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Page 1: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Circulation ECirculation E

Welcome!Welcome!

Page 2: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 71Case 71

Clinical: female aged 65 years - lesion on Clinical: female aged 65 years - lesion on extensor aspect of right elbowextensor aspect of right elbow

Specimen: Biopsy of lesion. Specimen: Biopsy of lesion. Macro: Multiple scaly lesionsMacro: Multiple scaly lesions

Page 3: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 4: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 5: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 6: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 7: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

PorokeratosisPorokeratosis

Page 8: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 72Case 72

Clinical: Lesion on dorsum aspect of right Clinical: Lesion on dorsum aspect of right foot foot

Immuno- HHV8 negativeImmuno- HHV8 negative

Specimen: Excision Specimen: Excision

Macro: Tissue measuring 8x7x7mm Macro: Tissue measuring 8x7x7mm

Page 9: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 10: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 11: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 12: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 13: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 14: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 15: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 16: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 17: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Spindle cell haemangioma Spindle cell haemangioma

Page 18: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 73Case 73

Clinical: 12 month history of growing lesion Clinical: 12 month history of growing lesion left hand. ?SCC. Also keeps tropical fish.left hand. ?SCC. Also keeps tropical fish.

Specimen: Incisional biopsy lesion dorsum Specimen: Incisional biopsy lesion dorsum left handleft hand

Macro: 25mm diameter ulcerated lesion Macro: 25mm diameter ulcerated lesion

Page 19: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 20: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 21: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 22: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 23: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Fish tank granulomaFish tank granuloma

Page 24: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 74Case 74

Clinical: male aged 13 - tender deeply Clinical: male aged 13 - tender deeply pigmented molepigmented mole

Specimen: Excision skin right shoulderSpecimen: Excision skin right shoulder

Macro: Ellipse of skin 19x6x6mm with a Macro: Ellipse of skin 19x6x6mm with a grey brown 5mm nodulegrey brown 5mm nodule

Page 25: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 26: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 27: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 28: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 29: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 30: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 31: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 32: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 33: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Most popular diagnosis…..Most popular diagnosis…..

Page 34: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Deep penetrating naevusDeep penetrating naevus

Page 35: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 75Case 75

Clinical: male aged 43- Necrotising Clinical: male aged 43- Necrotising fascitis debrided yesterday, increased fascitis debrided yesterday, increased sepsis, clinical deterioration today. sepsis, clinical deterioration today. Therefore further debridement from skin Therefore further debridement from skin and subcutaneous tissue from right thigh.and subcutaneous tissue from right thigh.

Page 36: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 37: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 38: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 39: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 40: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 41: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Necrotising fasciitis Necrotising fasciitis

Page 42: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 76Case 76

Clinical: male aged 46 - pigmented Clinical: male aged 46 - pigmented naevus changed recently ?junctionalnaevus changed recently ?junctional

Specimen: Skin ellipse excisionSpecimen: Skin ellipse excision

Macro: 12x4x3mm skin ellipse with a Macro: 12x4x3mm skin ellipse with a central 3mm pigmented lesioncentral 3mm pigmented lesion

Page 43: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 44: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 45: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 46: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 47: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnostic categories: Popularity:Diagnostic categories: Popularity: 1 Mildly atypical naevus 1 Mildly atypical naevus 1.271.27 3 Atypical naevus 3 Atypical naevus 2.642.64 4 Benign naevus 4 Benign naevus 5.295.29

2 Moderately atypical naevus 2 Moderately atypical naevus 0.480.48

Page 48: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 77Case 77

Clinical: male aged 72 ?Dermatofibroma Clinical: male aged 72 ?Dermatofibroma anterior abdominal wallanterior abdominal wall

Macro: An ellipse of slightly pigmented Macro: An ellipse of slightly pigmented skin with nodule on cut surfaceskin with nodule on cut surface

Page 49: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 50: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 51: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 52: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 53: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 54: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

1 Tubular apocrine adenoma 1 Tubular apocrine adenoma 4.984.98 2 Papillary eccrine adenoma 2 Papillary eccrine adenoma 3.833.83

Page 55: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 78Case 78

Clinical: female aged 71, diabetic, Clinical: female aged 71, diabetic, yellow/brown plaques anterior shin for yellow/brown plaques anterior shin for three years.three years.

Specimen: punch biopsy Macro: 4mm Specimen: punch biopsy Macro: 4mm punchpunch

Page 56: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 57: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 58: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 59: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 60: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Necrobiosis lipoidica Necrobiosis lipoidica 7.967.96

Page 61: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 79Case 79

Clinical: male aged 12 yearsClinical: male aged 12 years

Specimen: Excision of lesion of the left Specimen: Excision of lesion of the left calfcalf

Page 62: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 63: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 64: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 65: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 66: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 67: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 68: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Spitz naevus Spitz naevus

Page 69: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Case 80Case 80

Clinical: male aged 58 - lesion on right ear Clinical: male aged 58 - lesion on right ear present 1 year ?wart ?haemangiomapresent 1 year ?wart ?haemangioma

Specimen: Curettage lesion on earSpecimen: Curettage lesion on ear Macro: a single piece of tissue which Macro: a single piece of tissue which

appears to be entirely lesional and in appears to be entirely lesional and in which the skin surface is difficult to which the skin surface is difficult to distinguish 9x7x5mm. Bisected all distinguish 9x7x5mm. Bisected all embedded.embedded.

Page 70: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 71: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple
Page 72: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Diagnosis…..Diagnosis…..

Page 73: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

Syringocystadenoma papilliferum Syringocystadenoma papilliferum

Page 74: Circulation E Welcome!. Case 71  Clinical: female aged 65 years - lesion on extensor aspect of right elbow  Specimen: Biopsy of lesion.  Macro: Multiple

The EndThe End