Key Clinical MessageA rare case of slow‐growing retro‐auricular panfolliculoma is presented. The ... more Key Clinical MessageA rare case of slow‐growing retro‐auricular panfolliculoma is presented. The lesion was biopsied to rule out basal cell carcinoma but histopathology revealed a follicular tumor with differentiation toward all segments of the hair follicle. Panfolliculoma is a benign follicular tumor with no report of recurrence after surgical excision and no malignant transformation of the previously reported cases.Panfolliculoma is a rare slow growing adnexal tumor, characterized by differentiation toward all parts of the hair follicle including the infundibulum, isthmus, stem, and bulbs. Clinically this adnexal tumor may mimick basal cell carcinoma and other adnexal neoplasm including trichoblastoma and trichoepithelioma. In this study, we present a rare case of slow‐growing retro‐auricular panfolliculoma of a 70‐year‐old female mimicking basal cell carcinoma that was successfully excised without recurrence.
Adenolipoma of the breast is an uncommon mammary lesion classified as a hamartomatous lesion, pre... more Adenolipoma of the breast is an uncommon mammary lesion classified as a hamartomatous lesion, presenting as a soft, mobile and well-defined mass. The typical mammographic findings is of a well-circumscribed lesion containing both fat and soft tissue surrounded by a capsule. Microscopically, adenolipoma exhibits a hamartomatous mixture of ducts and lobules intermingled with adipose and fibroconnective tissue. Enucleation is the standard treatment and recurrences are rare. We report a 29-year-old woman with a mobile, tender and firm mass, 6x5 cm, in the upper inner quadrant of the right breast of 1 month duration. Mediolateral mammography images demonstrated a well-defined mass with mixed granular and fat density. Histopathology of the excised mass revealed well-circumscribed lobules of ducts and glandular structures haphazardly embedded in mature fatty tissue. Breast hamartoma should be differentiated from other benign lesions of the breast. Awareness among radiologists and pathologists of this benign lesion would help avoid an incorrect diagnosis and unnecessary intervention.
Cutaneous malignant melanoma (CMM) is currently the most fatal of skin cancers accounting for 500... more Cutaneous malignant melanoma (CMM) is currently the most fatal of skin cancers accounting for 50000 deaths annually. Five distinct melanomas are described histopathologically: superficial spreading, lentigo maligna, nodular, acral lentiginous and mucosal melanoma. The aim of this study was to investigate the characteristics of patients with various types of malignant melanoma and evaluate histopathological findings. In this retrospective study, we obtained our data from the records of 111 patients with melanoma. Biopsied specimens were collected and re-evaluated. Demographic information and histopathological findings were noted. SPSS 16 was used for analyzing data. Chi-square and one-way ANOVA was conducted for comparing categorical and numerical variables respectively. The mean age of patients was 59.33±14.68 years old. Most common melanoma type was acral lentiginous (40.5%), followed by nodular (35.1%) and mucosal (10.8%). The highest tumor thickness was viewed in nodular melanoma followed by mucosal melanoma. The highest rate of metastasis, microsatellitosis, perineural invasion and Clark level of the invasion were reported in nodular and acral lentiginous respectively. The most frequent rate of ulceration and vascular invasion was reported in mucosal melanoma. Distribution of melanoma types varies largely in different regions. Lack of classic presentations in some types necessitate specific public education about warning signs. Histopathological and pathological characteristics in melanoma can aid in better staging and management of the tumor.
Cutaneous metaplastic synovial cyst (CMSC), presents as a solitary, tender subcutaneous nodule th... more Cutaneous metaplastic synovial cyst (CMSC), presents as a solitary, tender subcutaneous nodule that usually occurs at the site of previous surgery or trauma. Histologically, the lesion is characterized by a cystic structure with villous-like projections that lined by metaplastic synovial tissue. The main cause remains unclear, but trauma is presumed to be a precipitating factor, as most reported cases have a history of antecedent cutaneous injury. Here we present a case of CMSC in a 51 year old man, presented with a painless deep-seated dermal nodule in the medial aspect of left ankle without history of any trauma or surgery in this site. Immuno-histochemistry study reveals positive reaction for CD68 in the cystic wall and negative reactions for S-100. CMSC is a unique lesion and worthy to attention, and should be included in the differential diagnosis of deep dermal cutaneous cysts.
Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM... more Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM with a very severe presentation at birth and fatal outcome.
Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM... more Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM with a very severe presentation at birth and fatal outcome.
Dear Editor, Pseudolymphoma of skin or cutaneous lymphoid hyperplasia (CLH) is an exaggerated imm... more Dear Editor, Pseudolymphoma of skin or cutaneous lymphoid hyperplasia (CLH) is an exaggerated immune response to different stimuli such as contact dermatitis, tattoos, infections, arthropod bites, exposure to drugs and in many instances is idiopathic.CLH can resolve spontaneously or persist for a long time. Coronavirus disease (COVID-19) is a pandemic that leads to morbidity and mortality around world. Intravenous immunoglobulin (IVIG) had been used as an adjuvant therapy for COVID-19 pneumonia.Herein, we present dramatic resolution of CLH after treatment for COVID-19 infection. An otherwise healthy 52-year-old woman presented with 1-year history of multiple asymptomatic red nodules on forehead and nasolabial area which gradually became larger and coalesced into large firm multinodular plaques on forehead. Skin biopsy show nodular infiltrate of lymphoid cells composed of small to medium-sized lymphocytes admixed with some histiocytes and plasma cells with vague lymphoid follicle morphology. Infiltrate extends in between follicular structures and deep dermis with an uninvolved Grenz zone undersurface of epidermis. Immunohistochemistry study reveals multiple immunoreactions of small lymphocytes for CD2, CD3, CD20, scattered reactivity for CD4, CD5, CD8, Bcl-2 and Bcl-6, and negative immunoreaction for CD21, CD23 (Figure 1). Ziehl-Neelsen stain, fungal cultures, polymerase chain reaction test for leishmania and mycobacteria, antinuclear antibody and rapid plasma reagin; were all negative. Chest, abdomen and pelvis computed tomography scan did not show any lymphadenopathy or mass. CLH was diagnosed and
Key Clinical MessageA rare case of slow‐growing retro‐auricular panfolliculoma is presented. The ... more Key Clinical MessageA rare case of slow‐growing retro‐auricular panfolliculoma is presented. The lesion was biopsied to rule out basal cell carcinoma but histopathology revealed a follicular tumor with differentiation toward all segments of the hair follicle. Panfolliculoma is a benign follicular tumor with no report of recurrence after surgical excision and no malignant transformation of the previously reported cases.Panfolliculoma is a rare slow growing adnexal tumor, characterized by differentiation toward all parts of the hair follicle including the infundibulum, isthmus, stem, and bulbs. Clinically this adnexal tumor may mimick basal cell carcinoma and other adnexal neoplasm including trichoblastoma and trichoepithelioma. In this study, we present a rare case of slow‐growing retro‐auricular panfolliculoma of a 70‐year‐old female mimicking basal cell carcinoma that was successfully excised without recurrence.
Adenolipoma of the breast is an uncommon mammary lesion classified as a hamartomatous lesion, pre... more Adenolipoma of the breast is an uncommon mammary lesion classified as a hamartomatous lesion, presenting as a soft, mobile and well-defined mass. The typical mammographic findings is of a well-circumscribed lesion containing both fat and soft tissue surrounded by a capsule. Microscopically, adenolipoma exhibits a hamartomatous mixture of ducts and lobules intermingled with adipose and fibroconnective tissue. Enucleation is the standard treatment and recurrences are rare. We report a 29-year-old woman with a mobile, tender and firm mass, 6x5 cm, in the upper inner quadrant of the right breast of 1 month duration. Mediolateral mammography images demonstrated a well-defined mass with mixed granular and fat density. Histopathology of the excised mass revealed well-circumscribed lobules of ducts and glandular structures haphazardly embedded in mature fatty tissue. Breast hamartoma should be differentiated from other benign lesions of the breast. Awareness among radiologists and pathologists of this benign lesion would help avoid an incorrect diagnosis and unnecessary intervention.
Cutaneous malignant melanoma (CMM) is currently the most fatal of skin cancers accounting for 500... more Cutaneous malignant melanoma (CMM) is currently the most fatal of skin cancers accounting for 50000 deaths annually. Five distinct melanomas are described histopathologically: superficial spreading, lentigo maligna, nodular, acral lentiginous and mucosal melanoma. The aim of this study was to investigate the characteristics of patients with various types of malignant melanoma and evaluate histopathological findings. In this retrospective study, we obtained our data from the records of 111 patients with melanoma. Biopsied specimens were collected and re-evaluated. Demographic information and histopathological findings were noted. SPSS 16 was used for analyzing data. Chi-square and one-way ANOVA was conducted for comparing categorical and numerical variables respectively. The mean age of patients was 59.33±14.68 years old. Most common melanoma type was acral lentiginous (40.5%), followed by nodular (35.1%) and mucosal (10.8%). The highest tumor thickness was viewed in nodular melanoma followed by mucosal melanoma. The highest rate of metastasis, microsatellitosis, perineural invasion and Clark level of the invasion were reported in nodular and acral lentiginous respectively. The most frequent rate of ulceration and vascular invasion was reported in mucosal melanoma. Distribution of melanoma types varies largely in different regions. Lack of classic presentations in some types necessitate specific public education about warning signs. Histopathological and pathological characteristics in melanoma can aid in better staging and management of the tumor.
Cutaneous metaplastic synovial cyst (CMSC), presents as a solitary, tender subcutaneous nodule th... more Cutaneous metaplastic synovial cyst (CMSC), presents as a solitary, tender subcutaneous nodule that usually occurs at the site of previous surgery or trauma. Histologically, the lesion is characterized by a cystic structure with villous-like projections that lined by metaplastic synovial tissue. The main cause remains unclear, but trauma is presumed to be a precipitating factor, as most reported cases have a history of antecedent cutaneous injury. Here we present a case of CMSC in a 51 year old man, presented with a painless deep-seated dermal nodule in the medial aspect of left ankle without history of any trauma or surgery in this site. Immuno-histochemistry study reveals positive reaction for CD68 in the cystic wall and negative reactions for S-100. CMSC is a unique lesion and worthy to attention, and should be included in the differential diagnosis of deep dermal cutaneous cysts.
Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM... more Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM with a very severe presentation at birth and fatal outcome.
Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM... more Diffuse cutaneous mastocytosis (DCM) is a rare variant of mastocytosis. We describe a case of DCM with a very severe presentation at birth and fatal outcome.
Dear Editor, Pseudolymphoma of skin or cutaneous lymphoid hyperplasia (CLH) is an exaggerated imm... more Dear Editor, Pseudolymphoma of skin or cutaneous lymphoid hyperplasia (CLH) is an exaggerated immune response to different stimuli such as contact dermatitis, tattoos, infections, arthropod bites, exposure to drugs and in many instances is idiopathic.CLH can resolve spontaneously or persist for a long time. Coronavirus disease (COVID-19) is a pandemic that leads to morbidity and mortality around world. Intravenous immunoglobulin (IVIG) had been used as an adjuvant therapy for COVID-19 pneumonia.Herein, we present dramatic resolution of CLH after treatment for COVID-19 infection. An otherwise healthy 52-year-old woman presented with 1-year history of multiple asymptomatic red nodules on forehead and nasolabial area which gradually became larger and coalesced into large firm multinodular plaques on forehead. Skin biopsy show nodular infiltrate of lymphoid cells composed of small to medium-sized lymphocytes admixed with some histiocytes and plasma cells with vague lymphoid follicle morphology. Infiltrate extends in between follicular structures and deep dermis with an uninvolved Grenz zone undersurface of epidermis. Immunohistochemistry study reveals multiple immunoreactions of small lymphocytes for CD2, CD3, CD20, scattered reactivity for CD4, CD5, CD8, Bcl-2 and Bcl-6, and negative immunoreaction for CD21, CD23 (Figure 1). Ziehl-Neelsen stain, fungal cultures, polymerase chain reaction test for leishmania and mycobacteria, antinuclear antibody and rapid plasma reagin; were all negative. Chest, abdomen and pelvis computed tomography scan did not show any lymphadenopathy or mass. CLH was diagnosed and
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