DermPath Flashcards
diagnosis of epidermal tumors slammed up against the epidermis
S- scc (keratin +)
L- leomyosarcoma (desmin +, smooth muscle actin)
A- afx
M- melanoma (s100+)
Differences between KA and SCC
KA - never acantholysis, has neutrophil microabcesses, eos, and collagen trapping
Pagets Disease immuno markers
CK7+
S100-
CEA +
PAS+, diastase negative bc of sialomucin (difference from Bowens which is diastase positive)
multiple pilomatricomas are associated with which disease?
Myotonic Dystrophy
Stains strongly in BCC
BCL-2
Which two paisley tie tumor dx do you see horn cysts in?
Desmoplastic Tricho ep
MAC
What do desmoplastic trichoeps have that none of the other paisley tie tumors have?
calcification
syringomas look like what on physical exam and are common in whom?
Red small papules on the lower lids, common in downs patients
on path are a paisley tie tumor with no horn cysts calcification or perinueral invasion
Fibrofolliculoma is the same this as:
Trichodiscoma
Multiple fibrofolliculomas, trichodiscomas, acrochordons
Birt-Hogg-Dube (likely they are all the same thing) \+chromophobe RCC \+renal oncocytomas \+spontaneous pneumothorax
Kamino bodies
Spitz Nevus
translocation in clear cell sarcoma
(t12,t22)(q13,q12)
ddx of collections of neutrophils within the stratum corneum:
Psoriasis, tinea, candida, syphilis, seb derm, impetigo
Diagnoses with plasma cells:
Syphilis Kaposis Leichmeniasis Squamous cell Melaonma Rhinoscleroma Tuberculosis
What is the pneumonic for spongiosis with eos? and what does is stand for
HAAPIE Herpes gestationis arthropod bite allergic contact derm pemphigus pemphigoid incontia pigmenti e tox
Subcorneal split
- essentially in the granular layer
- dsg-1
Pemphigus folieceous
Medlar bodies
copper pennies in Chromoblastomycosis
“chain of coins, or brass knuckles”
Lobomycosis
deep fungal inx associated with dolphins
Lobomycosis
Splendore-Hoeppli phenomenon
yeast cell surrounded by eosinophilic fringe (also known as Asteroid body)
thick walled spherules loaded with endospores
Coccidiodomycosis
broad based budding
Blastomycosis
Mariners wheel
PUaracoccidiodomycosis (south american blastomycosis)
Morula
Protothecosis
Which is positive for which (DFSP vs DF)
- CD34
- Factor XIIIa
DFSP - CD34 (has abt 34 letters)
DF- Factor XIIIa (has abt 13 letters)
Which is positive for which (DFSP vs DF)
- CD34
- Factor XIIIa
DFSP - CD34 (has abt 34 letters), factor XIIIa negative
DF- Factor XIIIa (has abt 13 letters), CD34 negative
What spindled tumor is CD68+?
AFX
Conditions in which you find angiod streaks
P-penacillamine E- ehlers danlos P- PXE S- sickle cell I- increased phosphate L- lead poisoning T- thalessemia
Conditions with spongiosis with eosinophils:
H- herpes gestationis A- allergic contact derm A- arthropod P- pemphigoid P- pemphigus I- incognitia pigmenti E- e tox
Conditions with spongiosis with eosinophils:
H- herpes gestationis A- allergic contact derm A- arthropod P- pemphigoid P- pemphigus I- incognitia pigmenti E- e tox
Stains for mast cells
Leider
Toltidine blue
Giemsa
CD117
Epitheliod Sarcoma histo markers
Vimentin
Pankeratin
EMA (Epithelial membrane antigen)
*epitheliod sarcomas has features of an epithelial cells and of sarcoma cells
Culture medium used for Mycobacteria
Lowenstein-Jensen
Culture medium for Neisseria Gonorhhea
Chocolate agur
Culture medium for staph or strep
Sheep blood agar
Russel Bodies
Plasma cells with immunoglobulin within them
Found in:
Rhinoscleroma
&Granuloma inguinale
Donovan bodies
Granuloma inguinale
DDs for PEH with pus:
Here Come Big Green Leafy Veggies
Halogenoderma Chromomycosis Blastomycosis Granuloma inguinale Leichmeniasis V pemphigus vegetans
Globi found in the dermis
Lepromatous Leprosy
Donovan bodies
Granuloma inguinale (organisms within histiocytes)
Mycobacteria (Lepromatous Leprosy) stain well with:
Fite stain
*NOTE= tuburculoid leprosy does not stain well with Fite stain
Guaneri bodies
Smallpox
The presence of which types of cells help distinguish LyP from PLEVA?
CD30+ cells (present in LyP but not PLEVA)
Name two endothelial cell markers
CD31, CD34
What stain is used to identify cells of mesenchymal origen?
Vimentin
What finding clinches the diagnosis for infantile digital fibroma?
Pink Red inclusions within cells
Finding: pink/red inclusions within cells of a big pink dermal ball
Infantile digital fibromatosus
Pustulo-ovoid bodies of Milan
Granular cell tumor
Virchow cells
Lepromatous leprosy
Sudan III stain
Used to stain Virchow cells in lepromatous leprosy
What stain do you use to stain Virchow cells in leprosy
Sudan III stain
Most common stain for leprosy
Fite stain
Does a DF stain for:
- CD34
- Factor XIIIa
CD34- (This is positive in DFSP)
Factor XIIa +
What will a DF stain with?
Factor XIIIa +
CD34-
Variant of DFSP with melanin in it
Bednar tumor
Stains of an AFX
S186+
CD10+
Procollagen+
What does a cellular neurothekeoma stain with?
PGP9.5
What does PGP9.5 stain?
Cellular neurothekeoma
Leukemia with following features:
- bland chromatin (blasts)
- box car (cells lined up splaying the collagen)
Myeloid Leukemia (leukemia cutis)
Classic markers for MF
CD3+, CD4+, CD7-
Name the site of each b cell lymphoma clinically:
- Marginal zone
- Follicle center
- Marginal zone - extremities
2. Follicle center - head and neck (like a lollipop)
3 Ls of inflammation around the eccrine glands
Lupus (lymphocytes or plasmas)
Lymphoma
Lichen Striatus
AND BUGBITE (must have eos)
Von Kossa stains what
Calcium
Ber-Ep4 is positive in what type of tumor?
MAC or Desm BCC
BCC/Desmo trichoep
Negative in MAC
What stain is used to distinguish MAC from BCC or Desmo trichoep
Ber-Ep4 (positive in BCC/Trichoep, negative in MAC)
T/F NLD has mucin deposition
False - it does not!
Path stain for mucin
Alcian blue
Colloidal iron
Toluidine blue
Characteristic immunohistochemical finding in Pagetoid Reticulosis
CD45- (pagetoid reticulosis is a rare type of CTCL found as scaly lesions on the hands and feet)
Merkel cell tests positive for what stain
Cytokeratin 20
(Also for CAM5.2, NSE, chromogranin, synaptophysin)
S-100 negative*
Neurofilament stain is positive in everything nerve related except:
Schwannoma
Osteoclastic giant cells found in:
Giant cell tumor of the tendon sheath (no epi)
&
NXG
What part of the hair follicle is a trichelomma derived from?
Outer root sheath (glycogen derived)
What cell type differentiates LyP from PLEVA?
Eos! (In LyP)
Kamino bodies
Spitz
*will never have kamino bodies in melanoma
Histologic findings in morphea, that are different from NSF and scleromyxedema
Morphea has plasma cells
Trapped eccrine glands
Morphea has a reduced number of CD34+(unlike scleromyxedema or NSF)
Reduced number of CD34+ cells
Morphea
Characteristic staining pattern of nodular amyloid
Green birefringence under polarized light with Congo red stain
Is amyloid diastase resistant or positive?
Resistant
What type of protein is macular and lichen amyloid derived from?
Keratinocyte derived (vs nodular amyloid which is AL light chain derived)
Which is the only cutaneous amyloidosis that is NOT keratinocyte derived?
Nodular amyloid
Clinical findings of each of the following:
Lichen amyloid
Macular amyloid
Nodular amyloid
Lichen amyloid: highly pruritic shiny flat topped papules on the shins
Macular amyloid: hyperpigmented small firm papule with rippled appearance coalescing into plaque in the interscapular area
Nodular amyloid: single or multiple waxy nodules with purpura on the extremities
Primary systemic amyloidosis due to what type of protein?
AL (light chain)
Primary systemic amyloid due to what cause mainly?
Multiple Myeloma
Secondary Systemic amyloid due to what type of protein
AA (non-immunoglobulin protein; amyloid associated protein)
Type of amyloidosis due to chronic inflammation, rheumatoid arthritis, TB, periodic fever syndromes like TRAPS Muckle Wells ect
Secondary systemic amyloid
The 5 L’s of eccrine gland inflammation
Lues (syphilis) Lichen striatus Lymphoma Pernio CTCL Bugbite
Merkel cell stains with what CD marker
CD20 in a perinuclear dot pattern
Follicular mucinosis is positive for all of the following except:
CD3, CD4, CD5, CD6, CD7, CD8, CD9, CD10
Follicular mucinosis is negative for CD10
What is the most specific stain for Langerhans cells??
CD207 (Langerin), stains Birbeck granules
Monocytes/Macrophages stain positive for what?
CD68 & HAM56
What is LCH negative for?
Factor VIIIa(dendritic cells), & CD68, and HAM56 (macrophages)
Pustulosis-ovoid bodies
Granular cell tumor
Who has a granular layer and who does not?
Pilar cyst vs epidermal inclusion cyst
EIC - granular layer
Pilar cyst - no granular layer
Name some palisaded granuloma diseases
NLD, GA, some venereal diseases
Giant cells seen in the septae of erythema nodosum
Miescher’s granulomas
Miescher’s granulomas
Giant cells/granulomas seen in the septae of E nodosum
What stain is more specific for calcium than Von Kossa?
Alizarin red. *stains calcium red-orange
Most common stain used for calcium
Von Kossa
Name the three stains that stain the pink inclusions of infantile digital fibromatosis
Masson trichromatic
Movats pentachrome
PTAH (phosphotungistic acid hemotoxylin)
What is another name for the HHV-8 stain to test for Kaposis?
LANA-1
LANA-1
Another name for the HHV-8 stain that they use to stain Kaposis sarcoma
Translocation in DFSP
Chromosome 17:22
Stains for amyloid
Stains for mucin
AMYLOID: Thioflavin T, crystal violet, PAS
MUCIN: Alcian blue, colloidal iron, toluidine blue
Marker for Merkel Cell
CK20
What is CK20 a marker for?
Merkel cell