-Jaime Steven, MD | ||||
| Description: | There is a flattened epidermis and a basaloid tumor containing melanophages and loose melanin pigment in between the epithelioid cells. | ||||
| Comments: | This 85-year-old man was evaluated by his dermatologist for a brown nodule on the right forehead.The tumor measured 0.4 x 0.4 x 0.4 cm in the greatest dimension. No ulcerated or endophytic component was observed. The lesion was removed with a 1.0 cm resection margin, and histology revealed a pigmented basal cell carcinoma. Pigmented basal cell carcinoma is an epithelial tumor wich is more common in darkly pigmented races. It is a variation of nodular basal cell carcinoma. Due to the abundant pigment this lesion is sometimes misdiagnosed as malignant melanoma. The characteristic microscopic features of pigmented basal cell carcinoma are present in this case. They include basaloid tumor cell nests budding from the epidermis into the dermis with variable atypia, retraction artifact (the stroma is separated from tumor nests due to formalin effect during fixation process), peripheral palisading of nuclei on basal layer, presence of mucin within the stroma (might be present within basaloid aggregates), variable amount of melanin and melanocytes within the tumor, variable lymphocytes, plasma cells or lymphoid follicules around the tumor in the dermis. Basal cell carcinoma almost never metastazises. Their biological behavior bears no resemblance to melanoma. Last but not least, this variant of basal cell carcinoma is not among the most aggressive basal cell carcinomas. | ||||
| Related Images: | All related Images Pigmented_Basal_Cell_Carcinoma_2_061020 Pigmented_Basal_Cell_Carcinoma_3_061020 Pigmented_Basal_Cell_Carcinoma_4_061020 Pigmented_Basal_Cell_Carcinoma_5_061020 | ||||
 © 2001-2009, DermAtlas | Image Name: | basal_cell_carcinoma_1_060728 | File Type: | jpg | |
| Diagnosis: | CARCINOMA, BASAL CELL | Category: | neoplasm, epidermal | ||
| Body Site: | nose | Age: | 57 years | ||
| Contributor: | Franco Fulciniti, MD, PhD | ||||
| Description: | 1.5 cm pink nodule with peripheral crusting and central erosion | ||||
| Comments: | This 57-year-old woman had a 2 year history of a nodule on the nose. Initially the lesion was slow growing, but over the last 2-3 months it grew more quicklyand crusting developed at the periphery. The tumor was excised successfully. | ||||
 © 2001-2009, DermAtlas | Image Name: | extramammary_paget_1_060410 | File Type: | jpg | |
| Diagnosis: | PAGET DISEASE (EXTRAMAMMARY) | Category: | neoplasm, epidermal / neoplasm, malignant | ||
| Body Site: | scrotum | Age: | 73 years | ||
| Contributor: | Emily Desantis, MD | ||||
| Description: | Histologic sections of skin show an acanthotic epidermis containing single cells and nests of large epithelioid mononuclear cells at all levels of the epidermis (upper panel). The cells have vesicular nuclei, prominent nucleoli, and abundant pale vacuolated cytoplasm. | ||||
| Comments: | This is a typical example of extramammary Paget disease. The differential diagnosis would include squamous cell carcinoma in situ (Bowen disease), melanoma in situ, and other carcinomas with pagetoid growth. A diagnosis of Paget disease is favored when positive for intracellular mucin, cytokeratin, and negative for s100, as in this case. | ||||
| Related Images: | extramammary_paget_2_060410 | ||||
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