—  SPECIALTY CONFERENCE HANDOUT  —

Dermatopathology
 Thursday, March 22, 2012, 7:30 PM
Convention Centre 220-222




Clinical histories are printed below.
Click on the case numbers for text and references of each case.
Click on each slide thumbnail image for an enlarged view



Technical Problems in Dermatopathology
Moderator: MARK ROBERT WICK
Univ of Virginia Health System
Charlottesville, VA
Disclosure: In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose.
Panelists:

Problems with Histotechnology in Dermatopathology: Their Causes and Consequences
ZSOLT B. ARGENYI, Univ of Washington, Seattle, WA

Pitfalls in the Use of In-Situ Hybridization in Dermatopathology
BORIS BASTIAN, University of California-San Francisco Medical Center, San Francisco, CA

Recent Advances in Laboratory-Systems Engineering and Their Applications to Dermatopathology
A. NEIL CROWSON, Regional Medical Lab, Tulsa, OK

Pitfalls and Misuses Associated with "Molecular" Technology in Dermatopathology, Especially Concerning Lymphoreticular Disease
JOAN GUITART, Northwestern University, Chicago, IL

Immunohistology in Dermatopathology: Problem Areas
MARK ROBERT WICK, Univ of Virginia Health System, Charlottesville, VA



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Case 1 - Click here for Text and References

Submitted by: Zsolt B. Argenyi - Univ of Washington, Seattle, WA





Case 2 - Click here for Text and References

Submitted by: Boris Bastian - University of California-San Francisco Medical Center, San Francisco, CA




Case 3 - Click here for Text and References

Submitted by: A. Neil Crowson - Regional Medical Lab, Tulsa, OK




Case 4 - Click here for Text and References

Submitted by: Joan Guitart - Northwestern University, Chicago, IL

Clinical Summary:

This 74 year old male had a long history of mycosis fungoides and now presents with oral erosive lesions and an ulcerated tumor in the upper gingival mucosa. The patient also complaint of recent onset of daily fevers, asthenia and anorexia. Past medical history is significant for peptic ulcer disease and hyperlipidemia.

On examination multiple erythematous papulosquamous patches and plaques were noted mostly involving the extremities and face. The oral mucosa showed extensive erosive patches with an ulcerated tumor on the gingival mucosa. There was no evidence of lymphadenopathy or organomegaly.

A biopsy of the oral mucosa showed a tumor composed of intermediate size uniform mononuclear cells with cytoplasmic TIA-1 expression.


Case 4 - Figure 1
Case 4 - Figure 2
Case 4 - Figure 3



Case 5 - Click here for Text and References

Submitted by: Mark Robert Wick - Univ of Virginia Health System, Charlottesville, VA

Clinical Summary:

A 20 year old woman presented with a 0.6 cm flesh-colored nodule in the left nasal skin, which had slowly enlarged over the previous six months. Physical examination showed no other abnormalities, and the patient was otherwise well. The lesion was removed by excisional biopsy.


Case 5 - Figure 1
A tumor is present in the left nasal skin.
Case 5 - Figure 2
An epithelioid and spindle-cell proliferation effaces the dermis.
Case 5 - Figure 3
An epithelioid and spindle-cell proliferation effaces the dermis.

Case 5 - Figure 4
An epithelioid and spindle-cell neoplasm is present in the dermis with variably-prominent nucleoli and mitotic activity.
Case 5 - Figure 5
An epithelioid and spindle-cell neoplasm is present in the dermis with variably-prominent nucleoli and mitotic activity.
Case 5 - Figure 6
Immunostains on the dermal tumor (labeled individually).

Case 5 - Figure 7
S100 immunostain done at the presenter's institution, showing no reactivity in cellular neurothekeoma. This result was obtained with both a heteroantiserum and a mixture of monoclonal antibodies to S100 protein.
Case 5 - Figure 8
Positive immunostain for S100A6 protein in cellular neurothekeoma.



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