MEETING No. 44, - JULY 6th, 2002 AT THE
MANTUA HOSPITAL

Case 2
Case 3
Case 4
Case 5
Case 6
Case 7

Case 3


"RAISED SKIN LESION"
A. CASSISA - Mantua Hospital
(Macroscopical pictures by dr. Cassisa)

Clinical history: a 54y.o.man presents on the left leg a slow growing skin lesion since 3 years, with a clinical diagnosis of basal cell carcinoma. An excisional biopsy is performed.
Macroscopical description: a 6x2, 2 cm skin ellipse with irregular, focally depressed surface.
Microscopical description: the skin shows atrophy and disappearance of the skin hair follicles, with junctional and dermis lymph-monocytic infiltrate (pict. 1 - pict. 2).
The epidermis is partly hyperplastic with marked exocytosis (pict. 3) and partly atrophic with basal epidermotropism (pict. 4).
The nodular dermis infiltrate surrounds and invades gland structures consisting of hypertrophic basaloid-like cells (pict. 5 - pict. 6). The lymphoid cells are small and medium in size and have convoluted nuclei (pict. 7).
Immunohistochemical staining: there is a prevalence of CD8 positive intra-epithelial lymphocytes (pict. 8), fewer CD4 positive cells (pict. 9) are noted; there are S100 positive dendritic cells, rare CD1a positive cells, focally fascine positive dendritic cells and CD20 positive B cells.
Molecular biology (it has been performed at San Paolo Hospital in Milan): there is molecular rearrangement for TCRy.

Diagnosis

pict. 1	pict. 2
pict. 3	pict. 4
pict. 5	pict. 6
pict. 7	pict. 8
pict. 9

Click HERE to send your comments.