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Dermpath-India

Dermatopathology - Glossary

Dr Sampurna Roy MD             

 

                                                                                                   

 

 

Acantholytic cell : Refers to an epithelial cell that has undergone dyshesion (i.e separation from another epithelial cell) by dissolution of intercellular bridges and has consequently become round.


Acantholytic dyskeratosis: Characterized by suprabasilar clefting with acantholytic and dyskeratotic cells at all levels of the epidermis.  

Example: Darier's disease, Grover's disease, Warty Dyskeratoma , Acantholytic solar keratosis.

       


Acanthosis : Increase in keratinocyte population of spinous layer with thickening of the epidermis. This may be papillomatous or psoriasiform.


Apoptosis : Cell death, in which the cells becomes condensed and then fragment into smaller bodies by an active budding process.

These contain pyknotic nuclear remanants.

In the skin, these apoptotic bodies are known as Civatte bodies.

Apoptotic bodies extruded into the papillary dermis, are known as Colloid bodies, these contain immunoglobulins, particularly IgM.


Ballooning degeneration : This is intracellular edema with cellular swelling and is often secondary to viral injury or nutritional deficiency.
 


Basket weave pattern : This applies to the normal appearance of the cornified layer in the section of skin (except for that of the palms and soles).
 


'Bottom- Heavy' Infiltrate:  Dense lymphoid infiltrate may be found in lower dermis in the following conditions- Cutaneous lymphoma ; Herpes folliculitis ;  Hidradenitis suppurativa (mixed infiltrate and scarring).



Bulla: A noncystic, transparent fluid filled elevation 1 cm or larger in greatest dimension.



'Busy' Dermis:   This refers to a dermis that appears  focally hypercellular on scanning magnification and is not usually due to usual inflammatory infiltrate. Example: Incomplete granuloma annulare ; Interstitial granulomatous dermatitis; Interstitial granulomatous drug reaction ; Resolving vasculitis ; Folliculitis (at deeper levels) ; Subtle breast carcinoma recurrence; Desmoplastic melanoma; Kaposi sarcoma (early stage).



'Chunks of coal': Large atypical lymphoid cells within a heavy mixed infiltrate occur in Lymphomatoid Papulosis



Compact orthokeratosis : This  denotes normal configuration of the stratum corneum on palms and soles and in pathological condition such as lichen simplex chronicus wherein the cornified cells are closely packed together.



Cornoid Lamellation:  This is localized faulty keratinization characterized by a thin column of parakeratotic cells with an absent or decreased underlying granular zone and vacuolated or dyskeratotic cells in the spinous layer.

Exmple: Porokeratosis and it variants.
 



Corps Ronds : These are found as solitary cells or sometimes small groups of separated cells in the upper malpighian layer and stratum corneum.

They have a small pyknotic nucleus, a clear perinuclear halo and brightly eosinophilic cytoplasm.



Crust : A heap composed  of inspissated plasma that contains white blood cells, red blood cells or both (also called scab).  Example. Impetigo


Dyskeratosis: Described as cell death associated with premature keratinization below the level of the stratum granulosum.
 



Epidermotropism: This is directed emigration of lymphocytes into the epidermis, usually involving only the lower one- third to half of the epidermis. The cells have a  tendency to aggregate.  Spongiosis is usully not prominent. Example: Mycosis fungoides.




Exocytosis: Random immigration of inflammatory cells through the epidermis, some cells reach the surface. This is common in inflammatory dermatoses.  Example. Spongiotic Drug Reaction.



Grains: These are small cells with elongated nuclei and scanty cytoplasm in the upper layers of the epidermis.



Hypergranulosis: Increase in thickness of the granular layer. Example. Lichen Planus


Hyperkeratosis: This is  defined  as  increased  thickness of stratum corneum, either by normal or abnormal keratinocytes. Example. Lichen Planus


Laminated Orthokeratosis: Refers to configuration of the stratum corneum in some pathological states such as icthyosis vulgaris and X- linked icthyosis wherein the cornified cells are arranged in plate-like fashion.

 


Lichenification  : This denotes thickening of the skin characterized clinically by induration, hyperpigmentation and accentuation of the normal skin markings.

 


Macule : A lesion less than 1.0 cm in greatest dimension ; Flush with the level of surrounding normal skin; Colour differs from that of the surrounding normal skin ;  Example. Traumatic senile purpura.



Nodule: A solid or cystic elevation 1.0 cm or more, but less than 2.0 cm in diameter.




Orthokeratosis: This is defined as a process of normal keratinization which leads to the production of a stratum corneum composed of anucleate squames .


Papule : A solid or cystic elevation less than 1.0 cm in diameter.

 



Papillomatosis (Church Spiring):  Increase in keratinocytes with formation of projections (papillae) from the surface of skin.

Example. Verruca vulgaris, Seborrheic keratosis.

 



Parakeratosis :  This is a process of keratinization in which the keratinocytes retain their nuclei. This is abnormal in skin but normal in mucous membrane.

 



Patch : A lesion 1.0 cm or larger in greatest dimension ; Flush with the level of surrounding normal skin ;  colour differs from that of the surrounding normal skin ;  Example.  Mongolian Spot.

 



Pigmentary incontinence : Basal layer damage results in damage to melanocytes with loss of pigment into the dermis where it is taken up by macrophages.

 




Plaque: A lesion that rises slightly above the surface of the skin and is larger than 1.0 cm in greatest dimension. Example. Psoriasis.

 




Psoriasiform Hyperplasia:  Increase in keratinocytes with elongation of dermal papillae. Example.  Psoriasis.




Pustule: An elevation formed of pus. Example. Drug Eruption.




Satellite Cell Necrosis: Single cell death in the epidermis in association with one or more lymphocytes, the implication being that the lymphocytes have trigerred the apoptosis pathway.
 



Scale: A collection of dry horn composed of abnormally shed or accumulated stratum corneum. It is visible on the skin surface as a flake.  Example. Psoriasis.

 




Spongiosis: Widening of the interspaces between keratinocytes due to edema fluid without detachment of cells from each other.  Example. Contact dermatitis.

 




Squirting dermal papillae: Dermal papillae rise high and the epidermal region over the dermal papillae are thinned.

The dermal papillae contain prominent blood vessels.

The term 'squirting dermal papillae' has been used to describe a phenomenon where neutrophils are discharged from these vessels resulting in collection of neutrophils in association with parakeratotic mounds.

 



Theque: Refers to intraepidermal collections of three or more nested melanocytes on H and E sections.
 



Transepithelial elimination:  A biological phenomenon whereby materials foreign to the skin (Example. Elastic fibers, collagen, erythrocytes, amyloid, bone, calcium salt , mucin, fungi etc) are eliminated through pores between cells of the epidermis or hair follicle or are carried up between cells as a passive phenomenon, during maturation of the epidermal cells. 

This phenomenon is observed in the following lesions - Necrobiosis lipoidica; necrobiotic xanthogranuloma ; perforating folliculitis ; Pseudoxanthoma elasticum ; Reactive perforating collagenosis. etc

 



Tumour: A solid or cystic elevation 2.0 cm or more in diameter .
 



Ulcer: A lesion in which there has been destruction of the epidermis and which goes into the papillary or reticular dermis or even deeper. It usually heals with scarring




Vacuolar degeneration (vacuolization): Formation of vacuoles within the cells. This is often noted in the basal keratinocytes.
 



Vesicle: A noncystic transparent fluid filled elevation 1.0 cm in greatest dimension. Example. Herpes Simplex.

 

 

 

 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)


 

 

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