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Histopathology > Histopathology > Flashcards

Histopathology Flashcards

1
Q

Atypical fibroxanthoma

A

Dermal spindle cell tumour
Stains: CD10, CD68
Deep= pleomorphic dermal sarcoma

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2
Q

Spindle cell tumours

A
  • Spindle cell melanoma
  • Spindle cell SCC
  • AFX/PDS
  • Other sarcomas:
    E.g. Leimyosarcoma (fasicular appearance); dermatofibrosarcoma protuberans; angiosarcoma
  • If benign: dermatofibroma, neurofibroma (wavy appearance; mast cells), leiomyoma (cigar cells)
  • Scar

Markers:
SCC: cytokeratin stains
Smooth muscle: SMA, desmin, caldesmon
Vascular: CD31, CD34, ERG

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3
Q

Granulomatous processes

A
  • Granuloma annulare
  • Rheumatoid nodule
  • Necrobiosis lipoidica
  • Foreign body reaction
  • Infection
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4
Q

Stains for granulomatous histo (for infection)

A
  • PAS (Periodic Acid Schiff stain) or GMS (Grocott’s methenamine silver)
  • Ziehl Neelson or Wade Fite stain
  • Gram stain
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5
Q

Stains for melanocytes

A

SOX 10 - negative in histiocytes
S100 - can also stain positive histiocytes/dendritic cells
Melan-A
PRAME
HMB-45

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6
Q

Stains for SCC

A

AE1/AE3 (PCK-pancytokeratin)
Cytokeratin MNF116
CK56
P40, P63

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7
Q

Keratin-filled cysts

A

Epidermoid cyst - keratin more laminated
Dermoid cyst
Trichilemmal (pilar) cyst (missing granular layer) - keratin more compact
Pilomatricoma
Cystic SCC
Skin adnexal tumours e.g. poroma (less cystic)
Steatocystoma - sebaceous lobules in cyst wall, wavy keratin, absent granular layer, contains sparse keratin and sebaceous material

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8
Q

Trichoepithelioma

A
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9
Q

Blue cell tumours

A

BCC
Melanoma
Merkel cell/neuroendocrine
Lymphoma
Metastasis
Basaloid SCC

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10
Q

Merkel Cell Stain

A

Perinuclear dotting staining AE1/AE3
CD56
Chromogranin
Synaptophysin
CK20 - perinuclear dottiing
Poliomavirus stain

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11
Q

Syringoma

A

Nests, cords, ductular structures (containing pink amorphous material), can be like tadpoles/comma shapes
Ddx: trichoepithelioma, BCC, microcystic adnexal carcinoma

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12
Q

Stains for DF vs DFSP

A

DF: 13A, CD10
DFSP: CD34

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13
Q

Blue naevus

A

Spindle cells
Dense pigment
Granular melanin
Well circumscribed

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14
Q

SCC in situ

A

No maturation of keratinocytes in epidermis (just as large on top as on bottom of epidermis)
Mitoses
Nuclear pleomorphism
Upper dermal lichenoid inflammation

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15
Q

Neurofibroma

A

Spindle cell tumour
Mast cells
S100 positive (patchy)
CD34 positive (swirling pattern)
SMA negative (just staining blood vessels)
Can be polypoid

Ddx:
Palisaded and encapsulated neuroma
Schwannoma

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16
Q

herpes inclusions

A

multinucleation
moulding
margination

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17
Q

Stains for BCC

A

BerEp4

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18
Q

Trichilemomma

A

Clear cells (follicular epithelial cells)
Well circumscribed, symmetrical
Associations: Cowdens (PTEN mutation, also a/w breast, thyroid, GI ca)

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19
Q

Eccrine spiradenoma

A
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20
Q

Lesions that are painful

A

Blend an egg

Blue rubber bleb
Leimyoma
Eccrine spiradenoma
Neuroma
Dermatofibroma
Angiolipoma
Neurilemomma
Endometriosis
Granular cell tumour
Glomus tumour

Schwannomas
Angiolipomas
Glomus tumours
Granular cell tumours
Tufted angiomas
Leiomyomas

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21
Q

Keratoacanthoma (wdSCC, keratoacanthoma type)

A

Invagination of epidermis with colarette
Keratin-filled crater
Atypical squamous epithelium with pale glassy appearance cytoplasm, often down to deep dermis
Neutrophil collections

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22
Q

Solar keratosis

A

Atypia along basal layer
Thinning of granular layer
Parakeratosis, hyperkeratosis

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23
Q

Amyloid stain

A

Crystal violet (magenta, metachromatic staining)
Congo red

24
Q

Difference between sebaceoma and sebaceous adenoma

A

Sebaceoma - >50% basaloid cells
Sebaceous adenoma - <50% basaloid cells (basaloid cells at periphery, with sebaceous cells centrally)
Sebaceous carcinoma - more invasive, atypical mitoses, pleomorphism

25
Q

Deep penetrating naevus stain (to differentiate from blue naevus)

A

Beta catenin

26
Q

Stain for PEIN

A

P16

27
Q

Muir Torre Stains/Mutations

A

MLH1, MSH2, MSH6, PMS2 (loss of)

28
Q

Peripheral nerve sheath tumours

A

SOX10, S100 positive
Melan-A negative

Schwanomma - encapsulated, verocay bodies
Neurofibroma - circumscribed but not encapsulated

29
Q

Ductal lumen stains

A

EMA
CEA

30
Q

Ddx for syringoma

A

Desmoplastic trichoepithelioma
Microcystic adnexal carcinoma

31
Q

Poroma

A

Growth of terminal duct cells
Circumscribed
Compact cuboidal keratinocytes, small monomorphous nuclei, scant eosinophilic cytoplasm

Stain: CEA positive

Ddx: seb k, porocarcinoma

32
Q

Spiradenoma

A

Lobulated, circumscribed
Two types of basaloid cells - smaller palisaded at peripheries; adjacent larger spaced out basaloid cells
Scattered lymphoyctes
Cystic change/cyst like degeneration

Ddx: cylindroma, spiradenocarcinoma

33
Q

Cylindroma

A

Two cell types, same as spiradenoma (smaller basaloid cells palisaded at peripheries; adjacent larger spaced out)
Occasional scattered lymphocyte superimposed
Duct formation
Jigsaw puzzle appearance

Ddx: spiradneoma

34
Q

Hidradenoma papilliferum

A

Finger-like projections (papillary growth), apocrine differentiation, cuboidal columnar epithelium lining ducts, duct formation (maze-like)

ddx: syringocystadenoma papilliferum (plasma cells)
tubular apocrine adenoma (more simple arrangement of glands, less maze-like)

35
Q

Hidradenoma

A

Clear cells, poroid cells, squamous cells, mucin
Duct formation
Sclerotic stroma

36
Q

Xanthogranuloma

A

Spindle cells
Xanthomatisation
Touton giant cells
Superimposed lymphocytes, eosinophils
Stain: CD68 or CD163

Ddx: dermatofibroma

37
Q

Granuloma faciale

A

Dense polymorphous dermal infiltrate (plasma cells, neutrophils, lymphocytes)
Perivascular accentuation, sometimes vascular damage
Red cell extravasation
Sweeping bands fibrosis
Grenz zone

Ddx: EED, Sweets

38
Q

Langherans cell stains/markers

A

CD1A, langerin

39
Q

Langerhans cells

A

Abundant pale eosinophilic cytoplasm
Footprint nucleus
Can get multiple nuclei

40
Q

Warty dyskeratoma

A

Grains and corp ronds
Acantholysis and clefting
Acanthylotic dyskeratosis
Reticulated areas

ddx: Acontholytic dyskeratotic acanthoma

41
Q

Spindle cell lipoma

A

Sharp demarcation, well circumscribed
Adipocytes
No septae
Mucin/myxoid change n stroma
Spindle cells
Scattered mast cells
Ropey collagen

CD34 will stain spindle cells

42
Q

Angiolipoma

A

Uniform adipocytes
Small closely packed vessels, particularly peripherally

43
Q

Naevoid melanoma - stains to help differentiate naevus and melanoma

A

KI67 - melanocytic proliferation
hmb45 (+ve in melanoma, -ve in naevi)
p16 (-ve in melanoma, +ve in naevi)
Beta catenin more diffusely positive in deep penetrating naevus than in melanoma

44
Q

Glomus tumour

A

Basaloid cells - concentric surrounding vessels
Bland monotonous benign tumour of basaloid cells
Positive for smooth muscle actin
Negative for desmin

45
Q

Glomangiomyoma

A

Circumscribed
Some spindle cells
Some smooth muscle differentiation
Vascular

46
Q

Granuloma annulare

A

Interstitial infiltrate - histiocytes, somewhat circumscribed

Stain: alcian blue or colloidal iron for mucin

Ddx: NLD - less spared normal dermal collagen, more diffuse, less circumscribed, no mucin
Interstitial granulomatous dermatitis - also less circumscribed, more diffuse, more neutrophils

47
Q

Types of dermatofibroma

A

Aneurysmal
Cellular
Atypical
Lipidised
Fibrocollagenous
Clear cell
Epithelioid
Haemosiderotic
Deep fibrous histiocytoma

48
Q

Stains for melanin v haemosiderin

A

Schmorl’s stain - melanin
Prussian blue - haemosiderin

49
Q

Xanthelasma

A

Xanthomatised histiocytes
CD68 CD163

50
Q

Trichoblastoma

A

Most commonly associated with sebaceous naevus

Prominent cellular stromal component
Predominantly basaloid epithelial cells in nests with peripheral palisading
May show cribriform, rippled or solid patterns

51
Q

Calcium stain

A

Von Kossa

52
Q

Elastin stain

A

Verhoeff’s stain VVG

53
Q

Elastosis perforans serpiginosa

A
54
Q

Lymphoma stains

A

CD45 - Bs and Ts
CD3 - T cells
CD20 - B cells

55
Q

Lung met

A

CK7
TTF1

Histopathology (1 decks)

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