Dermatopathology Primer of Cutaneous Tumors
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Dermatopathology Primer of Cutaneous Tumors Dermatopathology Primer of Cutaneous Tumors Omar P. Sangueza, MD Parisa Mansoori, MD Professor of Dermatology Visiting Fellow in Dermatopathology Wake Forest University School of Medicine and Pathology Winston-Salem, North Carolina, USA Director of Dermatopathology Saleha A. Aldawsari, MD Wake Forest University Visiting Fellow in Dermatopathology Health Sciences Department of Pathology Winston-Salem, North Carolina, Wake Forest University School of Medicine USA Winston-Salem, North Carolina, USA Amir Al-Dabagh, MD Visiting Fellow in Dermatology Department of Dermatology Wake Forest University School of Medicine Sara Moradi Tuchayi, MD, MPH Winston-Salem, North Carolina, USA Research Fellow Department of Dermatology Amany A Fathaddin, MD Wake Forest University School of Medicine Visiting Fellow in Dermatopathology Winston-Salem, North Carolina, Wake Forest University School of Medicine USA Winston-Salem, North Carolina, USA Steven R. Feldman, MD, PhD Professor of Dermatology and Pathology Wake Forest University Health Sciences Winston-Salem, North Carolina, USA CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2016 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Version Date: 20150527 International Standard Book Number-13: 978-1-4987-0392-5 (eBook - PDF) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. 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Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com 3.1.4 Pilar sheath acanthoma 37 Contents 3.1.5 Tumor of the follicular Acknowledgements 7 infundibulum 38 Introduction 9 3.2 Sebaceous tumors 1 Tumors of the Epidermis 3.2.1 Benign neoplasms 1.1 Benign tumors 3.2.1.1 Sebaceous hyperplasia 39 1.1.1 Epidermal proliferations 3.2.1.2 Sebaceoma 40 1.1.1.1 Epidermal nevus 10 3.2.1.3 Sebaceous adenoma 41 1.1.1.2 Clear cell acanthoma 11 3.2.2 Malignant tumors 1.1.2 Warts and variants 3.2.2.1 Sebaceous carcinoma 42 1.1.2.1 Viral warts 12 3.3 Sweat gland neoplasms 1.1.2.2 Trichilemmoma 13 3.3.1 Benign neoplasms 1.1.2.3 Inverted follicular keratosis 14 3.3.1.1 Apocrine adenoma 43 1.1.2.4 Solar lentigo 15 3.3.1.2 Syringocystadenoma 1.1.2.5 Seborrheic keratosis 16 papilliferum 44 1.1.2.6 Warty dyskeratoma 17 3.3.1.3 Hidradenoma 45 1.2 Malignant tumors 3.3.1.4 Cylindroma 46 1.2.1 Basal cell carcinoma and variants 3.3.1.5 Apocrine hidrocystoma 47 1.2.1.1 Basal cell carcinoma and 3.3.1.6 Mixed tumor 48 variants 18 3.3.1.7 Spiradenoma 49 1.2.2 Squamous cell carcinoma and 3.3.1.8 Syringoma 50 variants 3.3.1.9 Poroma 51 1.2.2.1 Bowen’s disease 20 3.3.2 Malignant tumors 1.2.2.2 Keratoacanthoma 21 3.3.2.1 Adenoid cystic carcinoma 52 1.2.2.3 Squamous cell carcinoma 22 3.3.2.2 Microcystic adnexal carcinoma 53 3.3.2.3 Extramammary Paget’s disease 54 2 Melanocytic Neoplasms 3.3.2.4 Hidradenocarcinoma 55 2.1 Benign neoplasms 3.3.2.5 Porocarcinoma 56 2.1.1 Lentigo simplex 24 2.1.2 Melanocytic nevi 25 4 Tumors of Fibrous Tissue 2.1.3 Halo nevus 26 4.1 Benign tumors 2.1.4 Spitz nevus 27 4.1.1 Nodular fasciitis 57 2.1.5 Blue nevus 28 4.1.2 Dermatofibroma 58 2.2 Malignant lesions 4.1.3 Superficial fibromatosis 59 2.2.1 Malignant melanoma and variants 31 4.2 Malignant tumors 4.2.1 Fibrosarcomas 60 3 Tumors of Cutaneous Appendages 4.2.2 Dermatofibrosarcoma 3.1 Hair follicle tumors protuberans 61 3.1.1 Trichoepithelioma 33 4.2.3 Atypical fibroxanthoma 62 3.1.2 Trichoblastoma 35 3.1.3 Trichofolliculoma 36 5 Tumors of Fat 9 Cutaneous Cysts 5.1 Lipoma 63 9.1 Epidermoid cyst 91 5.2 Angiolipoma 64 9.2 Pilar cyst 92 5.3 Nevus lipomatosus superficialis 65 9.3 Dermoid cyst 93 9.4 Steatocystoma 94 6 Tumors of Smooth Muscle 9.5 Bronchogenic cyst 95 6.1 Benign neoplasms 9.6 Cutaneous ciliated cyst 96 6.1.1 Leiomyoma 66 9.4 Median raphe cyst 97 6.2 Malignant tumors 6.2.1 Leiomyosarcoma 67 10 Cutaneous Metastases 10.1 Cutaneous metastases 98 7 Neural Tumors 7.1 Nerve sheath tumors 11 Cutaneous Infiltrates: Non Lymphoid 7.1.1 Neurofibroma 68 11.1 Mast cell infiltrates 7.1.2 Schwannoma 69 11.1.1 Mastocytosis 100 7.1.3 Perineurioma 71 11.2 Histiocytic infiltrates 7.1.4 Palisaded and encapsulated 11.2.1 Juvenile xanthogranuloma 102 neuromas 72 11.2.2 Xanthomas 103 7.1.5 Cutaneous ganglioneuroma 73 11.2.3 Langerhans cell histiocytosis 104 7.1.6 Nasal glioma 74 11.3 Neuroendocrine infiltrates 7.1.7 Cutaneous meningioma 75 11.3.1 Merkel cell carcinoma 105 7.1.8 Granular cell tumor 76 12 Cutaneous Infiltrates: Lymphoid and 8 Vascular Tumors Leukemic 8.1 Hyperplasias 12.1 Pseudolymphomas 8.1.1 Pyogenic granuloma 77 12.1.1 Cutaneous pseudolymphomas 106 8.2 Benign neoplasms 12.2 Cutaneous lymphomas 8.2.1 Infantile hemangiomas 78 12.2.1 T-cell lymphomas 107 8.2.2 Cherry angiomas 79 12.2.2 Primary cutaneous CD30+ T-cell 8.2.3 Arteriovenous hemangioma 80 lymphoproliferative disorders 109 8.2.4 Microvenular hemangioma 81 12.2.3 B-cell lymphomas 110 8.2.5 Tufted angioma 82 12.3 Leukemic and miscellaneous infiltrates 8.2.6 Glomeruloid hemangioma 84 12.3.1 Leukemia cutis 111 8.2.7 Acquired elastotic hemangioma 85 References 112 8.2.8 Kaposiform hemangioendothelioma 86 Glossary of Terms 121 8.2.9 Glomus tumor and glomangioma 87 8.3 Malignant tumors 8.3.1 Kaposi sarcoma 88 8.3.2 Angiosarcoma 90 Acknowledgements The second volume of Dermatopathology Primer is a complement to the first volume on inflammatory disease. This volume was produced in collaboration with many of the international fellows of the Section of Dermatopathology of the Wake Forest University School of Medicine. We want to thank especially Professor Luis Requena from the Department of Dermatology of the Universidad Autonoma de Madrid for allowing us to use some of his wonderful material. We also thank Mr. Charles P. Sangueza for his help in editing and critically reviewing many chapters of this manuscript. 7 Introduction The second volume of the Dermatopathology Primer series deals with neoplastic diseases of the skin. This volume is a complement the first volume on inflammatory diseases. As we noted in the first volume, the intent of these books is to introduce the basic concepts of dermatopathology to medical students and residents training in pathology and dermatology. The book is organized into chapters discussing the differentiation of various neoplasms.