MEETING No. 46 - OCTOBER 12th, 2002 - SONDRIO HOSPITAL

Case 1
Case 2
Case 3
Case 4
Case 5

Case 4


"SUBUNGUEAL LESION"
A. AMBROSI – Sondrio Hospital
(pict. by dr. Ambrosi)

Clinical history: a 62y.o. man presents with a long-standing subungual lesion at the thumb, lately growing. A biopsy is performed and then amputation and disarticulation of the finger is done.
Microscopical description of the biopsy: epithelioid malignant tumor mainly consisting of nucleolated cells with big nuclei (pict. 1) but with crush artefacts (pict. 2); these cells are negative with immunohistochemical staining for S100, weakly positive or negative for HMB45 (pict. 3) and intensely positive for CD68 (pict. 4) and EMA (pict. 5).
Macroscopical description: small phalanx of the thumb with lightly pigmented, 0,8 cm subungual lesion.
Microscopical description of the surgical specimen: sections show cells cytologically similar, but more prominent, to those in the biopsy because there are no crash artefacts (pict. 6 - pict. 7 - pict. 8 - pict. 9).
In areas adjacent to the epidermis there are nests and single malignant cells (pict. 10).
The immunohistochemical staining results are exactly the same as those on the biopsy.

Diagnosis

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

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