Amanuel Negussie DOS 531 Week VII Benign: Hemangioma Histology: Cutaneous hemangiomas are identified as raised lesions

that are benign neoplastic proliferation of vascular endothelial cells.1 Simplistic classification schema of hemangioma:1,2 Capillary hemangiomas also known as superficial hemangiomas - small vessel Cavernous hemangiomas also known as deep hemangiomas large vessel Mixed hemangiomas

Refined classification schema of hemangioma:2 Capillary hemangioma, including juvenile Cavernous hemangioma Venous hemangioma Arteriovenous hemangioma Epithelioid hemangioma Hemangioma of granulation tissue Miscellaneous hemangioma of deep soft tissue [including synovial and intramuscular hemangiomas] Lymph node drainage: No lymph node drainage2 Benign: Hetrotopic Bone Histology: Hetrotropic ossifications are classified as:3 Neurogenic hetrotropic ossification Traumatic myositis ossification Fibrodsyplasia ossificans progressiva [Muchmeyers disease]

Histology subtypes:3 Mature fatty bone marrow Mature trebucular bone

Figure 2. Retrieved from Orthobullets.3

Lymph node drainage: Since hetrotropic bone dose not metastasize to other sites, there is no lymph node drainage.

Gynecomastia Histology: *Histology is independent of cause4 Early phase4 Intraductal epithelial proliferation Both epithelial or myepithelial May be micropapillary or cribriform May show squamous metaplasia May be atypical

Periductal stroma typically edematous

Late phase4 Less epithelial proliferation Periductal fibrosis

Lobule formation infrequently seen

Lymph node drainage Lymphatic drainage of male breast is similar to that of the female breast. It includes axillary, internal mammary, and supraclavicular/infraclavicular nodes.5

Figure 2. Retrieved from American Cancer Society.5

Basal Cell Histology: There is no specific generally accepted classification of basal cell carcinoma. Most classifications are based on growth pattern of the tumor. The most basic histological types are :6 Nodular type [solid] in 30-75% of all BCC Superficial type [multicentric, multifocal] 10-15% of all BCC Infiltrative 10% of all BCC

Lymph node drainage: It is very rare for basal cell carcinoma to spread to lymph nodes.7 The drainage sites depend on the location of the original diagnosis.

Squamous Cell Histology: Histologically, squamous cell carcinomas of the skin demonstrate dermal invasion, pleomorphism of tumor cells, and presence of karatinization (may be absent in poorly differentiated type).8 Histologic subtype include:9 Keratoacanthoma Acantholytic spindle cell verrucous clear cell papillary signet ring pigmented desmoplastic

Lymph node drainage: Although still rare, squamous cell carcinomas spread more to lymph nodes than basal cell carcinoma.10 The drainage sites depend on the location of the original diagnosis. Melanoma Histology: Histologic subtypes of melanoma include:11 Superficial spreading melanoma [75% of all melanomas] Epidermal malanocytes [ Intraepidermal melaocytes [commonly large cells] Nodular melanoma [most common in middle aged adults] Lentigo maligna and maligna melanoma [seen on sun damaged head and neck of elderly people] Acral lentiginous melanoma [rare and found on acral surfaces] Mucosal lentiginous melanomas

Lymph node drainage: When melanomas progress beyond stage II, they spread to nearby lymph nodes.12 References 1. Wirth FA, Lowitt MH. Diagnosis and treatment of cutaneous vascular lesions. http://www.aafp.org/afp/1998/0215/p765.html. Accessed July 8, 2013. 2. Kistler BJ, Gellman H. Orthopedic surgery for hemangioma workup. http://emedicine.medscape.com/article/1255694-workup#a0723. Accessed July 8, 2013. 3. Woon C. Hetrotropic ossification. http://www.orthobullets.com/pathology/8044/heterotopic-ossification. Accessed July 8, 2013. 4. Gynecomastia. Stanford school of medicine. http://surgpathcriteria.stanford.edu/breast/gynecomastia/. Accessed July 8, 2013. 5. Breast cancer in male. American cancer society. http://www.cancer.org/cancer/breastcancerinmen/detailedguide/breast-cancer-in-menwhat-is-breast-cancer-in-men. Accessed July8, 2013. 6. Vantuchova Y, Curik R. Histological types of basal cell carcinoma. http://www.med.muni.cz/biomedjournal/pdf/2006/05/261_270.pdf. Accessed June 8, 2013. 7. Skin Cancer: Basal and Squamous cell. American Cancer Society. http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skincancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell. Accessed July 8, 2013. 8. Squamous cell carcinoma. http://www.mrcophth.com/pathology/skin/squamouscellcarcinoma.html. Accessed July 8, 2013. 9. Rinker MH, Fenske NA, Scalf LA, et al. Histologic variants of squamous cell carcinoma of the skin. http://www.medscape.com/viewarticle/409063. Accessed July 8, 2013. 10. Skin Cancer: Basal and Squamous cell. American Cancer Society. http://www.cancer.org/cancer/skincancer-basalandsquamouscell/detailedguide/skincancer-basal-and-squamous-cell-what-is-basal-and-squamous-cell. Accessed July 8, 2013.

11. Smoller BR. Histologic criteria for diagnosing primary cutaneous malignant melanoma. http://www.nature.com/modpathol/journal/v19/n2s/full/3800508a.html. Accessed July 9, 2013. 12. Lymph node involvement. Skin cancer foundation. http://www.skincancer.org/skincancer-information/melanoma/the-stages-of-melanoma/lymph-node-involvement. Accessed 9, 2013.