Contributed by Andre Thompson, M.D. and Jian-Ping Cai, M.D. under the supervision of Andrzej Slominski, M.D., Ph.D.
HistopathologyA 76-year-old white male with slow-growing, indurated, flesh-colored, and slightly depressed plaque on the left cheek.
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Image (1) Sun-damaged skin (solar elastosis on the left side) with atrophic epidermis, fibrosis in the papillary and superficial reticular dermis, micronodular inflammatory infiltrate, and diffuse proliferation of spindle cells in deep reticular dermis. | |
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Image (2) Admixed with inflammatory infiltrate and bundles of collagen are small fascicles of atypical spindle cells. |
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Image (3) Some of the proliferating cells have epithelioid appearance with occasional prominent nucleoli. |
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Image (4) High power view showing proliferation of atypical epithelioid cells with mitosis. |
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Diagnosis
Desmoplastic melanoma
Comment: Immunohistochemical staining showed that neoplastic cells were positive for S-100 and negative for Keratin.