ABSTRACT
63-year-old man presented with a dome-shaped, black nodule on his right forehead, where hairs were preserved. The black surface tone measured 7 mm in diameter and spread irregularly from the periphery of the nodule. He had been conscious of the preceding, black macule for approximately 50 years. A snap shot of the patient in adolescence showed a tiny, black macule, which was a few millimeters in diameter. Histological examination demonstrated irregular proliferation of melanoma cells from the epidermis to the dermis. Partially, there were well-circumscribed, oval nests composed of nevus cells in the acanthotic epidermis and follicles. Nevus cells were also seen in the dermal component, presenting a burnt-out appearance. In this case, the small final size, the preserved hairs and the snap shot suggested a preceding, acquired melanocytic nevus. Malignant melanoma could arise from acquired melanocytic nevus.
Subject(s)
Cell Transformation, Neoplastic/pathology , Melanoma/pathology , Nevus, Pigmented/pathology , Skin Neoplasms/pathology , Adolescent , Forehead , Hair/pathology , Humans , Male , Middle AgedABSTRACT
This is a report of papillary endothelial hyperplasia in a 9-year-old girl with a pilomatricoma showing bullous appearance. Histologically, papillary proliferation of endothelial cells was found within dilated lymphatic endothelium-lined vascular channels overlying a pilomatricoma. The endothelial cells covering the papillae were of a lymphatic endothelial cell nature proved by immunohistochemistry and electron microscopy. Abundant fibrous long-spacing collagen was observed in the connective tissue and fibroblasts within papillae.
Subject(s)
Hair Diseases/diagnosis , Pilomatrixoma/diagnosis , Skin Neoplasms/diagnosis , Child , Diagnosis, Differential , Endothelium/pathology , Female , Hair Diseases/pathology , Humans , Lymphatic Vessels/pathology , Pilomatrixoma/pathology , Scapula , Skin Neoplasms/pathologyABSTRACT
The authors report two cases of pharyngoesophageal reconstruction using free jejunum transfer, which required additional microsurgical reconstruction, due to total or partial loss of the free jejunal graft, despite successful microvascular anastomoses. Replacement and additional transfer of the second free jejunum segment were successfully carried out, with minimal risk and low morbidity. The second free jejunal transfer is one of the reliable reconstructive choices in the management of complicated pharyngoesophageal reconstruction with free jejunum.
Subject(s)
Hypopharyngeal Neoplasms/surgery , Jejunum/transplantation , Plastic Surgery Procedures/methods , Anastomosis, Surgical , Esophagectomy/methods , Female , Follow-Up Studies , Humans , Laryngectomy/methods , Male , Middle Aged , Neck Dissection , Pharyngectomy/methods , Reoperation , Surgical Flaps , Tissue and Organ Harvesting , Treatment Outcome , Wound Healing/physiologyABSTRACT
Acral pseudolymphomatous angiokeratoma of children (APACHE) is a recently recognized, rare clinical entity. We report a case of APACHE in a 9-year-old Japanese girl with a dark red, linear plaque on the posterior area of the right lower leg. Histopathologic findings revealed further evidence that APACHE was a cutaneous pseudolymphoma rather than a vascular neoplasm because of the presence of distinct primary and secondary lymphoid follicles, and thick-walled, long blood vessels lined with prominent plump endothelial cells similar to high endothelial venules in the paracortical area of the lymph node. In addition to previous descriptions, the patient presented with a distinct linear lesion. Vacuolar alteration of the basal cell layer and scattered eosinophilic bodies in the epidermis were observed, which suggested a lichenoid tissue reaction. We believe that APACHE might show a distinct linear pattern accompanied by a lichenoid tissue reaction.
Subject(s)
Angiokeratoma/pathology , Pseudolymphoma/pathology , Skin Diseases/pathology , Angiokeratoma/immunology , Child , Female , Humans , Pseudolymphoma/immunology , Skin Diseases/immunologyABSTRACT
BACKGROUND: Primary adenocarcinomas of the vulva have been classified as sweat gland carcinomas, extramammary Paget's disease, and primary breast carcinomas of the vulva. They share some common histopathologic features. METHODS: We describe a 72-year-old Japanese woman with apocrine carcinoma of the vulva and local lymphatic metastasis. RESULTS: The patient presented with a bruise on her inguinal area. Physical examination revealed a 4 cm x 7 cm, dark-red, irregularly elevated tumor on the left labium majora. Dome-shaped, flesh-colored, small papulovesicles were scattered on the abdomen, accompanied by erythema and induration. The lesion showed a band-like arrangement. General examination revealed multiple bone metastases, particularly in the spine. Microscopic examination revealed a moderately differentiated adenocarcinoma with signet ring cells. A few pagetoid clear cells were present in the hypertrophic epidermis. The peripheral papulovesicles demonstrated the same histopathologic view as in inflammatory and telangiectatic, metastatic breast carcinoma. Tumor cells were positive for various ductal and glandular markers. Estrogen and progesterone receptors were not expressed. Ultrastructural findings suggested differentiation towards apocrine or mammary glands because of the presence of an apocrine process and electron-dense mucous granules. The patient died in spite of combination chemotherapy and irradiation therapy. CONCLUSIONS: We report a rare case of apocrine carcinoma of the vulva in a band-like arrangement with local lymphatic metastasis which showed the clinical and histopathologic characteristics of inflammatory and telangiectatic carcinoma.
