Membranous type Basal Cell Adenoma (BCA).
🧨 Morphologically identical to cutaneous cylindroma, hence aka dermal analogue tumor.
🧨 This is a unique morphologic subtype that one should be aware of.
Why? Read below. #ENTpath
#pathology #pathboards #S&L 1/3

🧨 Because this particular subtype can be multifocal.
🧨 This can be associated with Brooke Spiegler syndrome, a rare AD disease caused by mutation of CYLD gene on chr 16.
🧨 This has a higher rate of local recurrence (25%) than other subtypes. 2/3

🧨 And this has high propensity for transformation into a basal cell adenocarcinoma.
🔬 Islands of basaloid cells surrounded by eosinophilic hyaline material, jigsaw puzzle like pattern & peripheral palisading.
3/3 #S&L

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Yale Pathology

@YalePathRes

Beautiful example of a secretory carcinoma of the salivary gland. Secretory carcinoma (aka mammary analogue secretory carcinoma) is a ~recently described malignant tumor of the salivary gland, most commonly the parotid as in this case. Classically presents as a painless mass 1/5

in a middle-aged adult. Histologic appearance can vary significantly from well-circumscribed, lobulated growth with fibrous septa to infiltrative; papillary, solid, follicular and cystic architectures are common. Watch out for excessive solid growth, necrosis, mitotic 2/5

activity and/or significant cytologic atypia in cases of SC with high-grade transformation. Because of the variable histologic findings, IHC can be essential (esp. when presenting outside of the salivary gland): classically S100+ mammaglobin+ GCDFP-15+ SOX-10+ TTF1- AR-. 3/5

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Bin Xu

@BinXu16

Time for another #grossognosis #ENTpath #Pedipath

Tongue lesion in a young kid.

@TheKarenPinto @renemaf @AnnieMcLeanDMD @DrAhmedKalebi @DrRolaAli @merva_st @TheKarenPinto @VijayPatho @doc_kartik @luishcruzc @kis_lorand

@DrAhmedKalebi

H&E: Sorry @DrAhmedKalebi No pseudoepitheliomatous hyperplasia. @OkelloAliker

Any differential? Any IHC/molecular you would like to have?

I should also mention that the patient is immune compromised.

@lizawati38

This turns out to be EBV-associated smooth muscle tumor (HE/SMA/EBER). Kudo to @lizawati38

3 spindle cell tumors in immune compromised:
- KS
- EBV-SMT
- microbacterial spindle cell pseudotumor

Without clinical history: ddx broader including all cellular spindle cell lesions.

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Bin Xu

@BinXu16