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  • Presentation

Greatest Cases from the Dermatopathology Slide Club

Description

Campbell Stewart, a dermatopathologist at UConn Health, presents intriguing dermatopathology cases in a recent session. The first case involves a 38-year-old male with a neoplastic lesion found to be associated with Ehlers-Danlos syndrome, characterized by molluscoid pseudotumors – dermal fibroblastic proliferations with specific histological features. The second case is a 63-year-old female exhibiting a solitary alopecia plaque that, upon biopsy, revealed a Nevus lipomatosus. This benign condition usually lacks follicles and presents on the scalp. Lastly, a 64-year-old male with a bright red ulcerated plaque led to a serious diagnosis of metastatic pulmonary enteric adenocarcinoma, a challenging case compounded by the patient's smoking history. This highlights the importance of thorough patient evaluations, including imaging, alongside histopathology to reach an accurate diagnosis. Ultimately, the presentations underscore the complex interplay between clinical history, morphology, and molecular characteristics in dermatopathology.

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Conclusions

  • The presence of molluscoid pseudotumors is strongly associated with classic Ehlers-Danlos syndrome, characterized by specific histopathological features.
  • Histopathology of molluscoid pseudotumors reveals cytologically bland dermal fibroblastic proliferation, multifocal edema, and lymphangiectasia.
  • Management of molluscoid pseudotumors should be tailored to patient symptoms, as excisional therapy is primarily indicated for symptomatic lesions.
  • Nevus psiloliparus is a distinct skin condition typically localized to the scalp, featuring abundant adipose tissue and absent hair follicles.
  • Nevus psiloliparus may present in various clinical contexts, including neurological and ocular anomalies as part of encephalocraniocutaneous lipomatosis.
  • The diagnosis of nevus psiloliparus can be challenging and often relies on the histopathological examination to confirm the absence of hair follicles.
  • Metastatic pulmonary enteric adenocarcinoma (MPEAC) is a rare subtype of lung cancer that shares morphologic features with colorectal adenocarcinoma.
  • Diagnostic challenges when identifying MPEAC include differentiating it from other carcinomas using a combination of histopathology, immunohistochemistry, and imaging techniques.
  • MPEAC exhibits specific immunohistochemical profiles that can aid in diagnosis, including CK7 and CK20 positivity.
  • Treatment approaches for MPEAC may include chemotherapy regimens, with patients potentially responding well to systemic therapies.
  • Happle R, Küster W. Nevus psiloliparus: a distinct fatty tissue nevus. Dermatology. 1998;197(1):6-10. doi: 10.1159/000017968. PMID: 9693178.
  • Torrelo A, Boente Mdel C, Nieto O, Asial R, Colmenero I, Winik B, Zambrano A, Happle R. Nevus psiloliparus and aplasia cutis: a further possible example of didymosis. Pediatr Dermatol. 2005 May-Jun;22(3):206-9. doi: 10.1111/j.1525-1470.2005.22305.x. PMID: 15916565.
  • Doolan BJ, Lavallee M, Hausser I, Pope FM, Seneviratne SL, Winship IM, Burrows NP. Dermatologic manifestations and diagnostic assessments of the Ehlers-Danlos syndromes: A clinical review. J Am Acad Dermatol. 2023 Sep;89(3):551-559. doi: 10.1016/j.jaad.2023.01.034. Epub 2023 Feb 8. PMID: 36764582.
  • Agarwala S, Hafeez F. Histopathological characterisation of molluscoid pseudotumour seen in Ehlers-Danlos syndrome. Histopathology. 2021 Sep;79(3):440-441. doi: 10.1111/his.14385. Epub 2021 Jul 21. PMID: 33848374.
  • Roman J, Taylor NA, Oza VS, Kim RH. Nevus psiloliparus: Newly described histopathological features from transverse sections. J Cutan Pathol. 2020 Jul;47(7):633-637. doi: 10.1111/cup.13663. Epub 2020 Feb 16. PMID: 32034785.
  • Nottegar A, Tabbò F, Luchini C, Brunelli M, Bria E, Veronese N, Santo A, Cingarlini S, Gilioli E, Ogliosi C, Eccher A, Montagna L, Pedron S, Doglioni C, Cangi MG, Inghirami G, Chilosi M. Pulmonary Adenocarcinoma With Enteric Differentiation: Immunohistochemistry and Molecular Morphology. Appl Immunohistochem Mol Morphol. 2018 Jul;26(6):383-387. doi: 10.1097/PAI.0000000000000440. PMID: 27753661.
  • Meneses M, Galdeano AF, Garay M, Moreno S. Nevus Psiloliparus: Case Series. Actas Dermosifiliogr. 2022 Mar;113(3):319-321. English, Spanish. doi: 10.1016/j.ad.2022.02.022. Epub 2022 Feb 9. PMID: 35526928.
  • Todisco A, Internò V, Stucci LS, Ostuni C, Lovero D, D'Oronzo S, Mele F, Duda L, Palmirotta R, Silvestris F. Cutaneous metastasis as a primary presentation of a pulmonary enteric adenocarcinoma. Int J Biol Markers. 2019 Dec;34(4):421-426. doi: 10.1177/1724600819877190. Epub 2019 Sep 26. PMID: 31556336.