Contributed by Allene Gagliano, MD, Leena Lourduraj, MD and Drazen Jukic, MD, PhD
Published on line in June 2005
PATIENT PRESENTATION:
74 yo female with inflamed "seborrheic keratosis" on dorsum of right ankle. Her only other pertinent history is that of a seborrheic keratosis removed in eight years ago. We received a pale-tan fragment of cutis and subcutis that corresponded to a shave biopsy, which was 1.3 x 1.0 x 0.2 cm.
MICROSCOPIC EXAMINATION:
Fig. 1: Low power H&E of shave biopsy specimen.
Figs. 2 and 3: 10X H&E of shave biopsy demonstrating desmoplastic spindle cell tumor.
Fig. 4: High power H&E.
IMMUNOSTAINS:
Fig. 5: S100 immunostain demonstrating strong diffuse staining throughout.
Fig. 6: HMB45 immunostain demonstrating loss of staining in desmoplastic cells.
Fig. 7 and 8: MelanA immunostain demonstrating loss of staining in some desmoplastic cell nests.
Fig. 9: Tyrosinase demonstrating decreased staining in desmoplastic cells.
Fig. 10: Ki67 demonstrating rare positive cells.