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Excised Lesions (excised + lesion)
Selected AbstractsAtypical apocrine proliferation involving anogenital mammary-like glands of the perianal regionJOURNAL OF CUTANEOUS PATHOLOGY, Issue 2009Slim Charfi Anogenital mammary-like glands (MLGs) are a normal constituent of the anogenital area showing similarities to breast glands. MLGs are recognized to be the possible origin for various neoplastic and reactive conditions that show homology to their mammary counterparts. We report the case of an 85-year-old woman presenting with 10 cm polypoid mass of the perianal region. Histopathological examination of the excised lesion showed atypical apocrine proliferation arising in a complex lesion with features of fibroadenoma, adenosis and hyperplastic and cystic change. Normal MLGs were observed at the tumor periphery. There was no recurrence after 3 years of follow up. This report represents an illustration of the complexity of lesions developed from MLG. [source] Congenital panfollicular nevus: report of a new entityJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005Laura S. Finn The various forms of non-melanocytic nevi (hamartomas) are usually encountered in pediatric patients, and nevus sebaceous of Jadassohn is the most common to have undifferentiated pilosebaceous units. We report a unique congenital follicular nevus that fails to meet the criteria of any previously described follicular neoplasm, despite the plethora of alternatives. Clinically considered a syringocystadenoma papilliferum, the excised lesion contained multiple dermal nodules that exhibited nearly all stages of follicular differentiation. The periodicity of the follicular proliferations was akin to normal terminal hair, and a prominent perifollicular sheath surrounded each. This benign lesion of abortive hair follicles was unassociated with any established genodermatous syndrome or other adnexal neoplasm. [source] Myointimoma of the Glans PenisJOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2006S. Thurber A 54-year-old man presented with a 2-month history of a firm, non-tender, non-mobile 0.4 cm nodule of his coronal sulcus. An incisional biopsy was performed and histopathology revealed a multinodular proliferation of cytologically bland spindled cells embedded in a fibromyxoid matrix. The lesional cells were immunoreactive for smooth-muscle actin but not S-100 protein. A Verhoeff van Gieson stain demonstrated a meshwork of elastic fibers surrounding individual tumor nodules. The clinical and histologic findings were diagnostic of a myointimoma. The lesion has not recurred one month after the initial partial biopsy. Myointimomas are a recently described, myointimal proliferation affecting the corpus spongiosum. Clinical experience with this type of lesion is limited. Reports in the literature thus far suggest this neoplasm is benign with persistence of incompletely excised lesions but no recurrences or metastases following complete excision. Myointimomas represent a strictly intravascular proliferation of intimal cells of blood vessels. [source] INDETERMINATE RESULTS IN CORE BIOPSIES OF BREAST FROM MAMMOGRAPHICALLY DETECTED LESIONS: OUTCOMES OF EXCISION BIOPSYPATHOLOGY INTERNATIONAL, Issue 12 2001Harvey J INTRODUCTION: Protocols for excision of mammographically detected lesions following core biopsy include all diagnoses of atypical ductal hyperplasia (ADH) or intraductal atypia of uncertain significance (AUS). The aims of this study were to look at: i) the prevalence of reporting ADH and AUS, ii) the proportion of cases where excision revealed breast carcinoma, iii) whether any cases could be downgraded to hyperplasia on review. METHODS: Breast core biopsy reports from the SCGH Breast Centre for the years 1999,2000 were retrieved. The results of excision biopsy were obtained and slides reviewed. RESULTS: There were 1048 core biopsies from 911 women. Breast carcinoma was diagnosed in 197 samples (18.8%) including 88 with invasive carcinoma (8.4%), 109 with ductal carcinoma in situ (10.4%) and 3 samples (2.9%) suspicious of invasive carcinoma. The suspicious cases all proved to be invasive carcinomas. There were 53 samples (5.1%) with a diagnosis of ADH or AUS. 46 were excised, showing 7 invasive carcinomas 15 DCIS, 11 ADH, 2 lobular carcinoma in situ (LCIS), 1 mucocoele-like lesion, 1 fibroadenoma and 9 fibrocystic change (FCC). The 22 malignancies represented 47.8% of the excised lesions. At review, 8 of the 53 original diagnoses were downgraded to benign hyperplasia; 5 underwent excision; 2 showed ,incidental' invasive carcinomas, 1 ,incidental' LCIS, 1 ADH and 1 FCC. CONCLUSIONS: There was a low prevalence of reporting of ADH and AUS in core biopsies (5.1%) and a high rate of carcinoma (47.8%) in subsequent excision biopsies. Very few diagnoses of ADH/AUS were downgraded at review. Current protocols for excision of lesions with a core biopsy diagnosis of ADH/AUS appear to be justified. [source] Is there just one lesion?ANZ JOURNAL OF SURGERY, Issue 10 2009The need for whole body skin examination in patients presenting with non-melanocytic skin cancer Abstract Background:, In patients presenting with non-melanoma skin cancer (NMSC) the frequency of concurrently presenting tumours is poorly documented. Whole body skin examination is recommended but in a recent survey of Australian General Practitioners and skin cancer clinics doctors it was infrequently performed. The aim of this study was to examine the incidence of concurrent skin cancer at initial presentation and therefore to examine the need for whole body skin examination for NMSC presentations. Method:, One hundred consecutive patients with a referral diagnosis indicative of NMSC were examined. Data was analysed as to the referring doctor's diagnosis, whole body skin examination findings and histology of excised lesions. Epidemiological data was obtained by patient questionnaire. Results:, One hundred patients, 41 males and 59 females, with a mean age of 70 years (range 39,91 years) underwent whole body skin examination. Sixty-seven per cent of patients were found to have additional lesions requiring treatment, 46% skin cancers (30 patients basal cell carcinomas, five squamous cell carcinomas, seven basal and squamous cell carcinomas, two lentigo maligna, two adenexal tumours) and 21% solar keratoses. Thirty-four of the additional lesions detected were in areas covered by clothing. Sixty-eight patients had a past history of skin cancer excision. Conclusions:, In the Australian patient population, the need for whole body skin examination is essential to avoid missing concurrent lesions. Ongoing surveillance is also essential as these patients have a high risk of developing future NMSC. [source] Dermoscopic monitoring of melanocytic skin lesions: clinical outcome and patient compliance vary according to follow-up protocolsBRITISH JOURNAL OF DERMATOLOGY, Issue 2 2008G. Argenziano Summary Background, Dermoscopic monitoring of melanocytic lesions increases the likelihood that featureless melanomas are not overlooked and minimizes the excision of benign lesions. Objective, To examine clinical outcome and patient compliance using different follow-up protocols. Methods, A retrospective analysis of 600 lesions from 405 patients (aged 6,79 years) was performed to examine patient compliance and clinical outcome in patients with multiple atypical melanocytic lesions undergoing sequential dermoscopy imaging during short-, medium- or long-term follow-up. Based on the degree of dermoscopic atypical features, patients were scheduled for short-term monitoring with follow-up after 3 months, medium-term monitoring with follow-up after 6 months or long-term monitoring with annual follow-up. Criteria leading to excision of monitored lesions differed according to the follow-up protocol. Results, In a median follow-up period of 23 months, 54 (9%) lesions were excised, revealing 12 early melanomas (occurring in 3% of monitored patients), one basal cell carcinoma and 41 melanocytic naevi. The melanoma/benign ratio of excised lesions was 1 : 3·4. Seven of 12 melanomas showed changes after two to four visits, corresponding to 8,54 months of follow-up. Patient compliance was 84% for short-term monitoring, 63% for medium-term monitoring and 30% for long-term monitoring. Conclusions, In patients with multiple naevi sequential dermoscopy imaging is a useful strategy to avoid missing melanomas while minimizing unnecessary excision of benign lesions. For better compliance, the first re-examination should be scheduled at 3 months after the baseline visit. Regular annual follow-up monitoring is also needed to detect slow-growing melanomas in which subtle changes may become apparent only over time. [source] Histological evolution of recurrent basal cell carcinoma and therapeutic implications for incompletely excised lesionsBRITISH JOURNAL OF DERMATOLOGY, Issue 3 2004S. Boulinguez Summary Background, It has been proposed that the management of incompletely excised recurrent basal cell carcinomas (BCCs) should depend on their histological appearance, and that nonaggressive recurrent BCCs may not require re-excision. Objectives, To determine the histological evolution of recurrent BCCs. Methods, In a 14-year retrospective study analysing histological sections of recurrent BCCs, 390 specimens from 191 patients were blindly classified by three physicians into aggressive and nonaggressive types according to Sexton's classification. Initial histological sections were available for 33 of the recurrent BCCs. Descriptive analysis was performed. Results, Eight of 33 (24%) recurrent BCCs became histologically more aggressive. Four of 20 (20%) originally nonaggressive BCCs became aggressive during recurrence and four of 13 (31%) originally aggressive BCCs showed a more aggressive component during recurrence. These incompletely excised aggressive BCCs were sited in periorbital and perinasal areas and on the cheek, and were re-excised. Conclusions, Management of incompletely excised nonaggressive BCCs (nodular or superficial types) is still a matter of debate. Previously reported studies have shown recurrence in < 10% of nonaggressive incompletely excised BCCs. Our study showed that rare recurrences of these initially nonaggressive BCCs showed an aggressive component in 20% of cases. These results suggest that initially nonaggressive incompletely excised BCCs do not require re-excision except if they are located in sites with a poor prognosis. [source] | ||||||||||