2016-08-16_0001.jpg

Author: Dr Tim Bracey


touching diathermy margins

2016-08-16_0001.jpg

Author: Dr Tim Bracey

2016-08-16_0001.jpg

Author: Dr Tim Bracey

2016-08-16_0001.jpg

Author: Dr Tim Bracey

2016-08-16_0001.jpg

Author: Dr Tim Bracey



BEREP4




EMA


08/08/2016               12:01 AM              Suffix - Tissue Types                                       HI020967H/16
                                                                                                     - Not Fully Authorised -
          1 - Skin Biopsy                                                               2 - Skin Biopsy
  

  Report sequence 1                           Slides Issued                                                                       11/08/2016 11:08
                                                                                     By     Paul Cunningham                                         CELLPATH (Histology Lab2)

NATURE OF SPECIMEN:

1.   Anal skin tag.  
2.   Anal skin tag.

CLINICAL DETAILS:

Anal skin tag (1) ?SCC.
Anal skin tag (2) benign.

GROSS DESCRIPTION:

1. Skin-covered, variably-pigmented, dome-shaped lesion measuring 11 x 6 x 10 mm in height.
                        S3 1B ns

2. Skin-covered, fleshy lesion measuring 20 x10 x 12 mm in height.
                        S2 1B sk AG|AE

HISTOLOGY:




Pathologists:  
Dr K Syred - Histopathologist


1.   Katherine. This looks like a perianal cutaneous skin tag and it contains
nodular basal cell carcinoma.   Assuming the tumour is contained within
the skin tag, it is 11 mm diameter and 1.5 mm in thickness.   There is
no nerve or vascular invasion.   The immunohistochemistry (BerEP4
positive and EMA negative, as well as the obvious palisading, clefting
and trichoid calcification) useful excludes the most important
differential (basaloid squamous cell carcinoma).   Although anal basal
cell carcinoma is rare, it is well described and assuming this is
perianal skin it can be managed like a cutaneous BCC by wide local
excision (this tumour reaches a diathermy margin; 0 mm).   Unlike SCC,
it should show no propensity for spread into the mesenteric or
inguinal lymph nodes. Tim