Asunto(s)
Melanoma , Neoplasias Cutáneas , Humanos , Melanoma/patología , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Metástasis Linfática , Biopsia del Ganglio Linfático Centinela , Ganglios Linfáticos/cirugía , Ganglios Linfáticos/patología , Escisión del Ganglio Linfático , Pronóstico , Melanoma Cutáneo MalignoRESUMEN
This series of 2 articles on dermatopathologic diagnoses reviews conditions in which granulomas form. Part 1 clarifies concepts, discusses the presentation of different types of granulomas and giant cells, and considers a large variety of noninfectious diseases. Some granulomatous diseases have a metabolic origin, as in necrobiosis lipoidica. Others, such as granulomatous mycosis fungoides, are related to lymphomas. Still others, such as rosacea, are so common that dermatologists see them nearly daily in clinical practice.
RESUMEN
Part 2 of this series on granulomatous diseases focuses on skin biopsy findings. Whereas the first part treated noninfectious conditions (metabolic disorders and tumors, among other conditions), this part mainly deals with various types of infectious disease along with other conditions seen fairly often by clinical dermatologists.
RESUMEN
Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. It also has a wide variety of causes, including thrombi, which we recently addressed in partI of this review. In this second part, we look at additional causes of vascular occlusion.
Asunto(s)
Trastornos de la Coagulación Sanguínea/complicaciones , Embolia/complicaciones , Enfermedades Cutáneas Vasculares/etiología , Anticoagulantes/efectos adversos , Síndrome Antifosfolípido/complicaciones , Síndrome Antifosfolípido/patología , Calcifilaxia/complicaciones , Calcifilaxia/patología , Cocaína/efectos adversos , Femenino , Cuerpos Extraños/complicaciones , Cuerpos Extraños/patología , Humanos , Isquemia/etiología , Isquemia/patología , Levamisol/efectos adversos , Livedo Reticularis/etiología , Livedo Reticularis/patología , Masculino , Papulosis Atrófica Maligna/patología , Necrosis , Neoplasias/complicaciones , Neoplasias/patología , Paraproteinemias/complicaciones , Paraproteinemias/patología , Piel/irrigación sanguínea , Enfermedades Cutáneas Vasculares/inducido químicamente , Enfermedades Cutáneas Vasculares/patología , Úlcera Cutánea/etiología , Úlcera Cutánea/patología , Síndrome de Sneddon/patologíaRESUMEN
Vascular occlusion has multiple, diverse clinical manifestations, some of which can have grave consequences for patients. The causes of vascular occlusion are also highly variable, ranging from thrombi triggered by the uncontrolled activation of coagulation mechanisms, on the one hand, to endothelial dysfunction or occlusion by material extrinsic to the coagulation system on the other. In a 2-part review, we look at the main causes of vascular occlusion and the key clinical and histopathologic findings. In this first part, we focus on vascular occlusion involving thrombi.
Asunto(s)
Trombosis , Coagulación Sanguínea , Humanos , Trombosis/etiologíaRESUMEN
This article describes a proposed protocol for the histologic diagnosis of cutaneous melanoma developed for the National Cutaneous Melanoma Registry managed by the Spanish Academy of Dermatology and Venereology (AEDV). Following a review of the literature, 36 variables relating to primary tumors, sentinel lymph nodes, and lymph node dissection were evaluated using the modified Delphi method by a panel of 8 specialists (including 7 pathologists). Consensus was reached on the 30 variables that should be included in all pathology reports for cutaneous melanoma and submitted to the Melanoma Registry. This list can also serve as a model to guide routine reporting in pathology departments.
Asunto(s)
Dermatología , Melanoma , Neoplasias Cutáneas , Venereología , Consenso , Humanos , Melanoma/diagnóstico , Sistema de Registros , Literatura de Revisión como Asunto , Neoplasias Cutáneas/diagnósticoAsunto(s)
Melanoma , Neoplasias Cutáneas , Humanos , Escisión del Ganglio Linfático , Ganglios Linfáticos/patología , Metástasis Linfática , Melanoma/patología , Estadificación de Neoplasias , Pronóstico , Estudios Retrospectivos , Biopsia del Ganglio Linfático Centinela , Neoplasias Cutáneas/patologíaAsunto(s)
Neoplasias de las Glándulas Sudoríparas/congénito , Adenomas Tubulares de las Glándulas Sudoríparas/congénito , Diagnóstico Diferencial , Humanos , Masculino , Escápula , Neoplasias de las Glándulas Sudoríparas/patología , Neoplasias de las Glándulas Sudoríparas/cirugía , Adenomas Tubulares de las Glándulas Sudoríparas/patología , Adenomas Tubulares de las Glándulas Sudoríparas/cirugía , Adulto JovenRESUMEN
The Erdheim-Chester disease (ECD) is an extremely rare form of non-Langerhans cell histiocytosis. The main difficulty for its diagnosis lies in the wide variety of non-specific symptoms and signs that can occur in the disease process, leading, therefore, to there being no clear-cut algorithm as a guide for an optimal biopsy to confirm the diagnosis. An 81-year-old male with history of diabetes insipidus was admitted due to non-specific respiratory signs. Imaging techniques revealed osteoblastic lesions in the lumbar spine. Whole-body bone-scintigraphy (BS) was performed, in which lesions involving the axial and appendicular skeleton, with different rates of osteoblastic activity, were observed. This highlighted a symmetrical severely intense uptake in the knees, leading to an accurate biopsy specimen that enabled making the definitive diagnosis. BS is a widely available, safe, and inexpensive technique that shows a characteristic pattern of uptake for ECD, thus its use is highly recommended for screening and guiding biopsy if clinical suspicion exists. Furthermore, when the scintigraphy pattern is incidentally observed, biopsy of increased uptake areas (tibia preferably) is mandatory in order to rule out the disease.
Asunto(s)
Huesos/diagnóstico por imagen , Enfermedad de Erdheim-Chester/diagnóstico por imagen , Anciano de 80 o más Años , Biopsia , Huesos/patología , Enfermedad de Erdheim-Chester/patología , Histiocitosis de Células no Langerhans , Humanos , Masculino , Tibia/diagnóstico por imagenAsunto(s)
Neoplasias Óseas/secundario , Dermatomiositis/diagnóstico , Glucocorticoides/uso terapéutico , Interferón-alfa/uso terapéutico , Melanoma/patología , Metilprednisolona/uso terapéutico , Neoplasias Cutáneas/patología , Dermatomiositis/tratamiento farmacológico , Dermatomiositis/patología , Femenino , Humanos , Interferón alfa-2 , Melanoma/tratamiento farmacológico , Persona de Mediana Edad , Pronóstico , Proteínas Recombinantes/uso terapéutico , Neoplasias Cutáneas/tratamiento farmacológico , Resultado del TratamientoAsunto(s)
Errores Diagnósticos , Leiomiosarcoma/diagnóstico , Neoplasias Cutáneas/diagnóstico , Biomarcadores de Tumor/análisis , Carcinoma Basocelular/diagnóstico , Dermis/patología , Dermoscopía , Cejas/patología , Humanos , Leiomiosarcoma/química , Leiomiosarcoma/patología , Leiomiosarcoma/cirugía , Masculino , Persona de Mediana Edad , Neoplasias Cutáneas/química , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/cirugíaRESUMEN
This consensus statement, conceived as a joint initiative of the Spanish Society of Pathology (SEAP) and the Spanish Society of Medical Oncology (SEOM), makes diagnostic and treatment recommendations for the management of patients with advanced or metastatic melanoma based on the current scientific evidence on biomarker use. This document thus provides an opportunity to improve healthcare efficiency and resource use, which will benefit these patients. Based on the data available so far, this expert group recommends routinely testing patients with metastatic melanoma for BRAF mutation status, as the result affects the subsequent therapeutic management of these patients. The analysis of genetic alterations in KIT may be reasonable in patients with primary tumours in acral or mucosal sites or on chronically sun-exposed skin, in an advanced condition, but not in patients with other types of melanomas. This panel believes that testing for other genetic alterations, such as NRAS mutation status in patients not carrying BRAF mutations, GNAQ/GNA11 mutational analysis or genetic alterations in PTEN, is not currently indicated as routine clinical practice, because the results do not influence treatment planning in these patients at the present time. Other important issues addressed in this document are the organisational requirements and quality controls needed for proper testing of these biomarkers, and the legal implications to be borne in mind.