ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01346.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01347.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We report nine examples of a distinct cutaneous plaque‐like proliferation of fibroblasts and myofibroblasts. Eight of nine lesions were located in or around the shoulder, including axilla and upper arm. There was a predominance of women to men of 8:1. The lesions measured from 1 to 2 cm in greatest diameter. All patients were voting adults (mean age 29.8 yr). All lesions involved the reticular dermis in a plaque‐like fashion and extended to the upper part of the subcutaneous septa in seven cases. The lesions consisted of a proliferation of very uniform slender spindle‐shaped cells arranged as well‐defined elongated and intersecting fascicles with a predominantly parallel arrangement to the skin surface. There was no evidence of cytologic atypia and mitotic figures were infrequent. The spindle‐shaped cells were separated by thin collagen fibers. Elastic libers were preserved and some of them appeared thicker than normal. All adnexal structures were spared. Immunohistochemistry revealed that the cells stained positively for vimentin and muscle actin, but lacked smooth‐muscle specific actin. desmin, and S‐100 protein. Some dermal dendrocytes stained positively for Factor XIIa, but the spindle‐shaped cells were negative. Electron microscopy studies revealed a mixture of fibroblasts, myofibroblasts, and undifferentialted mesenchymal cells. All lesions were treated by conservative excision; follow‐up information revealed no evidence of recurrence. We name tins distinct lesiondermatolmyofibroma.To the best of our knowledge, this entity has not been previously described

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01348.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Seven cases of tricholemmal carcinoma (TLC), a rarely recognized cutaneous adnexal neoplasm of external hair sheath origin, are described. Most occurred on sun‐exposed skin; five involved the head and neck, one the right leg, and one the right thigh. TLC had a generally short history and all were treated by local excision. The lesions had an exophytic (3 cases) or polypoid (4 cases) gross appearance. Histologically, TLG exhibited a sharply circumscribed, tabular epithelial proliferation in continuity with the epidermis. A cytologic hallmark of these tumors was the presence of large cells with PAS‐reactive, diastase‐sensitive, clear iii‐ pale eosinophilic cytoplasm. High mitotic rate was a constant feature. Four tumors were infiltrative, with pushing borders, whereas three were intraepithelial. One case showed acantholysis. Immunocytochemistry revealed positively for prekeratin and negativity for (CEA and EMA, supporting the trichogenic origin of these tumors. Ultrastructural examination gave clear indication of epithelial origin for (he cells but did not verify hair follicular differentiation. Despite locally aggressive growth, (he clinical course of TLC appeared indolent. Moreover, there are no cases with metastases reported in the lit

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01349.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Trieliolemmal carcinoma (TLC) is a cutaneous adnexal tumor with presumed external hair sheath differentiation. In order to better understand the salient features of this neoplasm, we analyzed the histologic and clinical findings in 10 cases of TLC. Eight patients were males, and two were female; they ranged in age from 55–88 years. Each tumor occured in hair bearing, sun‐exposed. skin, and involved the scalp, face, trunk, or upper extremities. The lesions were usually slightly raised, pale tan or reddish, and keratotic; were usually present for less than I year; and measured 0.4–2.0 cm. All of them were treated by wide local excision; neither recurrence nor metastasis was reported after II to 92 months of clinical followup. Histologically, each I LC was composed of a lobular proliferation centered on the pilar apparatus. Cells with glycogen‐rich, mucin‐negative, clear or pale eosinophillic cytoplasm predominated. Brisk mitotic activity (4–39 mitoses per 10 high power fields) was typical. Involvement of the interfollicular epidermis was invariably noted, with superficial alteration in seven tumors. Transitional ones between TLC and the adjacent epidermis were not seen, although pagetoid spread occurred in two examples. Invasion of reticular dermis was present in eight cases, with infiltration to mid‐dermis in live TLC. All tumors exhibited areas of tricholemmal type keratinization; dyskeratotic cells were noted in six examples. Hyperkeratosis and parakeratosis were variably present as well. Actinic damage was a constant feature. Despite local invasion at diagnosis, the clinical course of TLC was indolent

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01350.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

The metastatic cascade depends on the presence of tumor cells which are capable of proliferation as well as of invasion with active motility. In the present study, it was examined whether the demonstration of both features in the primary lesion of malignant melanoma of the skin carries prognostic significance. Proliferation was assessed by mitotic counts and Ki 67 staining, and motility was estimated by image analysis and comparison of the image analysis results with computer simulations; 27 cases of primary malignant melanoma with a maximum vertical tumor thickness exceeding 1 mm were prospectively sampled. Mitotic counts were carried out on H&E stained sections, image analysis of the tumor pattern on S‐100 immunostained paraffin slides, and Ki67 labeling of actively cycling cells was evaluated on frozen sections. Neither proliferation nor pattern analysis alone provided a significant prognostic result with respect to overall survival and to metastasis free survival. The estimates of motility, derived from a combination of pattern analysis and proliferation values, however, proved to be significant predictors of overall survival and metastasis‐free survival (log rank test: p 0.05). The motility features were superior to Clark level and Breslow index in this set of cases. The results demonstrate that the assessment of tumor cell proliferation and motility in histological sections may reflect the metastatic potential of primary malignant melanomas of the s

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01351.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Epidermolysis bullosa (KB) refers to a group of hereditary mechano‐bullous conditions, many of which arc associated with chronic scarring. Several forms of (he disease have been reported in association with cutaneous malignancy. We present a series of 10 EB patients (eight generalised recessive dystrophic EB, one dominant dystrophic EB, one non‐lethal junctional EB) aged 24–25 years with a total of 29 squamous cell carcinomas (SCC). Three patients died from metastatic disease associated with invasive, poorly differentiated SCC. Six cases had multiple primary SCG, including three patients with simultaneous multifocal disease. Twenty‐eight of the 29 SCC arose on the limbs. I Histology revealed that most of the SCC were well or moderately differentiated (22/29). Unusual histological findings included two verrucous SCC, as well as a spindle cell (angiosarcoma‐like) SCC. Most of the SCC developed in areas of chronic non‐healing ulceration (10/29) or longstanding hyperkeratotic crusting (14/29). The dermis around or beneath the carcinomas was densely scarred, more so than in non‐malignant areas. In some cases it was difficult to distinguish the clinical appearances of certain areas of chronic ulceration, scarring, and crusting typical of dystrophic EB from many of the SCC. This study underlines the need for constant vigilance for the development of carcinomas in this group of patients, the occasional diagnostic difficulty, and the potential f

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01352.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

Mites and their eggs were thought to be rarely Found in nodular lesions of scabies. However, serial sections from 27 scabietic scrotal papules or nodules revealed mile parts in 22% (6/27). This supports the contention that scabietic nodules may result from persisting antigens of mile parts. In contrast lo previous studies, vasculitis with fibrinoid degeneration was uncommon (3/27) in our series. This discrepancy may be due lo the timing of the biopsies: 2 of 3 eases with vasculitis were associated with diffuse dense infiltration, and vasculitis may be a late event in the development of scabietic nodules. The specificity of immunoreactant deposits along the epidermodermal junction (EDJ) in scabies is controversial. In our study, direct immunofluorescence (DIF) was performed on 13 scabietic nodules. Four (31%) showed immunoreactants at the EDJ and two on blood vessels. Because of the relatively low positive rate, the low intensity of fluorescence, and 3 of 4 cases with positive immunoreactants having only a single class of immunoglobulin, the deposition may only be secondary lo inflammation instead of a specific type II immunologic reaction lo scabies.

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01353.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

A 57‐year‐old woman with cutaneous mastocytosis of 23 years duration developed a hyperpigmented abdominal plaque composed of confluent indurated papules that enlarged for a period of 1 year to 12×8 cm. Biopsy showed dermal infiltration by closely packed spindle‐shaped mast cells, fibroblasts, collagen, and scattered lymphocytes, predominately T‐suppressor cells/ Electron microscopy showed close contact between mast cells, fibroblasts, and lymphocytes Piecemeal mast cell degranulation and extrusion of mast cell granules was seen, with rare mast cell granules in fibroblasts, and collagen fibers in peripheral and perinuclear endoplasmic reticulum of mast cells. The termFibrous mastocytomais suggested for this tumor‐like dermal fibrosis, possibly induced by l

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01354.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

We describe two patients with crusted perincal plaques that were biopsied and diagnosed as Paget's disease. Resection specimens of each contained a dermal mucinous carcinoma with extensive epidermotropism and coexistent epidermal basaloid proliferations closely resembling fibroepithelioma (Pinkus). The presence of the Paget phenomenon was supported by histochemical, immnunohistochemical, and ultrastructrual evidence. No other primary neoplasms were found in either patient. Followup at 2 1/2 and 3 1/2 years, respectively, has been negative. We conclude that either the fibroepitheliomatous changes may be induced by or may represent a collision (unlikely) with the epidermotropic mucinous carcinoma. It is proposed that the concept fibroepitheliomatous Paget phenomenon be used to stand for the histologic changes common to our cases as well as those previously reported.

ISSN:0303-6987    

DOI:10.1111/j.1600-0560.1992.tb01355.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY