Cutaneous Leiomyoma: Novel Histologic Findings for Classification and Diagnosis

Smooth muscle tumors rather benign or malignant can arise wherever the muscular tissue presents but cutaneous leiomyoma is one of the rare benign tumors of the which even the diagnostic criteria from the malignant type of the tumor is still in doubt. This study was aimed to compare the subtypes of cutaneous leiomyoma from different histologic aspects in order to find unique criteria for better classification and diagnosis. The six year data base of our center was reviewed and 25 patients with cutaneous leiomyoma were included in this study. Of 25 patients, 5 were female and 20 were male. 5 patients had angioleiomyoma (ALM) and 20 had pilar leiomyoma (PLM). ALM had following characteristics: dilated vascular canals intermingled with compact smooth muscle bundles; well circumscribe counter and myxoid and hyaline changes through the tumor. In contrast, PLMs had following histologic features: poor defined outline, entrapped hair follicles and eccrine glands, acanthosis and elongated rete ridges with hyperpigmentation and smooth muscle bundles which are interdigitated with elongated rete ridges. Here we introduced some distinct histological features for each subtype of the cutaneous leiomyoma which can lead to create novel criteria for classification and diagnosis of the lesion

A case of retro‐auricular panfolliculoma mimicking basal cell carcinoma: A rare adnexal tumor with a review of the literature

Key Clinical Message A rare case of slow‐growing retro‐auricular panfolliculoma is presented. The lesion was biopsied to rule out basal cell carcinoma but histopathology revealed a follicular tumor with differentiation toward all segments of the hair follicle. Panfolliculoma is a benign follicular tumor with no report of recurrence after surgical excision and no malignant transformation of the previously reported cases. Abstract Panfolliculoma is a rare slow growing adnexal tumor, characterized by differentiation toward all parts of the hair follicle including the infundibulum, isthmus, stem, and bulbs. Clinically this adnexal tumor may mimick basal cell carcinoma and other adnexal neoplasm including trichoblastoma and trichoepithelioma. In this study, we present a rare case of slow‐growing retro‐auricular panfolliculoma of a 70‐year‐old female mimicking basal cell carcinoma that was successfully excised without recurrence

Recurrent Kaposi sarcoma of the ear in an HIV‐negative patient: A case report with review of the literature. Is ear a predilection site for Kaposi sarcoma in HIV‐negatives?

Abstract While Kaposi sarcoma (KS) of the head and neck is common in HIV‐positives, it is a rare presentation in HIV‐negatives. It is important to consider KS in the differential diagnosis of ear lesions in HIV‐negative patients

Nevoid hyperkeratosis of the nipple and/or areola: Treatment with topical steroid

Nevoid hyperkeratosis of the nipple and/or areola (NHNA) is a rare and benign disease, with poorly understood etiology and no definite therapeutic plan. Hereby, we report another case of NHNA, discuss about its clinical and histopathological features, differential diagnosis, and responsiveness to topical steroid

Lichenoid mycosis fungoides: Report of a case with lichen planus‐like histopathologic features

Key Clinical Message Mycosis fungoides is a diagnostic challenge. Herein, we report a case with marked lichenoid features in pathology assessments. After several biopsies and clinicopathologic correlation, the diagnosis of lichenoid mycosis fungoides was made. Abstract Mycosis fungoides (MF) is a great imitator and mimicks other dermatoses clinically and histopathologically. We report a 61‐year‐old patient with 5‐year history of generalized violaceous patches and plaques. His biopsy revealed a marked lichenoid band‐like infiltrate of inflammatory cells along the basal layer with basal layer vacuolar changes; the diagnosis of lichen planus was first made histopathologically. Several biopsy specimens, clinicopathologic correlation, and immunohistochemistry findings confirmed the diagnosis of lichenoid MF. Awareness of peculiar histopathologic findings of MF is essential to avoid a potential misdiagnosis. When in doubt, multiple biopsies with other diagnostic methods should be employed

Psoriasiform mycosis fungoides: a rare form of the disease with review of the literature

Background: Mycosis fungoides (MF) typically presents as erythematous scaly patches or plaques that may progress to cutaneous tumors. Although MF may be presented like other dermatoses, initial presentation as psoriasiform plaques simulating psoriasis is rare. Differentiating MF from psoriasis is important because systemic therapies used for psoriasis can worsen MF. We describe a case of psoriasiform MF and we also review the clinicopathological features of similar cases in the literature.Case: A 46-year-old woman was referred to our clinic with a history of psoriasiform plaques for 13 years. She had multiple, generalized, indurated plaques with thick psoriasiform scales that were unresponsive to topical treatments. The histopathology showed marked psoriasiform epidermal hyperplasia with epidermotropic atypical lymphocytes compatible with MF. Immunohistochemical (IHC) staining showed that atypical lymphocytes were positive for CD3, CD4, CD8, and CD5. Of note, upper dermal and intraepidermal large atypical lymphocytes were CD30 positive. The review of similar psoriasiform MF cases revealed that they had all been treated as psoriasis for many years and finally diagnosed as MF especially after deterioration induced by immunosuppressive therapies.Conclusions: In presumed cases of psoriasis that are unresponsive to treatment, progressive, or ulcerative, biopsy should be considered to rule out MF, particularly before starting a potent immunosuppressive agent

Psoriasiform mycosis fungoides: a rare form of the disease with review of the literature

Background: Mycosis fungoides (MF) typically presents as erythematous scaly patches or plaques that may progress to cutaneous tumors. Although MF may be presented like other dermatoses, initial presentation as psoriasiform plaques simulating psoriasis is rare. Differentiating MF from psoriasis is important because systemic therapies used for psoriasis can worsen MF. We describe a case of psoriasiform MF and we also review the clinicopathological features of similar cases in the literature.Case: A 46-year-old woman was referred to our clinic with a history of psoriasiform plaques for 13 years. She had multiple, generalized, indurated plaques with thick psoriasiform scales that were unresponsive to topical treatments. The histopathology showed marked psoriasiform epidermal hyperplasia with epidermotropic atypical lymphocytes compatible with MF. Immunohistochemical (IHC) staining showed that atypical lymphocytes were positive for CD3, CD4, CD8, and CD5. Of note, upper dermal and intraepidermal large atypical lymphocytes were CD30 positive. The review of similar psoriasiform MF cases revealed that they had all been treated as psoriasis for many years and finally diagnosed as MF especially after deterioration induced by immunosuppressive therapies.Conclusions: In presumed cases of psoriasis that are unresponsive to treatment, progressive, or ulcerative, biopsy should be considered to rule out MF, particularly before starting a potent immunosuppressive agent

Activated leukocyte cell adhesion molecule expression in oral squamus cell carcinoma and its association with clinical and histopathologic parameters

Introduction: The aim of the present research was to study the expression of activated-leukocyte cell adhesion molecule (ALCAM) in oral squamus cell carcinoma (OSCC) and its association with histopathological and prognostic parameters.Materials and Methods: In a cross-sectional study, samples of OSCC tumors from tongue and oral mucosa available in Institute of Cancer of Imam Hospital in Tehran were simultaneously studied in term of tumor size, lymph node metastasis, and differentiation and ALCAM expression. Analysis was performed using multiple logistic regression models. Results: 39 samples of tongue and 19 samples of oral medusa belonged to 35 men and 23 women with mean (Standard deviation) of age 58(15.69) years of old were studied. More than half of lesions had good differentiation and lymph node metastasis. From all, 42 (72.4%) of samples were positive of ALCAM. Odds of ALCAM total expression in tumors with size of at least 20 mm was more (OR=3.9, p=0.001). Odds ratios for membranous and cytoplasmic expression of ALCAM in positive samples of lymph node metastasis (OR=0.4, p=0.03) and in patients with age 40 and more (OR=2.7, p=0.002) were respectively significant.Conclusion: The study confirmed positive relationship between ALCAM expression and tumor size as while as ambiguity of ALCAM role as a "Paradox" indicator. Next researches may make the role of ALCAM in different phases of tumor developing cleare