Dermpath Case for the Day No.2: M75. Scalp, vertex: Pigmented lesion ?LM ?SEBK. I'll probably wait for a couple of responses on this one! Amar far too quick last time.
Dermpath Case of the Day. F80 Scalp nodule. Feel free to have a go even if you're not expert just make some comments or share with colleagues. Happy Thursday!
RAC9114: Some great responses to this TRICHOGERMINAOMATOUS variant of TRICHOBLASTOMA (only one nice papillary mesenchymal body noted). H&E diagnosis for me. Molecular Abn.??
2024: Wk29 RAC9142 F30s Cyst Rt forearm (from today outsource case - this is not a joke): Should I do IHC for fun? - I think this is benign & c/w perineurioma. Please bear in mind 45% shortage of pathologists, similar for lab staff, health system in crisis. Thanks. 😇🙏😇
2024 Wk1 Friday RAC8997: M80s Left neck. ?SCC ?PG Macro: exophytic tumour 39mm diameter.
#dermpath
Low power is best & common things are uncommon on X
@DanGrahamMD
🤣😇
Tuesday Basic: Solar (freckle) lentigo is NOT a lentiginous melanocytic proliferation but overlaps with thin SEBK. Textbook case has bulbous rete "mister-men fee" but can be challenging with flat rete and lichenoid keratosis (reaction pattern) obscuring the lesion.
2024 Wk 12 Fri: F70s, 2 years lesion on the heel ?Calcified Cyst. For trainees today (first). We'll let experts have a go if you don't get it😇
#TooFarToDx
#ItsNeverACyst
#dermpath
MP1: Brain cortex: Nearly every capillary RBC infected by unpigmented parasites (P. falciparum) - rare. Sparse malaria pigment from previous schizogeny. MP1: Liver with haemozoin in sinusoids, lack of parasitised RBC in sinusoids.
@BloodScientist
@ttmalawi
RAC91111: The patient had another fibrous papule (angiofibroma). Our first thought was EFH but I remembered the epithelioid cell variant of fibrous papule and given location this was our fav'd Dx. Some more images👇See also: PMID: 30028760
RAC9120: This was a example of a nodular BCC with a nice infudibulcystic pattern in areas. IFCBCC can be indistinguishable morphologically from BFH altho latter typically has reactive MC & is limited to expanding from single follicles (never deep).
2024 Wk31 RAC9148 F60s. 4 years h/o intermittent / transient subcutaneous small sometimes tender / firm nodules that can self resolve over days / weeks.
No skin rash. Affects hands (dorsal & palmar areas). Help please
#Dermpath
A)Right thumb
2024 Wk 5 Friday RAC9041: M90s scalp - same patient as Tuesday. We discussed u can have different patterns of p16/p53 aberrancy. Here SCC, subtle AK, & two BAK all within 7mm have 4 different highly aberrant p16/p53 patterns. Don't assume background AK related to inv cSCC😇
Dermpatholoyg case for interest (dipping my toe in here!) M55. Multiple lesions previously and now 3 more all look similar, two on thigh and one on lower leg. Representative H&Ex4. What is the diagnosis? What IHC stains might be helpful? Any other interesting facts?
2024 Wk6 (Sickie) Monday RAC8983. M60s Inner canthus, nodule 3 years, ?BCC. Is the first Monday in February really the day that most employees will call in sick?
RAC9127: Thanks for suggestions. Probably not a spot diagnosis. Saw old man with big brain. Some more images. Will be very grateful for opinions.
@mccalmo
Post on Gottlieb bodies being under-recognised made me think of my personal observation of intra-epithelial mucin as a clue to follicular lesions (follicular mucin), mainly FSCC but some SEBK, IFK & tricholemmoma. Missed by everyone as far as I'm aware (could be wrong again!)🤣😇
2024 Wk 3 Friday RAC9046: IHC as requested (colleagues case). My diagnosis H&E: Suspicious for lentigo maligna. MelanA in keeping with LM (Sox10 and PRAME are options). PRAME negative case.
#dermpath
@Dermpathl
2024 Wk 7 Friday EVERY DAY CASE RAC9057: F80s. "Bowen's" Excision biopsy, central lesion & edge of specimen. Diagnostic term(s) & management discussion. For critical debate...
#dermpath
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2024 Wk19 (just!) Sunday RAC9095. It will have to be blind of clinical as I seem to be slipping and forget to add to my database! Just a recent bench case.
V excited (published in reverse order): 1. follicular SCC common tumour can closely mimic KA (23Apr24); 2. p16 & p53 highlighting KA is NOT cSCC, fPEH in FSCC also v KA-like (Nov23); 3. WHO adopts KA NOT cSCC & recognises common FSCC (Feb23)!