July 2016 – Teaching preview

We’ve not had a multiheader session for a while, although I’ll start again towards the end of summer. In a few weeks I’ll be talking about ophthalmic pathology as part of the year’s Half Day Teaching programme, so here are a few exam-type cases to whet your appetite.

Case 1 is a young adult thought to have an epidermal (”sebaceous”) cyst on his eyelid, but it turns out to be something that makes many histopathologists smile when they see it.

 

Skin with a dermal lesion
Skin with a dermal lesion

This is a piece of skin with a dermal lesion which opens on to the surface.
Click here for more detail
There is an umbilicated nodular proliferation of epithelium, with the central cells becoming swollen with viral particles and developing a characteristic violaceous hue. This is molluscum contagiosum

Case 2 is a young child also thought to have an epidermal cyst.

Dermal lesion, low power
Dermal lesion, low power
Dermal lesion, medium power
Dermal lesion, medium power
This is a dermal nodule without epidermis. Photographs are at low and medium power.
Click here for more detail
At low power, there is a lobular tumour composed of ghost cells (eosinophilic, some quite pale) and basaloid cells. The former are more prominent. At higher power, the ghost cells ar seen to have lost their nuclei. There is a little acute inflammation. This is a pilomatrixoma.

Case 3 is an elderly patient with an eyelid tumour.

Eyelid tumour
Eyelid tumour
This is a portion of eyelid at medium power, at the free margin (skin at the top, tarsus at the bottom)
Click here for more detail
There is a lobulated basaloid tumour within the dermis, and focal calcification. This is a basal cell carcinoma

For those attending my August teaching afternoon, I’ll go over these and many other cases, as well as give you tips on how best to make use of your friendly local pathology service. See you then!

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