127 / 366
Conclusion:
Considering its rarity and its aggressive behavior, it is im-
portant we continue to collect data in order to establish clinical and prog-
nostic profile of this tumour.
PS-06-001
Follicular involvement in malignant melanoma
B. G. Özamrak
*
, P. Temiz
*
Manisa Celal Bayar University, Dept. of Pathology, Turkey
Objective:
In the last decade, following the reporting of follicular mela-
noma as a distinct entity, the issue of involvement of hair follicle with
melanoma cells attracted attention. We aimed to review cases from our
archives to evaluate follicular involvement by melanoma, analyze infil-
tration patterns according to recently proposed classification system.
Method:
Excisional biopsies of all melanoma cases diagnosed between
2006 and 2016 were reviewed.
Results:
Ninety two cases of melanoma were reevaluated (75 cases of
invasive melanoma(81,6 %), 17 cases of melanoma in situ (18,4 %)) and
follicular involvement was seen in 50 % of cases. The cases showed no
apparent sex predilection and most of them were localized at head and
neck region (71,7 %). Most of the cases presented with involvement
limited to infundibulum of hair follicle (41,3 %). In 10 cases, destruction
of hair follicle by melanoma cells was also noted.
Conclusion:
Involvement of hair follicle is a finding observed not infre-
quently in melanoma cases. Lack of recommendations in current guide-
lines causes it to be neglected at standard reporting. To determine its
possible associations with prognosis, a need to revise guidelines to in-
clude this finding seems to be a necessity.
PS-06-002
Two cases of primary cutaneous Ewing sarcoma/primitive
neuroectodermal tumour confirmed by molecular methods: S100
protein positivity can be a pitfall
H. Karatay
*
, G. Narli, S. Ozturk Sari, I. Yilmaz, M. Büyük, D. Tuncel, S.
Kayahan, R. Tanritanir, B. Bilgic, N. Büyükbabani
*
Istanbul Faculty of Medicine, Pathology, Turkey
Objective:
Primary cutaneous Ewing sarcoma/primitive
neuroectodermal tumour (ES/PNET) is a rare malignant small round-
cell tumour. Here we present two cases with immunohistochemical and
molecular findings.
Method:
Florescence in situ hybridization (FISH) analysis using dual-
color break-apart probe for EWSR1 gene and reverse-transcriptase poly-
merase chain reaction (RT-PCR) for EWSR1-FLI1 fusion gene were
performed.
Results:
Two patients presented with small solitary tumours on the skin:
A 25-year-old female with an acneiform lesion on the cheek and a 7-year-
old male with a nodule on the knee. An infiltration of small round-cells in
the dermis and subcutaneous fat was seen. Tumour cells showed immu-
noreactivity for CD99, caveolin-1 and S100 protein. Other small round-
cell tumours in the differential diagnosis were excluded using broad im-
munohistochemical panel. FISH analysis revealed EWSR1 gene rear-
rangement and RT-PCR analysis showed type 1 fusion product between
EWSR1 exon 7 and FLI-1 exon 6 generated by t(11;22)(q24;q12).
Conclusion:
Despite the low frequency, ES/PNETshould be kept in mind
in the differential diagnosis of small round-cell tumours of the skin.
CD99, caveolin-1 and FLI-1 are well-known immunohistochemical
markers. However, one should also be aware of the possible S100 protein
expression in ES/PNET to prevent misdiagnosis. Although immunohis-
tochemistry is helpful, molecular analysis is a requisite for the definitive
diagnosis.
PS-06-005
Lymphomatoid papulosis - a case report of a special localisation
V. Lupu
*
, F. Sarac, S. Taban
*
SCJU Pius Branzeu, Anatomopatologie, Timisoara, Romania
Objective:
Lymphomatoid papulosis(LP) is a subtype of the CD30-
positive T-cell lymphomas with cutaneous manifestation (CTLT).
Currently, it is considered a low-grade CTLT, its uniqueness being given
by the discrepancy between the histological features, suggesting a highly
malignant status, and the clinical self limiting proprieties of the relapsing
chronic lesions.
Method:
We present the case of a 43-year-old male, with a history of
chronic reoccurring dark red / brown papulous lesions located strictly at
the ear-lobe level, bilateral.
Results:
The microscopy images are dominated by rich dermal infiltrate
of lymphoid cells, containing large, regular or irregular nuclei, with eo-
sinophilic nucleoli and rich cytoplasm ;frequent atypical mitosis are also
present, suggesting the malignant aspect, over a hyperkeratotic epidermis
background. Using immunohistochemistry, we find that the large, atypi-
cal lymphocites presented themselves as CD3+, CD5+, CD10-, CD15-
and CD30+, while the rest of the small lymphoid cells were CD20 mar-
ginally positive. We consider this case as a LP one. Given the
histopathologycal results, the patient was treated with local liquid nitro-
gen application, achieving partial remission.
Conclusion:
We believe the particularity of this case is given by the
unique localisation of the lesions, since this is the first documented case
located solely in the described areas.
PS-06-006
Cutaneous clear cell sarcoma with intraepidermal component mim-
icking spitzoid melanoma
M. Zivanovic
*
, B. Luzar, C. E. Bacchi, J. E. Calonje
*
Institute of Pathology, Ljubljana, Slovenia
Objective:
To report a case of cutaneous clear cell sarcoma (CCCS) with
intraepidermal component mimicking spitzoid melanoma and to discuss
the diagnostic approach.
Method:
20-year-old male presented with a nodular lesion on the dorsum
of the foot that was marginally excised. We examined the lesion by light
microscopy, immunohistochemistry and FISH analysis.
Results:
Histopathological examination revealed poorly circumscribed
tumour centered in the dermis with several nests in the overlaying epider-
mis and focal extension into the superficial subcutis. Tumour cells were
mostly elongated with moderately pleomorphic vesicular nuclei and
abundant lightly eosinophilic cytoplasm, organized in an fascicular,
nested and focally discohaesive manner. Numerous »wreath like« giant
cells were apparent among the lesional cells. By immunohistochemistry,
tumour cells were positive for S100, melanA and HMB45. FISH analysis
using a break-apart probe for EWSR1 detected rearrangements in 79 % of
the tumour cells.
Conclusion:
Intraepidermal colonization by CCCS is extremely
rare event reported only twice. Since distinctive morphological
features of CCCS can be lacking, compound variant further
causes diagnostic challenges due to morphological and immuno-
histochemical overlap with melanocytic lesions. Molecular assess-
ment is crucial since the chromosomal translocation t(12;22)
resulting in EWSR1-ATF1 fusion is the hallmark of CCS and
has not yet been reported in melanoma.
Monday, 4 September 2017, 09:30
–
10:30, Hall 3
PS-06 Dermatopathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S113