By Sumaira Z. Aasi, David J. Leffell, Rossitza Z. Lazova
Mohs surgical procedure is microscopically managed surgical procedure used to regard universal sorts of pores and skin melanoma and enables the elimination of a dermis melanoma with a really slender surgical margin and a excessive treatment fee. besides the fact that, for these concerned with the Mohs process, it truly is serious to appreciate the optimum education and interpretation of frozen sections.
Complete with hundreds of thousands of excessive solution figures, Atlas of functional Mohs Histopathology is written by way of top specialists within the box and discusses every little thing from basic pores and skin histology and infrequent tumors to pitfalls and incidental findings. Dermatologic surgeons, Mohs cutaneous surgeons, dermatopathologists and pathologists alike will locate this ebook to be a accomplished and integral reference.
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Extra resources for Atlas of Practical Mohs Histopathology
24 A small artery (A) with a narrow lumen and a vein (Vn) with widely open lumen Fig. 25 A medium to large vein in longitudinal section with a patent partially collapsed lumen lined by flat endothelial cells (arrows) 2 Normal Skin endothelial cells without a muscular or adventitial layer. Veins are distinguished by their thinner walls, wider lumina, and the presence of valves. Normal Skin Eccrine Glands Sweat glands are unbranched, tubular structures that are composed of three segments: the intraepidermal duct (also known as the acrosyringium), the intradermal duct, and the secretory portion.
Three large nerves in longitudinal sections are also seen (thick arrows) Fig. 31 Minor salivary gland: closer examination reveals that these are acini of a minor salivary gland with glandular structures organized in lobules with small lumina seen in the center of the acini 21 22 Fig. 32 Parotid gland: sheets of basophilic staining cells organized in clusters/groups Fig. 33 Parotid gland: higher magnification reveals glands and ducts (arrows) 2 Normal Skin Normal Skin Apocrine Glands Apocrine sweat glands are mainly confined to the axillae and the genital regions where they produce a viscid milky secretion.
26 Fig. 39 Normal cartilage from the ear: cartilage is composed of chondrocytes positioned within lacunae 2 Normal Skin 3 Basal Cell Carcinoma Basal cell carcinoma (BCC) shows the following histologic features: • Neoplastic aggregates that vary in size and shape composed of basaloid cells • Aggregates often arise from the undersurface of the epidermis or connect to adjacent hair follicles • Peripheral palisading of nuclei within the tumor aggregates • Retraction artifact between the aggregates and surrounding stroma • Mucinous stroma surrounding the basaloid tumor aggregates • Tumor cells have large, oval, or elongated nuclei and little cytoplasm • Necrosis in the center of tumor aggregates and/or individual pyknotic/necrotic tumor cells • Lack of striking cytologic atypia and mitoses • Solar elastosis often in the surrounding dermis • Tumor may have surrounding inflammatory infiltrate • Calcifications may be present in long-standing lesions • Within one BCC more than one histologic subtypes may be seen Histologic types of basal cell carcinoma: Superficial BCC • Small buds of basaloid cells extending from the epidermis and hair follicle epithelium into the superficial dermis Nodular BCC • Basaloid aggregates of different shape and size in the dermis (a) Macronodular subtype – large aggregates of basaloid cells (b) Micronodular subtype – small aggregates of basaloid cells Infiltrative BCC (also see Chap.