Cutaneous Lymphadenoma with extras. Explained by a dermatopathologist. Unk #17.

Cutaneous lymphadenoma - currently believed to be variant of trichoblastoma - is a benign tumor most commonly on the head and neck of older individuals. They are typically biopsied to rule out BCC and other common malignancies.

These tumor are similar to other variants/derivatives of trichoblastoma, complete with CK20+ Merkel cells within tumor islands. Similar to trichoepitheliomas, the periphery of the tumor islands are positive for BCL2, differentiating it from BCC (diffuse staining of tumor).

The prior belief that these lesions were derived from pilosebaceous and sweat glands are fair assumptions since many of the tumor islands may show ductal like epithelium as well as sebocyte like cells.

Microscopically:
1. Dermal tumor composed of pale staining islands with dark blue rim, not dissimilar from clear cell BCC from low power.
2. Embedded in dense fibrous stroma.
3. Tumor cells show large nuclei with vesicular (translucent due to peripheral dispersion of chromatin) chromatin and prominent nucleoli. No mitotic figures.
4. Admixed with lymphocytes T greater than B
5. Basaloid rim of cells without clefting
6. Ductal like structures are negative for CEA but neative for EMA.
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