Soft tissue neoplasms

Angiolymphoid hyperplasia with eosinophilia

A skin lesion consisting of capillaries surrounded by endothelial cells, lymphocytes and diagnostically, eosinophils.

Originally though to be epithelioid hemangioma, it is now known to be a reactive process.

Next, a cyst like lesion in outer canthus of right eye. The location being typical, and the insular morphology being present, the only thing needed now

 is pallisading

 which leads to Basal cell carcinoma, keratinising.

Dedifferentiated liposarcoma

A soft tissue lesion showing mature fat cells and surprisingly, rhabdomyoblasts

 on more sections, even spindle cells and osteoid

Thus a dedifferentiated liposarcoma (anybody suggest a better name).

Well differeniated liposarcoma

 A more conventional, 'well differentiated liposarcoma' is this one

Dermatofibrosarcoma protuberans

This one is showing cotton flower or storiform apperance on low power,

 and high power confirms the spindly apperance

I searched for melanin (for a Bednar tumor) with no luck.

Glomus tumor

A vascular tumor made of perfectly round cells arising in terminal phalanx.

Probably arising from the glomus body, which is an AV shunt at terminals.

Granular cell tumor

Next, a skin lesion showing a Zell Ballen pattern, but with very much round nuclei

Malignant fibrous hisiocytoma

We have arrived at the wastebasket of soft tissue tumors, which is a malignant fibrous histiocytoma. This one needs no explanation.

Malignant peripheral nerve sheath tumor

 showing buckled nuclei among many spindle cells

 possibly malignant peripheral nerve sheath tumor. Need S100 to confirm.

Schwannoma

Another one with classic Antoni A and B areas, Verocay bodies. A Schwannoma.

Alveolar soft part sarcoma

Fibrous hamartoma of infancy

One from the 'infantile fibrous lesions' group - fibrous hamartoma of infancy. Look at the undifferentiated mesenchyme, stellate cells contained within the fibrous septa

Rhabdoid tumor of kidney

A common infantile kidney mass - a rhabdoid tumour

Ossifying fibromyxoid neoplasm

Areas of osteoid and osetocytes (?) are seen

 Angioleiomyoma

Angioleiomyoma or vascular leiomyoma, one of the most painful neoplasms.

Extranodal Rosai Dorfman

Next a collection of plump macrophages with emperipolesis in extranodal Rosai Dorfman disease

Synovial sarcoma

Almost monophasic

Neurofibroma

Xanthogranuloma on FNAC

Fresh ailments of winter 2012

A quality control slide, this one shows mucin filled columnar cells lining the bronchioles and alveoli, growing in a 'lepidic' (like butterflies on a fence) fashion over the bronchiolar epithelium. I just described bronchioloalveolar carcinoma.

 Sorry for this, hazy photograph, but the islets of small cells in an appendix speak of something ominous.

 Chromogranin

 And synaptophysin

 Carcinoid, eh? Next, an mature teratoma

 with ectodermal differentiation

 and showing mature brain tissue, complete with glia and neurones

 An omental nodule with many classical signet rings.

 On close up

This is where it comes from; a diffuse stomach neoplasm

A forehead nodule; revealed to be neural ? vascular?. Hemangiopericytoma like areas were seen. Any comments.

A newborn with a high WBC count; the cells look medium sized with cytoplasmic blebbing. Megakaryoblasts, maybe? Or transient abnormal myelopoeisis?

A bladder cancer

Fungi

Found this black beauty this morning. Aspergillus by its look. Any idea on speciation? Niger, maybe?

On India ink

This is a few month old skin biopsy showing a vague nodule.

On close up, few vacuolated spaces are seen, alongwith mild inflammation. Could have been histoid leprosy.

However, PAS stain shows nice pink bubbles. Possibly Cryptococcus

Gomori's silver methenamine lights up really well.

Budding cryptococci in CSF

Last one, a recurring theme in my blog, the proverbial rhinosporiodiosis. Note the maturing sporangia as they approach the surface, then rupture.

Mucor on culture and microscopy