By Sumaira Z. Aasi, David J. Leffell, Rossitza Z. Lazova
Mohs surgical procedure is microscopically managed surgical procedure used to regard universal different types of epidermis melanoma and allows the elimination of a dermis melanoma with a really slender surgical margin and a excessive treatment price. even though, for these concerned with the Mohs process, it's severe to appreciate the optimum coaching and interpretation of frozen sections.
Complete with 1000's of excessive solution figures, Atlas of functional Mohs Histopathology is written via best specialists within the box and discusses every little thing from general pores and skin histology and infrequent tumors to pitfalls and incidental findings. Dermatologic surgeons, Mohs cutaneous surgeons, dermatopathologists and pathologists alike will locate this ebook to be a entire and quintessential reference.
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Many vessels are aligned parallel to each other and perpendicular to the skin surface (arrows). Mild perivascular lymphocytic infiltrate is also seen. There is slight dermal edema 25 newly formed blood vessels. As the scar matures, the fibroblasts become less discernable, slender, and fewer in number. The collagen fibers become more prevalent, thickened, and display horizontal orientation. 26 Fig. 39 Normal cartilage from the ear: cartilage is composed of chondrocytes positioned within lacunae 2 Normal Skin 3 Basal Cell Carcinoma Basal cell carcinoma (BCC) shows the following histologic features: • Neoplastic aggregates that vary in size and shape composed of basaloid cells • Aggregates often arise from the undersurface of the epidermis or connect to adjacent hair follicles • Peripheral palisading of nuclei within the tumor aggregates • Retraction artifact between the aggregates and surrounding stroma • Mucinous stroma surrounding the basaloid tumor aggregates • Tumor cells have large, oval, or elongated nuclei and little cytoplasm • Necrosis in the center of tumor aggregates and/or individual pyknotic/necrotic tumor cells • Lack of striking cytologic atypia and mitoses • Solar elastosis often in the surrounding dermis • Tumor may have surrounding inflammatory infiltrate • Calcifications may be present in long-standing lesions • Within one BCC more than one histologic subtypes may be seen Histologic types of basal cell carcinoma: Superficial BCC • Small buds of basaloid cells extending from the epidermis and hair follicle epithelium into the superficial dermis Nodular BCC • Basaloid aggregates of different shape and size in the dermis (a) Macronodular subtype – large aggregates of basaloid cells (b) Micronodular subtype – small aggregates of basaloid cells Infiltrative BCC (also see Chap.
The mucosa lacks the stratum corneum and there is a lichenoid inflammatory infiltrate, which is commonly seen on conjunctival surfaces. (c) Transitional zone between skin on the left and conjunctival mucosa, containing Goblet cells (arrows) on the right. Conjunctival epithelium often has a disordered appearance 37 a b c 38 Fig. 13 Basal cell carcinoma: (a) Rare small islands of basal cell carcinoma are seen on the left of this photomicrograph. A few other neoplastic aggregates are present within areas of dense inflammation (arrows).
6 Superficial basal cell carcinoma: superficial basal cell carcinoma originating from the surface epidermis as well as from the infundibular portion of the hair follicle 3 Basal Cell Carcinoma Basal Cell Carcinoma Fig. 7 Keratinizing basal cell carcinoma: (a) At this magnification there are a few irregular basaloid aggregates in the superficial dermis, some showing angulated shapes. Within the center of a large aggregate is a keratin pearl (arrow). (b) Higher magnification of the keratinizing BCC.
Atlas of Practical Mohs Histopathology by Sumaira Z. Aasi, David J. Leffell, Rossitza Z. Lazova