Spindle cells much more common Epithelioid cells usually dispersed individually throughout lesion • Melanocytes “mature” by becoming smaller from superficial to deep • Kamino bodies: Eosinophilic globules at dermal-epidermal junction • Artifactual clefting…
Enlarges after upper respiratory tract infection • Along anterior border of sternocleidomastoid muscle • Initial work-up of suspected branchial cleft anomaly (in order) Intravenous or oral antibiotics (if infected), FNA, endoscopy &/or…
Variable admixture of bland spindle cells, ropey collagen, mature adipose tissue, myxoid stroma, and mast cells • PL contains multinucleated tumor cells • Morphologic variants: Fat-free, fat-poor, angiomatous Ancillary Tests • CD34(+); loss…
~ 85% of all cases • Subset of cases arise in skin of other sites (trunk, arms, head and neck) ~ 15% of cases • Single or multiple lesions at time of…
Epidermotropism &/or Pautrier microabscesses • Peripheral blood with multilobated “flower cells” • Lymph nodes with effaced architecture & diffuse infiltrate • Bone marrow with patchy involvement & increased osteoclasts Ancillary Tests • Confirmation of…
Can be multiple in some cases • Rare recurrences and association with, or progression to, malignancy [basal cell carcinoma (BCC)] Macroscopic • Nodular lesion involving deep dermis and subcutis • Large, typically >…
Irregular wrinkled nuclei Bi- and multinucleation Perinuclear vacuolization • Old lesions may mimic seborrheic keratoses Ancillary Tests • Immunostain for p16 is negative (there is no overexpression) • In situ hybridization and PCR…
Female predilection More prevalent in African Americans • Wide anatomic distribution, usually arises in skin and subcutaneous tissue Head and neck region common (tongue, oral cavity) • Usually solitary, painless nodule, plaque,…
Lesions restricted to cutis only rarely metastasize Microscopic • Perpendicularly oriented fascicles of spindle cells • Brightly eosinophilic cytoplasm • Blunt-ended nuclei • Nuclear atypia and mitoses Ancillary Tests • Labels as per smooth muscle:…
Rare to absent in early lesions, prominent and confluent in late lesions Nests are irregular in size and shape, randomly alternate with single melanocytes • Cells show elongated, ovoid hyperchromatic nuclei…
