PMC2957110_01
Two reddish-colored pendulated lesions at the peripheries of a keratotic light brown plaque.
DRP2010-192371.001.jpg
PMC2957110_01_DRP2010-192371.001.jpg
fig1
Examination revealed two reddish-colored pendulated lesions at the peripheries of a keratotic light brown plaque of 27x17 mm (Figure 1), which had been noticed for 5 years.
(a) Dermoscopic examination of the light brown plaque demonstrated a lot of whitish globular structures on the light brown background. (b) In the left pendulated nodule, prominent polymorphous vessels were observed together with irregularly shaped whitish negative network. (c) Vessels were more conspicuous and irregular in the right nodule.
DRP2010-192371.002.jpg
PMC2957110_01_DRP2010-192371.002.jpg
fig2
There were a few comedo-like, well-circumscribed dark brown structures surrounded by yellowish pink erosive areas (Figure 2(a)). At the two reddish-colored pendulated lesions, prominent polymorphous vessels, such as dotted, linear-irregular, glomerular, hairpin vessels were observed together with irregularly shaped whitish negative network (Figures 2(b) and 2(c)). Vessels were more conspicuous and irregular in the right nodule (Figure 2(c)).
Histopathologic examination of the flat pigmented plaque disclosed many well-defined nests within the epidermis. (HE x200).
DRP2010-192371.003.jpg
PMC2957110_01_DRP2010-192371.003.jpg
fig3
Histopathologic examination of the flat pigmented plaque disclosed many well-defined nests within the epidermis (Figure 3).
(a) In the right red nodule, the epidermis was prominently acanthotic with intraepidermal proliferation of clear cells and squamoid cells. Dermal invasion of atypical squamoid cells was partially apparent (HE x20). (b) In the right red nodule, the tumor cells were focally positive for carcinoembryonic antigen (CEA, x20). (c) In the right red nodule, markedly atypical cells proliferated and extended throughout the entire thickness of the acanthotic epidermis (HE x400). (d) The atypical clear cells expressed CEA (CEA x400). (e) The ductal structures expressed CEA (CEA, x400).
DRP2010-192371.004.jpg
PMC2957110_01_DRP2010-192371.004.jpg
fig4
In the right red nodule, markedly atypical cells proliferated and extended throughout the entire thickness of the acanthotic epidermis with apparent dermal invasion (Figures 4(a) and 4(c)). The ductal structures and atypical clear cells expressed carcinoembryonic antigen (CEA) (Figures 4(b), 4(d), and 4(e)).
In the left red nodule, although the atypical basaloid cells proliferated in the epidermis, there were no visible invasions in the dermis (HE x40).
DRP2010-192371.005.jpg
PMC2957110_01_DRP2010-192371.005.jpg
fig5
In the left red nodule, although the atypical basaloid cells proliferated in the epidermis, there was no visible invasion in the dermis (Figure 5).