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CASES 24-28

CASES 24-28. Professor Rino Cerio BSc FRCP(Edin.) FRCP(Lon.) FRCPath Departments of Dermatology and Pathology INSTITUTE OF CELLULAR MOLECULAR SCIENCE (School of Medicine & Dentistry) Barts and the Royal London Hospitals Queen Mary’s University of London, UK.

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CASES 24-28

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  1. CASES 24-28 Professor Rino Cerio BSc FRCP(Edin.) FRCP(Lon.) FRCPathDepartments of Dermatology and PathologyINSTITUTE OF CELLULAR MOLECULAR SCIENCE (School of Medicine & Dentistry)Barts and the Royal London Hospitals Queen Mary’s University of London, UK

  2. 30 y.o. Female. Lesion on the thigh. Painful. Suddenly growing pigmented lesion. No trauma. Melanoma?

  3. CASE 24 RC Pigmented thigh lesion

  4. CASE 24 RC • A. Melanoma • B. Aneusymal fibrous histiocytoma • C. Angiosarcoma • D. Kaposi’s sarcoma • E. Dermatofibrosarcoma protuberans

  5. CASE 24 RC • A. Melanoma • B. Aneurysmal fibrous histiocytoma • C. Angiosarcoma • D. Kaposi’s sarcoma • E. Dermatofibrosarcoma protuberans

  6. Santa Cruz, D.J. and M. Kyriakos, Aneurysmal ("angiomatoid") fibrous histiocytoma of the skin. Cancer, 1981. 47(8): p. 2053-61. Calonje, E. and C.D. Fletcher, Aneurysmal benign fibrous histiocytoma: clinicopathological analysis of 40 cases of a tumour frequently misdiagnosed as a vascular neoplasm. Histopathology, 1995. 26(4): p. 323-31.

  7. HISTIOCYTOMA LYMPHOHISTIOCYTIC INFILTRATE REGRESSING ATYPICAL HISTIOCYTOSIS HISTIOCYTOSIS X LANGERHANS’ CELL HISTIOCYTOSIS NON-X HISTIOCYTOSIS MULTICENTRIC RETICULOHISTIOCYTOSIS SELF-HEALING RETICULOHISTIOCYTOSIS MALIGNANT HISTIOCYTOSIS HISTIOCYTIC LYMPHPOMA

  8. FACTOR XIIIa

  9. CD34 + Type II DD NORMAL HUMAN SKIN

  10. Cerio et al 1998 • FXIIIa+DD distinct from CD34 Type 2 DD • FXIIIa+DD like HLA-DR do not vary with age or sex • Unlike CD34 DD which decrease with age especially in hands and feet compared with trunk

  11. Wilson Jones, E., R. Cerio, and N.P. Smith, Epithelioid cell histiocytoma: a new entity. Br J Dermatol, 1989. 120(2): p. 185-95.

  12. Kutzner, H., Expression of the human progenitor cell antigen CD34 (HPCA-1) distinguishes dermatofibrosarcoma protuberans from fibrous histiocytoma in formalin-fixed, paraffin-embedded tissue [see comments]. J Am Acad Dermatol, 1993. 28(4): p. 613-7. Cohen, P.R., R.P. Rapini, and A.I. Farhood, Expression of the human hematopoietic progenitor cell antigen CD34 in vascular and spindle cell tumors [see comments]. J Cutan Pathol, 1993. 20(1): p. 15-20. ALTMAN, D.A., B.J. NICKOLOFF, AND D.P. FIVENSON, DIFFERENTIAL EXPRESSION OF FACTOR XIIIA AND CD34 IN CUTANEOUS MESENCHYMAL TUMORS. J CUTAN PATHOL, 1993. 20(2): P. 154-8.

  13. DERMAL DENDROCYTES • Langerhans cells CD1a, CD40, CD80 CD86, Langerin HLA- DR, DP, DQ • Dermal dendritic cells DD Type 1 FactorXIIIa CD36, CD14 (22%) HLA-DR DD Type 2 CD36 ?? Further subsets

  14. DENDRITIC CELLS • Immunoregulatory cells • Most powerful professional antigen-presenting cell • Activates primary immune response • Down regulates immune response • Maintain immune homeostasis • Play a key role in immune escape of pathogens and tumours

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