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Hematopathology
Monday, February 28, 2005 - 7:30 PM
Convention Center, Ballrooom B
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Moderator:
John Cousar
University of Virginia Health System
Charlottesville, VA
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Click on each slide thumbnail image for an enlarged view
Submitted by:
Marsha C. Kinney
University of Texas
San Antonio, TX
This 57 year-old female presented in March 2004 with a several week history of a 1.5 x 1.0 cm focally
ulcerated, nodular lesion on the right elbow. There was no past history of similar lesions or any
other pertinent disease process. The clinical impression was a pyogenic granuloma. A pathologic
diagnosis was rendered, and the lesion was totally excised and treated with local irradiation to the
area. Within a few weeks, new lesions developed on the left elbow and the left upper arm. The skin
of the right elbow was free of disease.
The patient was referred to a university hospital in July, 2004 where she was noted to have a > 1 cm
lesion on the left upper arm and several plaques with satellite nodules on the left elbow. The
largest lesion measured 2 x 1.3 cm and the satellite nodules measured from 0.6-1.0 x 0.5-0.7 cm.
There was no lymphadenopathy or hepatosplenomegaly. The skin lesions were totally excised. The
specimen for review is from one of the satellite lesions on the left elbow. CT scans were negative.
Bone marrow examination was not performed.
Submitted by:
Paul J. Kurtin
Mayo Clinic
Rochester, MN
The patient is a 43 year old male who sought medical attention for skin lesions. He reported a 2
month history of progressive red/dusky, nodules on the lower legs. Recently, he developed periodic
fevers to 39°C. There was no reported trauma to the legs. At the time of the physical
examination he was afebrile. He had multiple indurated dark red nodules on both legs:
Lymphadenopathy, splenomegaly and hepatomegaly were not detected.
His complete blood count, blood glucose, alpha-1-antitrypsin level, liver enzymes levels, and lactate
dehydrogenase level were all normal. He had no antecedent history of an autoimmune disorder
A biopsy of one of the lesions was performed. The slides and digital images are from the histology of
the biopsied lesion. Microbiologic cultures from the lesions grew no organisms.
Submitted by:
Mark R. Wick
University of Virginia Health Science Center
Charlottesville, VA
A 36 year old woman developed a slowly-enlarging red-blue nodule in the skin of the right earlobe. It
was asymptomatic, and the patient felt otherwise well. Physical examination disclosed no evidence of
lymphadenopathy or organomegaly, and there were no peripheral blood abnormalities. A punch biopsy of
the lesion was performed.
Submitted by:
Randy D. Gascoyne
University of British Columbia
Vancouver, BC, Canada
A 74 year old man presented in 1988 with a raised, red skin mass involving his scalp. Following a
skin biopsy (submitted slides), complete lymphoma staging was performed. This revealed a normal LDH
and performance status and a negative bone marrow examination. FISH studies for the t(14;18) were
negative, but IGH PCR revealed a monoclonal B cell population.
He was diagnosed as stage 1AE and treated with radiotherapy alone. He did well and remained
lymphoma-free for nine years. In 1997 he died of unrelated causes resulting from circulatory
compromise associated with non-insulin dependent diabetes.
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