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Dermatopathology > Elston Chapter 1 Basics > Flashcards

Elston Chapter 1 Basics Flashcards

1
Q

Anaplasia

A

atypical nuclei and pleomorphism

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2
Q

Asteroid body

A

collections of eosinophilic material seen in sporotrichosis also refers to star-shaped intracytoplasmic inclusions seen in giant cells of sarcoidosis or berylliosis or other granulomatous process

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3
Q

ballooning degeneration

A

destruction of epidermis by dissolution of cell attachments and intracellular edema

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4
Q

caterpillar bodies

A

pale pink linear basement membrane material within epidermis seen in PCT, represents degenerated type IV collagen

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5
Q

civatte/colloid bodies

A

pink, globular remnants of keratinocytes (lichen planus)

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6
Q

cornoid lamellae

A

45 degree anle parakeratosis in a column above a focus with diminished granular layer and underlying dyskeratotic cells

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7
Q

corps ronds/grains/dyskeratosis

A

corps ronds =- rounded nucleus with ahlo of poale to pink dyskeratotic cytoplasm corps grains = dark blue flattened nucleus surrounded by minimal cytoplasm dyskeratosis = abnormal individual-cell keratinization

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8
Q

Cowdry A body

A

also known as Lipshutz body intranuclear pink inclusions of herpesvirus infections

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9
Q

Cowdry B body

A

intranuclear pink inclusions of adenovirus and poliovirus infection

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10
Q

Donovan body

A

intracytoplasmic collectinos of bacteria seen in granuloma inguinale

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11
Q

Dutcher body

A

intracytoplasmic pink masses of immunoglobulin that invaginate into the nucleus of plasma cells and appear to be intranuclear

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12
Q

epidermolytic hyperkeratosis

A

coarse, irregular hypergranulosis associated with disruption of cell membranes associated with keratin 1 and 10 mutations

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13
Q

festooning

A

papillary dermis retains undulating pattern (often in PCT)

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14
Q

flame figure

A

collagen encrusted with major basic protein from eosinophils

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15
Q

guarnieri body

A

eosinophilic inclusions of smallpox

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16
Q

henderson-paterson body

A

intracytoplasmic oval, pink inclusions of molluscum infection

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17
Q

hyper/hypopigmentation

A

increased/decreased melanin pigment

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18
Q

kamino body

A

dull pink to amphophilic basement membrane material within epidermis in Spitz

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19
Q

koilocytes

A

keratinocytes with clear cytoplasm and shrunken raisin-like pyknotic nuclei

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20
Q

medlar body

A

chromomycosis copper penny spores brown round structure resembling overlapping copper pennies divide by septation, resembling a hot-cross bun

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21
Q

michaelis-gutman body

A

intra-and-extracellular calcified, concentric circular structures, seen in malakoplakia

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22
Q

papillary mesenchymal body

A

structure resembling whorl of plump mesenchymal cells normally present in the hair papilla (seen in trichoblastoma and trichoepithelioma)

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23
Q

Psammoma body

A

extracellular laminated, calcified structures seen in meningioma, papillary thyroid carcinoma, ovarian carcinoma

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24
Q

pseudoepitheliomatous hyperplasia

A

acanthosis of adnexal epithelium and epidermis mimcking SCC, often a/w trapping of elastic fibers

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25
Q

pseudohorn cyst

A

keratin-filled cystic structure result of cutting through invaginations of stratum corneum (connects to surface)

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26
Q

reticular degeneration

A

destruction of epidermis with cell membranes remaining in a net-like pattern

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27
Q

russell body

A

intracytoplasmic pink inclusions of fIg in plasma cells, seen in rhinoscleroma and other conditions with many plasma cells

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28
Q

Schaumann body

A

laminated calcified structure seen in sarcoidosis

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29
Q

verocay body

A

composed of 2 nuclear palisades enclosing pink cytoplasmic processes, seen in schwannoma

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30
Q

eyelid and ear skin

A

have many vellus hair follicles; eyelid skin has skeletal muscle in upper dermis

conjunctival side of eyelid skin has no stratum corneum or hair follicles, does have goblet cells

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31
Q

Areolar skin

A

slight acanthosis with basilar hyperpigmentation

sometimes central invagination of epidermis that leads to follicle and sebaceous glands

smooth muscle bundles in mid-deep dermis

apocrine glands in the reticular dermis

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32
Q

acral skin

A

compact eosinophilic stratum corneum

slight papillomatosis on dorsal surfaces

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33
Q

volar skin

A

compact eosinophilic hyperkeratosis with underlying stratum lucidum

no hair follicles or sebaceous glands

eccrine glands numerous

Meissner and Pacinian corpuscles can be seen

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34
Q

Mucosa

A

absent granular layer

keratinocytes large and pale (filled with glycogen)

dilated vessels in submucosa

can get smooth muscle bundles

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35
Q

nasal turbinate

A

erectile tissue with fibrous septa and vascular sinusoids and mucous glands

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36
Q

fetal skin

A

stellate and spindled fibroblasts (mesenchyme)

densely cellular

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37
Q

Hair anatomy

A

infundibulum - from epidermis to insertion of sebaceous gland

isthmus - from insertion of sebaceous gland to insertion of arrector pili muscle (bulge)

stem - from insertion of arrectorp ili muscle (bulge) to Adamson’s fringe (only present in anagen hairs)

Bulb - below the step of anagen hair follicle, from Adamson’s fringe to base of hair follicle

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38
Q

hair infundibulum

A

from epidermis to insertion of sebaceous gland

intraepidermal portion = acrotrichium

keratinizes in pattern of normal epidermis with granular layer

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39
Q

hair isthmus

A

from insertion of sebaceous gland to insertion of arrector pili muscle (bulge)

keratin formed in ABSENCE of granular layer = trichilemmal keratinization

inner root sheath is lost at this level and outer rooth sheath develops an inner corrugated, dense pink cornified layer; peripheral palisading of the outer root sheath is seen

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40
Q

Adamson’s fringe (Hair)

A

point above which hair cornifies

dermaotophytes only infect cornified hair above Adamson’s fringe

above Adamson’s fringe, Huxley’s layer of the inner root sheath no longer has trichohyalin granules

hair tends to retract from the inner root sheath above Adamson’s fringe

the inner root sheath is fused and blue-gray at this level and trichohyalin granules are not seen

the outer root sheath is composed of pink cells with peripheral palisading

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41
Q

Bulb

A

below stem portion/from Adamson’s fringe to base of hair follicle

3 zones: matrix, supramatrix, keratogenous zone

matrix - from base to critical line (widest point of bulb and papillae)

supramatrix - from critical line to B-fringe (point at which outer root sheath becomes multilayered and Henle’s layer no longer has trichohyaline granules)

keratogenous zone - from B-fringe to Adamson’s fringe

layers of the hair follicle that can be seen: fibrous root sheath, vitreous basement membrane zone, outer rooth sheath, inner root sheath (henle’s layer, huxley’s layer, cuticle of inner root sheath), hair shaft (cuticle of hair shaft, cortex), medulla

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42
Q

anagen vs telogen hairs

A

anagen hairs have stem and bulb producing hair shaft

telogen hairs lack inferior segment

telogen hairs are easily recognized in vertical sections as the club hair and surrounding trichilemmal keratin give the imrpession of a flame thrower

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43
Q

eponychium

A

visible cuticle - thick keratinous material boarders proximal nail fold and adheres to nail plate

true cuticle is located beneath the visible portion and is derived from teh ventral proximal nail fold

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44
Q

hyponychium

A

everything ventral to nail plate

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45
Q

solehorn

A

subungual white to colorless keratin extending from ditsal nail bed underheath the onychodermal band to below the free,distal edge of the nail plate

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46
Q

types of keratinization of the nail

A

onychokeratinization (no granular layer) ard keratin of nail plate

onycholemmal keratinization - ventral part of proximal nail fold (has granular layer), bed epithelium (cuticle, bed horny layer, solehorn) no granular layer

epidermoid keratinization - dorsal proximal nail fold, lateral folds, hyponychium

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47
Q

dermal dendrocytes

A

macrophage-type cell in dermis; many are factor 13a positive, some are S100 positive

likely serve as antigen presenting cells

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48
Q

giant cell types

A

foreign body - ncueli haphazard

Langerhans - nuclei in wreath shape

Osteoclast-like - ncueli haphazard and eccentric; cytoplasm deep pink with scallooped border that molds to adjacent cells

touton - ncuel in wreath with foamy cytoplasm peripherally

ringed siderophage - touton with hemosiderin (characteristic of fibrous histiocytoma type of DF)

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49
Q

histiocytes

A

epithelioid cell with central round/oval nucleus and surrounding cytoplasm

tend to coalsecein tissue without intervening connective tissue

phagocytosis and antigen presentation

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50
Q

Langerhans cell

A

dendritic cells in epidermis and dermis

CD1a+, S100+ peanut agglutinin, langerin +

reniform with eccentric nucleus

originate in bone marrow

contain birbeck granuels, tennis-racked-shaped rod and oval bodies seen in EM

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51
Q

Th1 vs Th2 cytokines

A

Th1 cells prdouce IL-1, IL-2, IL-12 and IFN-gamma and are important for cell-mediated immunity and function in activating macrophages

TH2 cells produce IL-4, IL-5 and IL-10 and are important for humoral immunity

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52
Q

what cytokine induces eosionphil production

A

IL-5

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53
Q

eosinophils contain

A

major basic protein, eosinophil cationic protein, catalase and other proteins

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54
Q

Masson’s trichrome

A

collagen - blue green

smooth msucel - red

ex) scar (blue-green) vs leiomyoma (red)
pitfall: young collagen can stain red

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55
Q

Verhoeff-Van Gieson

A

stain elastic fibers black

ex) absence or reduction in scar, mid-dermal elastolysis, anetoderma, cutis laxa
ex) distorted fibers in PXE

get beaded elastic fibers in elastofibroma dorsei

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56
Q

toluidine blue

A

stains mast cell granules metachromatically

also stains mucin/acid mucopolysaccharides

can use in urticaria pigmentosa to get metachromatic staining

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57
Q

Leder stain

A

naphthol ASD choracetate esterase

mast cell cytoplasm stains red (not dependent on presence of granules)

also stains myeloid cells (eg leukemia cutis)

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58
Q

name 2 mast cell stains

A

toluidine blue

leder

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59
Q

Name 5 carbohydrate stains

A

PAS, alcian blue, colloidal iron, toluidine blue, mucicarmine

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60
Q

mucicarmine stains

A

acid mucopolysaccharides pink to red - stains mucinous capsule of Cryptococcus neoformans pink to red

61
Q

colloidal iron stains

A

acid mucopolysaccharides blue

hyaluronidase digestion can be combined with colloidal iron to differentiate between hyaluronic acid and other mucosubstances

62
Q

Alcian blue stains

A

acid mucopolysaccharides blue

in normal skin, most mucin is sulfated acid mucopolysaccharide (heparin, chondroitin, and dermatan sulfates)

in most patholgoic states with increased dermal mucin, mucin is prdominantely non-sulfated hyaluronic acid

non-sulfated acid mucopolysaccharides (hyaluoronic acid) stain with Alcian blue at pH 2.5 but not pH0.5

ex) follicular mucinosis, GA, myxoid cyst, dermal mucin in lupus

Sulfated acid mucopolysaccharides stain with Alcian blue at both pH 2.5 and pH 0.5

can use with or without hyaluronidase to differentiate hyalulronic acid from other mucopolysaccharides

63
Q

PAS stains what

A

glycogen, neutral mucopolysaccharides (like BM), and fungi

glycogen is diastase labile, ie. sections exposed to diastase before staining do not stain red with PAS

useful for clear cell acanthoma and trichilemomma

fungai and neutral mucopolysaccharides (basement membrane) are diastase resistant

can see thickened vessel walls in porphyria

acid mucopolysaccharides (hyaluronic acid) do not stain with PAS

64
Q

amyloid stains with what 3 stains

A

congo red - stains brick red and has apple green birefringence withp olarized light

thioflavin T - yellow to yellow-green with fluorescent microscope

Crystal violet - metachromatic stain for red-purple amyloid color

65
Q

Iron stains with what?

A

Prussian blue (Perls stain) - ferric ions react to form a deep blue color

distinguish melanin from hemosiderin

does not ID iron in intact RBCs

66
Q

Melanin stains with what

A

Fontana-Masson - silver stain resulting in black precipitate with melanin

67
Q

calcium stains with what 2 stains?

A

von kossa - silver stain stains calcium salts black (PXE, calcinosis cutis, calciphylaxis)

Alizarin red - binds directly to calcium ions resulting in orange-red color

68
Q

lipids stain with what stains?

A

oil red O

sudan black

osmium tetroxide

all require fresh tissue

69
Q

bacteria stain with

A

Brown Hopps - modification of Brown-Brenn technique; gram positive stains blue and gram negative stains red

70
Q

Fungi stain with what 2 stains

A

PAS - PAS positive and diastase resistant

GMS (Grocott’s methenamine silver) - gray-black reaction with fungal walls, also stains Nocardia and Actinomyces

71
Q

Mycobacteria stain with what 4 stains?

A

Ziehl-Neelsen acid-fast tain

Fite acid fast stain

Kinyoun’s acid fast stain

mycobacteria stain bright red

fite is preferred for partially acid-fast organisms such as lepra bacilli, atypical mycobacteria and Nocardia - it preserves color due to use of peanut oil and gentle decolorization

Auramine-rhodamine - mycobacteria fluoresce reddish yellow with fluorescent microscope

72
Q

Spirochetes stain with what stains?

A

Warthin-Starry, Dieterle, Steiner (modeified Dieterle)

silver stains stain black spirochetes

ex) lyme (around vessels and in dermal papillae), syphilis (lower epidermis)

also stains Legionella, Bartonella and Donovan bodies of granuloma inguinale

73
Q

Giemsa stains what organisms and features?

A

myeloid and mast cell granules purplish blue

bacteria, Leishmania and Histoplasma

74
Q

AE1/AE3 stains what?

A

cocktail of higha nd low molecuar weight monoclonal cytokeratin antibodies

stains epdermis and adnexal epithelium

stains all epithelial tumors (SCC and adnexal)

also stains epithelioid sarcoma, synovial sarcoma and mesothelioma

75
Q

pankeratin/CK polyclonal keratin is used rather than AE1/AE3 why?

A

greater sensitivity

76
Q

p63 is expressed where

A

basal and spinous cells of epidermis

germinative cells of sebaceous glands

myoepthelial cells of sweat glands

NOT reactive in metastatic carcinoma –>helps differentiate from primary cutaneous adnexal neoplasms

reactive in cutaneous spindle cell SCC

77
Q

CAM5.2 detects low molecular weight cytokeratines present in what?

A

glandular neoplasms

does not stain epidermis or stratified squamous epithelium

marks Paget’s disease and extramammary Paget’s

78
Q

CK7 use for what?

A

dtermine origin of metastatic carcinoma

marker for non-GI adenocarcinoma

Mark’s Paget’s disease and extramammary Paget’s

79
Q

CK20 stains what tumor?

A

Merkel cell carcinoma - stains in paranuclear pattern and distinguishes from metastatic oat cell carcinoma of lung that is typically negative

used in determining origin of metastatic carcinoma

marker of rGI adenocarcinoma

highlights sparase Merkel cells within basaloid islands of desmoplastic trichoep but not BCC

80
Q

CK7 +, CK20+

A

bladder, pancreatic

81
Q

CK7+, CK20 -

A

breast, lung, mesothelioma

82
Q

CK7-, CK20+

A

Colon cancer

83
Q

CK7-, CK20-

A

hepatocellular, prostate, renal, neuroendocrine and SCC of lung

84
Q

CK7 positive

A

(generally non-GI adenocarcinoma)

bladder, pancreatic (CK20+)

breast, lung, mesothelioma (CK20-)

85
Q

CK20 positive

A

(generally positive in GI adenocarcinoma)

bladder, pancreatic (CK7+)

colon (CK7-)

86
Q

CDX2 stains what

A

intestinal adenocarcinoma

cutaneous metastatic colon adenocarcinoma and extrammamary Paget’s a/w underlying colorectal tumor

87
Q

RCC (renal cell carcinoma)

A

positive in most cutaneous mets from RCC and negative in other clear cell tumors of skin

88
Q

TTF-1

A

thyroid transcription factor

reactive in metastatic small cell lung carcinoma but negative in Merkel cell carcinoma

89
Q

EMA

A

epithelial membrane antigen

highlights normal sebaceous and sweat glands

positive in sebaceous carcinoma, Paget’s and extramammary Paget’s

90
Q

CEA

A

carincoembryonic antigen

highlights sweat glands, sweat gland neoplasms, Paget’s, extrammamary Paget’s and most adenocarcinomas

91
Q

adipophylin stains

A

lipid droplets of sebaceous and xanthomatous lesions

helps distinguish sebaceous carcinoma from SCC and BCC

92
Q

Ber-EP4

A

marks most epithelial cells but not those with squamous differentiation

positive in BCC but negative in SCC

93
Q

Desmin stains

A

sekeletal and most smooth muscle

negative in vascular smooth muscle including glomus cells

94
Q

CD34 stains what normal structures

A

vascular endothelium and hematopoietic progenitor cells

positive in DFSP, negative in DF

positive in spindle cell lipoma, sclerotic fibroma, solitary fibrous tumor, superficial acral fibromyxoma, pleomorphic fibroma and pleomorphic hyalinizing angiectatic tumordecreased staining in morphea

increased staining in nephrogenic systemic fibrosis

stains connective tissue around normal hair folicles

typically hilights stroma of trichoeps but not BCCs

95
Q

Factor 13a stains

A

DF, not DFSP

highlights dermal dendritic cells

positive in fibrous papule of hte face/angiofibroma

96
Q

CD31 is a marker for

A

vascular origin of tumors

more specific for vascular than CD34

97
Q

D2-40 (podoplanin) is a marker of

A

lymphatic endothelium

increases detection of lymphovascular invasion

lack of reactivity in metastatic carcinoma assiststs in differentiation from primary cutaneous adnexal neoplasms

98
Q

UEA-1 *Ulex europeus agglutinin) binds

A

vascular endothlium

99
Q

GLUT1 STAINS

A

endothelial cells with blood-tissue barrier functiona sin placenta

positive in infantile hemangiomas and negative in vascular malformations

also stains perineurial cells and perineurioma

100
Q

Vimentin stains

A

general marker of sarcomas

stains mesenchymal cells, endothelial cells, fibroblasts, melanocytes, lymphocytes, macrophages

does not react with epithelium/keratinocytes

excludes most carcinomas except rare spindle cell carcinomas and synovial carcinoma

101
Q

S100 stains

A

neural crest-derived cells and some mesenchymal lines

staines melanocytes, Langerhans cells, sweat glands, nerves, schwann cells, myoepithelial cells, fat, muscle and chondrocytes

useful in ddx of spindle cell neoplasms

stains desmoplastic melanoma, langerhans cell histiocytosis, granular cell tumor, Rosai-Dorfman disease

102
Q

S100A6 (calcyclin) stains

A

member of S100 superfamily

positive in cellular neurothekeoma while S100 is negative

reactive in most atypical fibroxanthomas but not specific

also stains other spindle cell tumors

stains Spitz strongly and diffusely but spitzoid melanomas have weak or patchy staining

103
Q

HMB-45 is a marker of

A

premelanosome

loss of stianing of melanocytes with descent into dermis is manifestation of loss of premalnoosomes, marker ofr normal maturation

loss of staining in deep dermal component of most benig nevi but get uniform staining of blue nevi

does not stain desmoplastic melanoma reliably

104
Q

melan-A and Mart-1

A

2 different antibodfies stain same epitope

stain melanocytic lesions but staining of desmoplastic melanoma is unreliable

105
Q

p75 (nerve growth factor receptor)

A

early neural crest cell marker

expressed in type C (spindled) melanocytes and schwann cells

sensitive marker for spindle cell and desmoplastic melanoma

106
Q

MITF (micropthalmia-associated transcription factor)

A

essential in development and survival of melanocytes

nuclear melanocyte marker

positive in cellular neurothekeomas

107
Q

Sox-10

A

nuclear marker of melanocytes and Schwann cells

sensitive marker of melanoma including conventional, spindled and desmoplastic

108
Q

Neuron-specific enolase (NSE)

A

positive in neuroendocrine cells, neurons and tumors derived from them

fairly non-specific as positive in many other cell lines

109
Q

Chromogranin positive in what tumor?

A

merkel cell carcinoma

110
Q

synaptophysin positive in what tumor?

A

merkel cell carcinoma

111
Q

CD45Ra (LCA)

A

leukocyte common antigen (LCA) general marker of hematolymphoid differentiation

present on all hematopoietic cells and precursors with exception of maturing erythroids and megakaryocytes

112
Q

CD45Ro (UCHL-1)

A

stains mature T cells

113
Q

CD20 stains

A

B cells (often absent in plasma cells)

positive in B cell lymphoma

target for rituximab

loss correlates with rituximab resistance

114
Q

CD10 (CALLA)

A

common acute lymphoblastic leukemia antigen

early marker of B cell differentiation

useful for diagnosis of B cell lymphoproliferative disorders

positive in periadnexal mesenchymal cells, staining only stroma of trichoblastomas but epithelial cells of BCC

expressed in most atypical fibroxanthomas but not often seen in other spindle cell tumors

marker of renal cell carcinoma but also in other clear cell lesions including balloon cell nevi, clear cell hidradenoma and sebaceous tumors

115
Q

CD79a marker for

A

plasma cell and B cell

116
Q

CD138 (syndecan-1) stains

A

plasma cell marker

117
Q

CD3 stains

A

T cells - pan -T-cell marker

118
Q

CD4 stains

A

helper T cells

119
Q

CD8 stains

A

cytotoxic/suppressor T cell marker

120
Q

CD5 stains

A

pan-T cell marker but aberrant loss in CTCL is common

positive in mantle cell lymphoma and infiltrates of chronic lymphocytic leukemia

121
Q

CD30 (Ki-1, BERH2) stains

A

Reed-Sternberg cells of Hodgkin’s disease

positive in activated lymphs of anaplastic large cell lymphoma and lymphomatoid papulosis

many positive cells may be seen in scabies nodules and chronic tick bites

122
Q

CD7

A

immature T lymphocyte antigen

most common antigen lost in T cell lymphoma

123
Q

CD56

A

marker of NK cells and subset of T cells

stains blastic plasmacytoid dendritic cell neoplasm (fomerly known as blastic NK/T-cell lymphoma or CD4+/CD56+ hematodermic neoplasm)

124
Q

CD68 (KP-1)

A

reactive in virtually all monocyte/macrophage cells

125
Q

CD163

A

reactive in monocytes and macrophages

126
Q

CD123

A

marker of plasmacytoic dendritic cells

positive in blastic plasmacytoid dendritic cell neoplasm

127
Q

myeloperoxidase

A

major constituent of granuleso f neutrophilic myeloid cells

marker for acute myeloid leukemia

128
Q

ALK-1

A

anaplastic lymphoma kinase expressing chromosomal translocation t(2,5)

positive in most systemic anaplastic large cell lymphoma and negativ ein primary cutaneous anaplastic large cell lymphoma

few patients with ALK-1 negative systemic anaplastic large cell lymphoma have poor prognosis

129
Q

Kappa/lambda

A

normally expressed in ratio f 2/3 kappa to 1/3 lambda

10 fold deviation suggests clonal B-cell proliferation

130
Q

CD117 (c-Kit)

A

expressed in mast cells and melanocytes

in nevi and primary melanoma there is decrease in expression in dermal component

typically lost in metastatic cutaneous melanoma

131
Q

CD1a

A

stains Langerhans cells

132
Q

Langerin (CD207) stians

A

Birbeck granules in Langerhans cells

133
Q

CD43 (Leu-22)

A

pan-T-cell marker

aberrant coexpression with CD20 strongly suggestive of B cell lymphoma

134
Q

BCL2

A

onocogene that inhibits apoptosis

useful to differentiation B cell lymphoproliferative disorders

most BCCs have diffuse BCL2 staining wheras trichoeps only show staining of outermost epithelial layeres of tumor islands

135
Q

MUM-1 (Multiple myelanoma oncogene-1)

A

expressed in plasma cells, activated T cells, and subset of germinal center cells

distinguishes primary cutaneous diffuse large B cell lymphoma, leg type from diffuse follicle center lymphoma

reactivity reported in anaplastic large cell lymphoma, LyP and blastic plasmacytoid dendritic cell neoplasm

also expressed in benign and malignant melanocytic cells

136
Q

CD21

A

follicular dendritic cell marker

highlights residual follicle in lymphoma

CD23 has a similar staining pattern

137
Q

betaF1

A

identified alphabeta T cells

138
Q

Spindle cell neoplasms should be stianed with what?

A

pankeratin or AE1/AE3 - positive in SCC

CD10 - positive in atypical fibroxanthoma, may be positive in SCC, melanoma, leiomyosarcoma

S100/Sox-10 - positive in melanoma

Desmin - positive in leiomyosarcoma

139
Q

small blue cell tumors should be stained with

A

LCA - positive in lymphoma

TTF-1 - positive in metastatic small cell carcinoma of lung, sometimes in lymphoma

CK20 - positive in Merkel cell carcinoma

Synaptophysin - positive in Merkel cell carcinoma, sometimes metatstatic small cell carcinoma of lung

S100 - positive in melanoma, sometimes merkel cell carcinoma

140
Q

small round blue cell S100 positive

A

probably melanoma, could be merkel cell (get synaptophysin or CK20)

141
Q

small round blue cell TTF-1 positive

A

probably metastatic small cell caricnoma of lung, could be lymphoma, get LCA (Positive in lymphoma)

142
Q

small round blue tumor positive for synaptophysin

A

probably merkel cell but could be metastatic small cell carcinoma of the lung, get TTF-1 (positive in small cell carcinoma of lung)

143
Q

What tumors have intraepidermal buckshot scatter (pagetoid spread)

A

Paget’s, extramammary Paget’s, Bowens, Malignant melanoma

144
Q

for pagetoid scattered order what stains?

A

CK7 (positive in Paget’s and sometimes Bowens disease)

CEA (positive in Paget’s)

S100 (positive in melanoma)

145
Q

specific immunohistochemical antibodies available to many viruses, bacterial, fungal and parasitic antigens including

A

HHV8, HSV, VZV, CMV, EBV, bartonella, Rickettsia, treponema, Borrelia, Aspergillus, Leishmania and others

146
Q

markers of proliferation include

A

Mib-1 (Ki-67) - nuclear prolifereation marker expressedin all active phases of cell cycle

pHH3 - mitotic marker only stains M phase of cell cycle; helps differentiate mitoses from apoptotic or hyperchromatic nuclei

147
Q

what transport media should be used for electron microscopy

A

glutaraldehyde

148
Q

what transport medium should be used for immunofluorescence?

A

Michel’s medium (ammonium sulfate). if not available, use normal saline.

Dermatopathology (6 decks)

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