Affiliated Pathologists Medical Group

39 year old male presents with a tongue lesion. What would you like to know about his history? What’s your diagnosis?

47 y/o female presents complaining of otalgia; this was removed from the ear. What’s your diagnosis?

Happy Lab Week! Check out this endocervical adenocarcinoma in situ as viewed en face - don’t get to see this every day!

https://www.medscape.com/viewarticle/889238

This skin biopsy from the cheek of a 50 year old Hispanic female shows striking golden brown curvilinear structures within the dermis, against a background of solar elastosis. These deposits are compatible with ochronosis, an acquired disorder most commonly resulting from the use of topical hydroquinones. Clinically, this appears as bilaterally symmetrical gray brown to blue black macules on the cheeks and temples. Ochronosis is often misdiagnosed as melasma, a hormonally provoked hyperpigmentation which is found in a similar anatomic distribution. Ironically, melasma is usually treated with topical hydroquinones, the very products that cause and worsen ochronosis.

Not all multinucleated squamous cells signify viral infection! This biopsy from the lower leg of a 57 year old male inmate shows irregular epidermal hyperplasia with compact hyperkeratosis, parakeratosis, and hypergranulosis, with subjacent reactive dermal fibrovascular changes, all features of lichen simplex chronicus. The presence of scattered multinucleated keratinocytes is an unusual phenomenon occasionally seen in pruritic dermatitides, and, most curiously, in factitial dermatitis.

Can't believe it's been two years since we started the Northern CA axis!

Fetal membranes from the placenta of a full term intrauterine fetal demise show coccoid bacteria in the absence of a significant inflammatory response. Aggregates of bacteria were also present on the surface of the cord. The placenta showed evidence of meconium staining but no other significant pathologic change. 1. What is the most likely diagnosis? 2. Was this unfortunate outcome preventable? If so, how?

Sometimes a rose is not just a rose! 62 year old female, skin biopsy from the nipple. At first glance, this biopsy - with its atypical intraepidermal pigmented cells overlying dermal fibrosis and pigment incontinence - looks just like malignant melanoma in situ. However, this represents an unusual case of pigmented Paget's Disease of the nipple. The anatomic site should alert the pathologist to entertain a wider differential diagnosis than would skin biopsies from other sites. Immunohistochemical stains were confirmatory.

27 year old female with colposcopy guided cervical biopsy following an abnormal Pap smear. 1. What is your differential diagnosis? 2. What confirmatory studies would you do? 3. What is the clinical significance of this finding?

Our own Dr. Eric Glassy weighs in on the FDA's decision regarding whole slide imaging as a primary diagnostic tool. How do you feel about interpreting imaged slides? #digitalpathology http://www.captodayonline.com/whole-slide-imaging-primary-/