Path Quiz Case-95 : Diagnosis -

       Path Case 95: Case history and images:

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Seborrheic keratosis are benign often multiple lesions occuring in any part of the body except palms and soles.  These tumours may be exophytic or endophytic and are composed of basaloid cells admixed with some squamoid cells. Horn cysts are usually  present.

Histological patterns: Image1 ; Image2 ; Image3 ; Image4
-Acanthotic (solid);  Broad columns and sheets of basaloid cells with horn cysts.
-Reticulated (adenoid); Interlacing thin strands of basaloid cells enclosing small horn cysts.
-Hyperkeratotic (papillomatous) ; Exophytic lesion with hyperkeratosis, papillomatosis and acanthosis.
-Clonal ;  Intraepidermal nests of basaloid cells resembling Borst-Jadassohn phenomenon. Image link
-Irritated ; A dense lichenoid inflammatory infiltrate , squamous eddies and apoptotic cells .

Incidental focal findings include:  Tricholemmal differentiation ; sebaceous differentiation; acantholysis ; amyloid deposition.

Lesar Trelat sign:  There is sudden increase in the number of seborrheic keratosis associated with an internal cancer.