Dermatopathology (eBook)

Diagnosis by First Impression

Christine J. Ko, Ronald J. Barr (Autoren)

eBook Download: EPUB

2016 | 3. Auflage
John Wiley & Sons (Verlag)
9781119149477 (ISBN)

Infos

Christine J. Ko is a Professor of Dermatology and Pathology at Yale University School of Medicine. She trained in dermatology at University of California, Irvine, where she was strongly influenced by Dr. Barr. She subsequently completed a fellowship in dermatopathology under Dr. Scott Binder at University of California, Los Angeles. She lectures nationally and internationally; and has published numerous book chapters, journal articles, and five textbooks/atlases in the fields of dermatology and dermatopathology.
Ronald J. Barr is Professor Emeritus of Dermatology and Pathology at the University of California, Irvine. He is a nationally and internationally recognized dermatopathologist with board certification in dermatology, anatomic pathology, and dermatopathology. He received the Founders' Award from the American Society of Dermatopathology for his myriad contributions to the field of dermatopathology and the Society's Walter Nickel Award for excellence in teaching dermatopathology. He has authored over 150 original articles and book chapters. He is also past president of the American Society of Dermatopathology and past president of the American Board of Dermatology.

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The atlas that helps you differentiate visually similar diseases Written with the dermatology trainee in mind, Dermatopathology: Diagnosis by First Impression uses more than 800 high resolution color images to introduce a simple and effective way to defuse the confusion caused by dermatopathology slides. Focused on commonly tested entities, and using low- to high-power views, this atlas emphasizes the key differences between visually similar diseases by using appearance as the starting point for diagnosis. The Third Edition provides: 800 high resolution and annotated photographs, now all fully downloadable 'Key Differences' to train the eye on distinctive diagnostic features Disease-based as well as alphabetical indexes 75 new interactive self-assessment questions to perfect your diagnostic skills Brand new algorithms for pattern analysis Dermatopathology: Diagnosis by First Impression, Third Edition, once again provides simple and effective guidance to help you approach dermatopathology and accurate diagnosis of skin disease.

Inhalt

Preface, vi

Acknowledgments, vii

About the Companion Website, viii

Introduction, 1

Chapter 1 Shape on Low Power, 23

Epidermis

Regular acanthosis, 25

Lobular proliferation, 29

Reticulated proliferation, 35

Central pore, 42

Epidermal perforation, 46

Dermis

Circular islands, 49

Cords/tubules and comma shapes, 53

Space with a lining, 59

Papillations, 70

Polypoid (dome-shaped), 77

Square/rectangular, 82

Palisading reactions, 88

Pseudoepitheliomatous hyperplasia above abscesses, 93

Pink ball, (see Chapter 6)

Chapter 2 Gestalt: Rash/inflammatory, 97

Epidermal changes

Parakeratosis, 99

Spongiosis, 102

Papulosquamous (psoriasiform), 106

Interface (vacuolar), 112

Interface (lichenoid), 117

Inflammation: Specific patterns and Cell Type Epidermal eosinophils, 123

Perivascular, 127

Band-like dermal/papillary dermal infiltrate, 131

Diffuse/nodular, 137

Subcutaneous, 144

Chapter 3 Cell Type, 153

Melanocytic, 155

Spindle cells, 164

Endothelial, 178

Giant, 192

Clear, 202

Chapter 4 "Top-Down", 219

Hyperkeratosis/parakeratosis, 221

Upper epidermal change, 228

Acantholysis, 238

Subepidermal space/cleft, 248

Granular "material" in cells, 255

"Busy" dermis, 260

Dermal material, 263

Fat necrosis, 276

Chapter 5 Color - Blue, 279

Blue tumor, 281

Mucin and glands or ducts, 291

Mucin, 295

Chapter 6 Color - Pink, 303

Pink ball of spindle cells, 305

Pink material, 308

Pink dermis, 315

Epidermal necrosis, 317

Index (Pattern), 323

Index (Histological Category), 329

Index (Alphabetical), 333

Textauszug

1
Shape on Low Power

• Epidermis
  • Regular acanthosis, 25
  • Lobular proliferation, 29
  • Reticulated proliferation, 35
  • Central pore, 42
  • Epidermal perforation, 46
• Dermis
  • Circular islands, 49
  • Cords/tubules and comma shapes, 53
  • Space with a lining, 59
  • Papillations, 70
  • Polypoid (dome-shaped), 77
  • Square/rectangular, 82
  • Palisading reactions, 88
  • Pseudoepitheliomatous hyperplasia above abscesses, 93
  • Pink ball (see Chapter 6)

Bowen disease

• Epidermal acanthosis
• Parakeratosis
• Full-thickness disorder of keratinocytes with atypical cells and mitoses
• Basal layer may focally appear normal (“eyeliner” sign) (arrow)

  Clear cell acanthoma
  

• Epidermal acanthosis
• Clear cells well-demarcated from the normal epidermis and adnexal keratinocytes
• Parakeratosis above clear cells

  Psoriasis
  

• Epidermal acanthosis
• Parakeratosis
• Neutrophils in stratum corneum (asterisk)
• Hypogranulosis
• Thinned suprapapillary plates (long arrow)
• Dilated vessels in papillary dermis (short arrows)

  Key differences
  

  (a)

  (b)

  (c)

  1. Bowen disease: disordered keratinocytes and atypical mitoses
  2. Clear cell acanthoma: pale/clear keratinocytes well-demarcated from normal epidermis
  3. Psoriasis: confluent parakeratosis above thickened epidermis, neutrophils in stratum corneum, normal keratinocytes, thin suprapapillary plates, dilated vessels

  Inverted follicular keratosis
  

• Lobular proliferation
• Normal-appearing keratinocytes with some arranged in squamous eddies

  Molluscum contagiosum
  

• Lobular proliferation
• Blue-gray hue to some of the keratinocytes
• Large, pink cytoplasmic inclusions (Henderson-Paterson bodies)

  Poroma
  

• Lobular proliferation (can be reticulated)
• Uniform blue cells with interspersed ducts (arrows)
• Fibrotic or hyalinized stroma with dilated vessels

  Seborrheic keratosis, acanthotic
  

• Lobular proliferation
• Acanthosis of epidermis
• Pseudohorn cysts
• No ducts

  Trichilemmoma
  

• Lobular proliferation
• Proliferation composed of pale/clear cells
• Peripheral palisading (long arrow) with thickened basement membrane (short arrow)

  Key differences
  

  (a)

  (b)

  (c)

  (d)

  (e)

  1. Inverted follicular keratosis: squamous eddies of normal keratinocytes
  2. Molluscum contagiosum: intracytoplasmic pink inclusions (Henderson-Paterson bodies)
  3. Poroma: uniform blue cells with interspersed ducts, hyalinized stroma
  4. Seborrheic keratosis: pseudohorn cysts
  5. Trichilemmoma: pale/clear keratinocytes with peripheral palisading and thickened basement membrane

  Fibroepithelioma of Pinkus
  

• Reticulated proliferation
• Strands of basaloid cells in a fibrovascular stroma
• Some hints of palisading of cells (arrow)

  Fibrofolliculoma
  

• Reticulated proliferation
• Fibrotic stroma adjacent to the hair follicle has reticulated strands of epithelium
• This entity has overlap with trichodiscoma (most consider these a spectrum of the same entity)

  Nevus sebaceus of Jadassohn
  

• Reticulated proliferation
• Sebaceous glands, basaloid proliferations (arrow) connect to the epidermis
• Apocrine glands may be seen deep
• Absent terminal hairs in mature stage

  Seborrheic keratosis, reticulated
  

• Reticulated proliferation
• Strands of banal keratinocytes, often pigmented
• Interspersed pseudohorn cysts

  Syringofibroadenoma
  

• Reticulated proliferation
• Strands of banal, round cells
• Interspersed ducts

  Tumor of the follicular infundibulum
  

• Reticulated proliferation
• Pale cells in columns with “windows” of dermis in between
• Peripheral palisading

  Key differences
  

  (a)

  (b)

  (c)

  (d)

  (e)

  (f)

  1. Fibroepithelioma of Pinkus: strands of basaloid epithelium in fibrovascular stroma
  2. Fibrofolliculoma: hair follicle with adjacent fibrotic stroma and reticulated epithelium
  3. Nevus sebaceus: proliferation of epidermis connecting to sebaceous lobules and basaloid proliferations
  4. Seborrheic keratosis, reticulated: reticulated strands of banal keratinocytes, often pigmented; interspersed pseudohorn cysts
  5. Syringofibroadenoma: strands of uniform, round cells with interspersed ducts
  6. Tumor of the follicular infundibulum: pale cells in columns with “windows” of dermis in between

  Dilated pore of Winer
  

• Central pore
• Invaginated epidermis is acanthotic

  Pilar sheath acanthoma
  

• Central pore
• Invaginated epidermis is acanthotic and has areas resembling outer root sheath with peripheral palisading around slightly pale cells

  Trichofolliculoma
  

• Central pore
• Invaginated epidermis connects to a primary hair follicle
• Multiple secondary hair follicles radiating away from the central follicle

  Key differences
  

  (a)

  (b)

  (c)

  1. Dilated pore of Winer: acanthotic epidermis
  2. Pilar sheath acanthoma: epidermal acanthosis and areas resembling outer root sheath
  3. Trichofolliculoma: primary follicle and surrounding secondary follicles

  Elastosis perforans serpiginosa
  

• Epidermal perforation
• Elongated claw (epidermal rete) gripping thin, glassy, eosinophilic elastic fibers and debris
• Altered elastic fibers are thinner than the collagen fibers in the dermis

  Reactive perforating collagenosis
  

• Epidermal perforation
• Shallow cup-shaped architecture
• Pink collagen fibers extend vertically through epidermis

  Key differences
  

  (a)

  (b)

  (c)

  (d)

  1. Elastosis perforans serpiginosis: elongated rete forming a claw (tortuous channel); case courtesy of Whitney High, MD, JD
  2. Reactive perforating collagenosis: shallow, broad cup-shaped architecture
  3. Calcinosis cutis, perforating: chunky, bluish material (see page 264) at the base of an ulcer

  4. Granuloma annulare, perforating: palisading histiocytes around collagen with mucin (see page 89)

     Note Other entities may also perforate the epidermis, for example, chondrodermatitis nodularis helicis, pseudoxanthoma elasticum.

  Adenoid cystic carcinoma
  

• Circular dermal islands
• Islands contain basaloid cells with a cribriform pattern of duct-like spaces filled with amorphous material

  Cylindroma
  

• Circular dermal islands
• Islands contain basaloid cells surrounded by a thick pink basement membrane (arrow)
• Islands arranged like a “jigsaw puzzle”

  Trichoadenoma
  

• Circular dermal islands
• Islands of epithelium with central flaky keratin (horn cysts)
• Interspersed basaloid cords

  Key differences
  

  (a)

  (b)

  (c)

  1. Adenoid cystic carcinoma: cribriform pattern of duct-like structures
  2. Cylindroma: puzzle-like arrangement, thick/pink basement membrane
  3. Trichoadenoma: numerous horn cysts

  Desmoplastic trichoepithelioma
  

• Cords/tubules and comma shapes in dermis
• Numerous horn cysts (long arrow) in fibrotic stroma
• Tubules of two-layered epithelium (short arrow)
• Calcification often present
• Confined to dermis

  Metastatic breast carcinoma
  

• Cords/tubules and comma shapes in dermis and below
• Tubules of single-layered (“Indian filing” – long arrow) and multi-layered epithelium
• Some cells forming gland-like structures (short arrow)
• Other metastatic carcinomas may look like this – need clinical history; immunohistochemistry may be helpful

  Microcystic adnexal carcinoma
  

• Cords/tubules and comma shapes in dermis
• Comma shapes with duct-like spaces
• Deeply infiltrative (fills dermis)
• Perineural involvement

  Morpheaform basal cell carcinoma
  

• Cords/tubules and comma shapes in dermis
• Tubules of epithelium composed of basaloid cells with hints of peripheral palisading
• New collagen forming around islands (arrow)
• Deeply...

Produkt-Details

• Erscheint lt. Verlag: 6.9.2016
• Sprache: englisch
• Themenwelt: Medizin / Pharmazie ► Gesundheitsfachberufe
• Themenwelt: Medizin / Pharmazie ► Medizinische Fachgebiete ► Dermatologie
• Themenwelt: Studium ► 2. Studienabschnitt (Klinik) ► Pathologie
• Schlagworte: Appearance • Between • Color • commonly • Dermatologie • Dermatology • Dermatopathologie • Dermatopathology • dermatopathology diagnosis • Diagnosis • differences • Diseases • Edition • emphasizes • First Impression • Highresolution • images • Low • Medical Science • Medizin • Pathologie • Pathology • Point • similar • Simple • Third • Trainee • uses • Views
• ISBN-13: 9781119149477 / 9781119149477