MEETING No. 23, SEPTEMBER 20th, 2000, CREMA HOSPITAL

Case 1
Case 2
Case 3
Case 4

Case 2

"RAPIDLY GROWING SKIN LESION"
A. FARAVELLI - Desio Hospital
(pict. by dr. Faravelli)

Clinical history: a 55y.o. woman, with a previous history of breast carcinoma, presents with a 0.5 cm skin lesion on the forearm.
Microscopic description: the dermis shows edema and numerous blood vessels, whilst there are only a few skin appendages.
There are numerous nests of cells with large glassy nuclei and prominent nucleoli (pict. 1) - ( pict. 2) - (pict. 3) - (pict. 4) - ( pict. 5) - (pict. 6) - (pict. 7).
There is a moderate inflammatory infiltrate. The neoplastic elements sometimes appear to be in lymph vessels like structures even if an endothelial lining is not always recognizable.
The neoplastic cells are positive with immunohistochemical staining for CK20, in particular with a dot-like para-nuclear positivity (pict. 8) - (pict. 9) - ( pict. 10), for Chromogranin (pict. 11) and for NSE (pict. 12).
Staining for Estrogens and Progesterone receptors are negative. Staining for CD31 is not helpful in demonstrate the presence of endothelium in the previously described spaces.

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9	pict. 10
pict. 11	pict. 12

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