By Sumaira Z. Aasi, David J. Leffell, Rossitza Z. Lazova
Mohs surgical procedure is microscopically managed surgical procedure used to regard universal sorts of epidermis melanoma and allows the removing of a dermis melanoma with a really slim surgical margin and a excessive therapy price. notwithstanding, for these concerned with the Mohs approach, it really is serious to appreciate the optimum coaching and interpretation of frozen sections.
Complete with 1000's of excessive answer figures, Atlas of sensible Mohs Histopathology is written by way of best specialists within the box and discusses every little thing from basic epidermis 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 imperative reference.
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Extra resources for Atlas of Practical Mohs Histopathology
As the scar matures, the fibroblasts become less discernable, slender, and fewer in number. The collagen fibers become more prevalent, thickened, and display horizontal orientation. 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.
The upper plexus is beneath the papillary dermis and the deep plexus is in the lower part of the reticular dermis. The arteries in the subcutaneous fat and larger arterioles Fig. 22 Nerves (N) and vessels (V) often run together Fig. 23 A medium size artery with a small open lumen in the center, internal elastic membrane (IEM), smooth muscle layers (SM), and adventitia (ADV) 17 in the deep reticular dermis have three layers. The internal layer or “intima” contains endothelial cells and an internal elastic membrane.
B) Higher magnification 3 a b Basal Cell Carcinoma Basal Cell Carcinoma Fig. 18 Adenoid basal cell carcinoma: (a) At scanning magnification, the neoplastic aggregates look very similar to eccrine structures (arrows). (b) Compare the neoplastic aggregates (thin arrows) to the eccrine glands (thick arrows) 43 a b 44 Fig. 18 (continued) (c) In the central portion of this photomicrograph is an area showing eccrine glands and ducts on the right (rectangle) and aggregates of basal cell carcinoma on the left (ellipse) and superiorly.