Dr. Klingman Derm Review Picture Matching Flashcards
TrichiLemmoma
“lemmings” falling off surface
well defined
some palisading
TrichoFolliculoma
- Central cystic follicle
- NOT attached to surface
- whorled / collagenized stroma
- lace-like network between follicles
TrichoFolliculoma
Central cystic follicle
NOT attached to surface
whorled / collagenized stroma
lace-like network between follicles
TrichoEpithelioma
Close to surface
Look for epidermoid cysts
look for papillary mesenchymal bodies (bulb structures)
Can look like BCC or blastoma, lack the BCC stroma / retraction artifact
TrichoEpithelioma
Close to surface
Look for epidermoid cysts
look for papillary mesenchymal bodies (bulb structures)
Can look like BCC or blastoma, lack the BCC stroma / retraction artifact
TrichoEpithelioma
Close to surface
Look for epidermoid cysts
look for papillary mesenchymal bodies (bulb structures)
Can look like BCC or blastoma, lack the BCC stroma / retraction artifact
TrichoEpithelioma
Close to surface
Look for epidermoid cysts
look for papillary mesenchymal bodies (bulb structures)
Can look like BCC or blastoma, lack the BCC stroma / retraction artifact
TrichoEpithelioma
Close to surface
Look for epidermoid cysts
look for papillary mesenchymal bodies (bulb structures)
Can look like BCC or blastoma, lack the BCC stroma / retraction artifact
TrichoEpithelioma
Close to surface
Look for epidermoid cysts
look for papillary mesenchymal bodies (bulb structures)
Can look like BCC or blastoma, lack the BCC stroma / retraction artifact
Pilomatrixoma
Ghost cells / calcifications
young patients (under 20 y/o)
Giant cells (esp rupture)
Can transform into pilomatrixocarcioma
TrichoBlastoma
Blast = blue and more primitive
Low power looks like BCC
Symmetrical, uniform
Lacks retention artifact
can have pigment (hair)
Cholesteatoma
epidermoid cyst of the ear
usually rupture, giant cells
calcifications
granular cell layer
potential hearing loss, aggressive benign
Steatocystoma
epidermal inclusion cyst with basal palisaiding
looks like an OKC
Sebaceous elements in the wall or cyst lining
Nevus sebaceous
should be attached to an isthmus
can have a SK look in epi
beware of sebacous BCCs
Sebaceous Hyperplasia (Adenoma)
Middle age
nose, cheek, midface
some atypia allowed
worry when atypia is in an EYE lesion
Sebaceous carcinoma
usually around the EYE
lots of atypia
pigment
Muir-Torre Syndrome
Ghost cells possible
Camedo necrosis
IHC: EMA, AR
Sebaceous carcinoma
usually around the EYE
lots of atypia
pigment
Muir-Torre Syndrome
Ghost cells possible
Camedo necrosis
IHC: EMA, AR
Eccrine hidrocystoma
usually from around the conjunctiva
cuboidal lining = eccrine
columnar = apocrine
apocrine hidrocystoma
(these can just be signed out as hidrocystoma)
Poroma
DDx: trichelemmoma, Plexiform SK, BCC, hidradenoma
Attached to surface
Plexiform
Very uniform bland “poroid” cells
Will NOT form CYST like spaces (like a hidradenoma does)
Poroma
DDx: trichelemmoma, Plexiform SK, BCC, hidradenoma
Attached to surface
Plexiform
Very uniform bland “poroid” cells
Will NOT form CYST like spaces (like a hidradenoma does)
Hidradenoma (eccrine acrosporoma)
looks like a poroma, just not attached to the surface
can be cup shaped like a KA, but bland cells
Optically clear, very round nuclei
tumor budding allowed
slit like “cracking” spaces
Hidradenoma (eccrine acrosporoma)
looks like a poroma, just not attached to the surface
can be cup shaped like a KA, but bland cells
Optically clear, very round nuclei
tumor budding allowed
slit like “cracking” spaces
Hidradenoma (eccrine acrosporoma)
looks like a poroma, just not attached to the surface
can be cup shaped like a KA, but bland cells
Optically clear, very round nuclei
tumor budding allowed
slit like “cracking” spaces, cyst-like
Hyalinization
Hidradenoma (eccrine acrosporoma)
looks like a poroma, just not attached to the surface
can be cup shaped like a KA, but bland cells
Optically clear, very round nuclei
tumor budding allowed
slit like “cracking” spaces, cyst-like
Hyalinization
Hidradenoma (eccrine acrosporoma)
looks like a poroma, just not attached to the surface
can be cup shaped like a KA, but bland cells
Optically clear, very round nuclei
tumor budding allowed
slit like “cracking” spaces, cyst-like
Hyalinization
Hidradenoma (eccrine acrosporoma)
looks like a poroma, just not attached to the surface
can be cup shaped like a KA, but bland cells
Optically clear, very round nuclei
tumor budding allowed
slit like “cracking” spaces, cyst-like
Hyalinization
Spiradenoma
THINK LYMPHOCYTES! (inflammatory component is a defining feature)
NOT attached to surface
very blue
eccrine in origin
hyalinized product
tiny glands/lumina (basal cell adenoma look)
plexiform
Spiradenoma
THINK LYMPHOCYTES! (inflammatory component is a defining feature)
NOT attached to surface
very blue
eccrine in origin
hyalinized product
tiny glands/lumina (basal cell adenoma look)
plexiform
Spiradenoma
THINK LYMPHOCYTES! (inflammatory component is a defining feature)
NOT attached to surface
very blue
eccrine in origin
hyalinized product
tiny glands/lumina (basal cell adenoma look)
plexiform
Spiradenoma
THINK LYMPHOCYTES! (inflammatory component is a defining feature)
NOT attached to surface
very blue
eccrine in origin
hyalinized product
tiny glands/lumina (basal cell adenoma look)
plexiform
Cylindroma
NO inflammatory component (unlike the spiradenoma)
very basaloid
islands mon
JIGSAW pattern
not clear cells, just hyalinized
Cylindroma
NO inflammatory component (unlike the spiradenoma)
very basaloid
islands mon
JIGSAW pattern
not clear cells, just hyalinized
Syringoma
FISHTAILS / TADPOLE pattern
can look like a MAC (microcystic adnexal carcinoma)
not a nicely “packaged” lesion
islands/nests that “fishtail” off like hair pulp formation
Syringoma
FISHTAILS / TADPOLE pattern
can look like a MAC (microcystic adnexal carcinoma)
not a nicely “packaged” lesion
islands/nests that “fishtail” off like hair pulp formation with cystic spaces
eccrine adenocarcnoma
eccrine adenocarcinoma
apocrine hidrocystoma
apocrine hydrocystoma
tubular apocrine adenoma
like a cystadenoma in salivary tissue = multi compartments
hidroadenoma papilliferum (HPAP)
hard to distinguish from SPAP
papillary fronds
histiocytic / lymphocytic stroma
looks like a ductal papilloma of salivary tissue
lumen snouting, apocrine / holocrine secretions
hidroadenoma papilliferum (HPAP)
hard to distinguish from SPAP
papillary fronds
histiocytic / lymphocytic stroma
looks like a ductal papilloma of salivary tissue
lumen snouting, apocrine / holocrine secretions
hidroadenoma papilliferum (HPAP)
hard to distinguish from SPAP
papillary fronds
histiocytic / lymphocytic stroma
looks like a ductal papilloma of salivary tissue
lumen snouting, apocrine / holocrine secretions
hidroadenoma papilliferum (HPAP)
hard to distinguish from SPAP
papillary fronds
histiocytic / lymphocytic stroma
looks like a ductal papilloma of salivary tissue
lumen snouting, apocrine / holocrine secretions
hidroadenoma papilliferum (HPAP)
hard to distinguish from SPAP
papillary fronds
histiocytic / lymphocytic stroma
looks like a ductal papilloma of salivary tissue
lumen snouting, apocrine / holocrine secretions
Syringocystadenoma papilliferum (SPAP)
Plasma cells, lymphocytes in fibrovascular core stroma
Myoepithelial layer (may appear double layered
Growth into lumen
Can be connected to surface (“project from opening” in surface)
microcysts within the lining
Syringocystadenoma papilliferum (SPAP)
Plasma cells, lymphocytes in fibrovascular core stroma
Myoepithelial layer (may appear double layered
Growth into lumen
Can be connected to surface (“project from opening” in surface)
microcysts within the lining
Syringocystadenoma papilliferum (SPAP)
Plasma cells, lymphocytes in fibrovascular core stroma
Myoepithelial layer (may appear double layered
Growth into lumen
Can be connected to surface (“project from opening” in surface)
microcysts within the lining
Benign mixed tumor (Chondroid Syringoma)
Chondroid syringoma
Neurothekeoma (Nerve Sheath Myxoma)
