Contents

1Keratinocytic tumours 9 Persistent melanoma and local WHO and TNM classification 10 metastasis of melanoma 90 Introduction 11 Congenital melanocytic naevus 93 Basal cell 13 Superficial type 93 Superficial basal cell carcinoma 15 Proliferative nodules in congenital Nodular basal cell carcinoma 16 melanocytic naevi 93 Micronodular basal cell carcinoma 16 Blue naevi 95 Infiltrating basal cell carcinoma 17 Common blue naevus 95 Fibroepithelial basal cell carcinoma 17 Mongolian spot 96 Basal cell carcinoma with adnexal differentiation 18 Naevus of Ito and naevus of Ota 96 Basosquamous carcinoma 18 Cellular blue naevus 96 Keratotic basal cell carcinoma 19 Deep penetrating naevus 98 Other variants 19 Combined naevus 100 20 Melanotic macules 103 Acantholytic squamous cell carcinoma 21 Simple lentigo – lentiginous melanocytic naevus 104 Spindle-cell squamous cell carcinoma 22 Dysplastic naevus 105 Verrucous squamous cell carcinoma 22 Site specific and Meyerson naevi 110 Pseudovascular squamous cell carcinoma 23 Acral naevus 110 Adenosquamous carcinoma 24 Genital naevus 110 Bowen disease 26 Meyerson naevus 111 28 Persistent (recurrent) melanocytic naevus 113 Actinic 30 Spitz naevus 114 Arsenical keratosis 32 Pigmented spindle cell naevus (Reed) 117 PUVA keratosis 33 Halo naevus 118 Verrucas 34 Verruca vulgaris 36 3 Appendageal tumours 121 Verruca plantaris 37 WHO and TNM classification 122 Verruca plana 38 Introduction 123 Acanthomas 39 Malignant tumours with apocrine and Epidermolytic 39 eccrine differentiaton 125 39 Tubular carcinoma 125 Acantholytic acanthoma 40 Microcystic adnexal carcinoma 125 Lentigo simplex 40 Malignant mixed tumour 127 Seborrhoeic keratosis 41 Porocarcinoma 128 Melanoacanthoma 43 Spiradenocarcinoma 130 43 131 Large cell acanthoma 44 Mucinous carcinoma 131 44 Digital papillary carcinoma 133 -like keratosis 47 Adenoid cystic carcinoma 134 Apocrine carcinoma 135 2 Melanocytic tumours 49 Paget disease and extramammary WHO classification 50 Paget disease 136 TNM classification 51 Benign tumours with apocrine and Malignant melanoma: Introduction 52 eccrine differentiation 139 Superficial spreading melanoma 66 139 Nodular melanoma 68 140 Lentigo maligna 70 Poroma 141 Acral-lentiginous melanoma 73 Syringofibroadenoma 142 Desmoplastic melanoma and desmoplastic 143 neurotropic melanoma 76 143 Melanoma arising from blue naevus 79 145 Melanoma arising in giant congenital naevi 83 Tubular and tubular papillary adenoma 145 Childhood melanoma 84 Syringocystadenoma papilliferum 146 Naevoid melanoma 86 Hidradenoma papilliferum 147 Mixed tumour (chondroid syringoma) 147 B-cell lymphoma 199 Malignant tumours with follicular differentiation 149 Intravascular large B-cell lymphoma 200 Pilomatrical carcinoma 149 Lymphomatoid granulomatosis 202 Proliferating tricholemmal tumour 150 Cutaneous involvement in primary extracutaneous Benign tumours with follicular differentiation 152 B-cell lymphoma 204 152 Mantle cell lymphoma 204 153 Burkitt lymphoma 205 Tricholemmoma 155 Chronic lymphocytic leukaemia / small 156 lymphocytic lymphoma 205 Pilar sheath acanthoma 157 Hodgkin lymphoma 207 Tumour of the follicular infundibulum 158 Blastic NK-cell lymphoma 208 / 158 Precursor T-lymphoblastic leukaemia / lymphoma Tumours with sebaceous differentiation 160 and precursor B-lymphoblastic 160 leukaemia / lymphoma 210 161 Cutaneous involvement by myeloid leukaemia 211 162 Lymphoid infiltrates of the skin mimicking Cystic sebaceous tumour 163 lymphoma 212 Parapsoriasis 215 4 Haematolymphoid tumours 165 Small plaque parapsoriasis 215 WHO / EORTC classification 166 Parapsoriasis – Large patch type, TNM classification 167 with or without poikiloderma 215 Introduction 168 Langerhans cell histiocytosis 217 Mycosis fungoides (MF) 169 Indeterminate cell histiocytosis 220 Pagetoid reticulosis 173 Sinus histiocytosis with massive lymphadenopathy Syringotropic MF 173 (Rosai-Dorfman) 221 Folliculotropic MF 173 Juvenile xanthogranuloma 222 Granulomatous MF 174 Reticulohistiocytosis 224 Sézary syndrome 175 Mastocytosis 226 Granulomatous slack skin 178 CD30+ T-cell lymphoproliferative disorders 179 5 Soft tissue tumours 229 Lymphomatoid papulosis (LyP) 179 WHO and TNM classification 230 Primary cutaneous anaplastic large-cell Introduction 231 lymphoma 180 Vascular tumours 233 Subcutaneous panniculitis-like T-cell lymphoma 182 Haemangioma of infancy 233 Primary cutaneous peripheral T-cell lymphoma, Cherry haemangioma 233 unspecified 184 Sinusoidal haemangioma 234 Cutaneous γδ T-cell lymphoma 184 Hobnail haemangioma 234 Primary cutaneous aggressive epidermotropic Glomeruloid haemangioma 235 CD8+ cytotoxic T-cell lymphoma 185 Microvenular haemangioma 236 Primary cutaneous small-medium CD4+ T-cell Angiolymphoid hyperplasia with eosinophilia 237 lymphoma 186 Spindle cell haemangioma 239 Primary cutaneous PTL, unspecified 186 Tufted angioma 239 Cutaneous adult T-cell leukaemia / lymphoma 189 Bacillary angiomatosis 240 Extranodal NK/T-cell lymphoma, nasal-type 191 Reactive angioendotheliomatosis 241 Hydroa vacciniforme-like cutaneous T-cell Verrucous haemangioma 242 lymphoma 192 243 Cutaneous involvement in primary extracutaneous Cavernous haemangioma 243 T-cell lymphoma 193 Angiokeratomas 244 Systemic anaplastic large cell lymphoma (ALCL) 193 Arteriovenous haemangioma 245 Angioimmunoblastic T-cell lymphoma (AITL) 193 Cutaneous angiosarcoma 246 Cutaneous marginal zone B-cell lymphoma 194 Lymphatic tumours 247 Cutaneous follicle centre lymphoma 196 Lymphangioma circumscriptum 247 Cutaneous diffuse large B-cell lymphoma 198 Progressive lymphangioma 248 Diffuse large B-cell lymphoma, leg-type 198 Lymphangiomatosis 249 Diffuse large B-cell lymphoma, other 198 Smooth and skeletal muscle tumours 250 T-cell / histiocyte-rich large B-cell lymphoma 199 Smooth muscle hamartoma 250 Plasmablastic lymphoma 199 Pilar leiomyoma 251 Secondary skin involvement by diffuse large Cutaneous leiomyosarcoma 251 Rhabdomyomatous mesenchymal hamartoma 252 Fibrous, fibrohistiocytic and histiocytic tumours 254 Keloid scar 254 Hypertrophic scar 254 Dermatomyofibroma 255 Infantile myofibromatosis 256 Sclerotic fibroma 256 Digital mucous cyst 257 Digital fibrokeratoma 257 Pleomorphic fibroma 258 Giant cell fibroblastoma 258 Dermatofibrosarcoma protuberans 259 Dermatofibroma (fibrous histiocytoma) 261

6 Neural tumours 263 WHO and TNM classification 264 Palisaded, encapsulated neuroma and traumatic neuroma 265 Palisaded encapsulated neuroma 265 Traumatic neuroma 266 Primary malignant peripheral primitive neuroectodermal tumour (PNET) / Extraskeletal Ewing sarcoma (ES) 268 Nerve sheath myxoma / neurothekeoma 270 Merkel cell carcinoma 272 Granular cell tumour 274

7 Inherited tumour syndromes 277 Familial cutaneous melanoma 279 Xeroderma pigmentosum 282 Naevoid basal cell carcinoma (Gorlin) syndrome 285 Cowden syndrome 288 Carney complex 291

Contributors 295

Source of charts and photographs 300

References 301

Subject index 341