{"id":920,"date":"2019-05-10T15:44:13","date_gmt":"2019-05-10T15:44:13","guid":{"rendered":"https:\/\/ubwp.buffalo.edu\/histology\/?page_id=920"},"modified":"2019-05-14T20:45:33","modified_gmt":"2019-05-14T20:45:33","slug":"mystery-slide-cases-integument","status":"publish","type":"page","link":"https:\/\/ubwp.buffalo.edu\/histology\/mystery-slide-cases-integument\/","title":{"rendered":"Mystery Slide Cases (Integument)"},"content":{"rendered":"<p style=\"text-align: center\">APOLLO LOGIN:\u00a0<span style=\"color: #0000ff\"><a style=\"color: #0000ff\" href=\"https:\/\/pthscan.med.buffalo.edu\/epmmwebportalnew\/portal.php\">https:\/\/pthscan.med.buffalo.edu\/epmmwebportalnew\/portal.php<\/a><\/span><\/p>\n<hr \/>\n<h3 style=\"text-align: center\">Mystery Slide Case 1: John Smith<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-large wp-image-538\" src=\"https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/03\/Integument-SCC-Case-Image-1024x692.png\" alt=\"\" width=\"1024\" height=\"692\" srcset=\"https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/03\/Integument-SCC-Case-Image-1024x692.png 1024w, https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/03\/Integument-SCC-Case-Image-300x203.png 300w, https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/03\/Integument-SCC-Case-Image-768x519.png 768w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/>Clinical image: courtesy of Glenn Goldman, MD., Medscape, 2018<\/p>\n<p>John Smith is a 72y\/o man with ulcerated fungating growth on right temple, slowly growing over the past 2 years. Mr. Smith owns Schloss Alpli wines and is proud of the award winning Riesling wine he produces. He manages 25 acres of vines, doing the majority of the work himself including\u00a0 planting, harvesting,\u00a0 fermentation,\u00a0 and bottling.\u00a0His wife is concerned about the \u201cmushroom\u201d on his head. <em>Based on your integument knowledge, what typical and atypical histological features can be identified in Mr. Smith&#8217;s tissue biopsy? What cell types are involved?\u00a0<\/em><strong>SEE MYSTERY SLIDE #1 (A1) on APOLLO<\/strong><\/p>\n<h3 style=\"text-align: center\"><span style=\"color: #ff0000\">Identified as: Squamous Cell Carcinoma (SCC)<\/span><\/h3>\n<p>Structures identified (Refer to Mystery Slide A1 in Apollo):<\/p>\n<ul>\n<li>Hyperkeratinization at the surface of the gross specimen, which corresponds to the densely\u00a0 Eosinophilic staining of Keratin seen in the histological sample<\/li>\n<li>Well-progressed squamous cell carcinoma &#8211; we can determine it is epidermal tissue and can identify characteristic features of the epidermal strata (stratum spinosum etc.) in many areas of the tissue<\/li>\n<\/ul>\n<hr \/>\n<h3 style=\"text-align: center\">Mystery Slide Case 2: Jane Doyle<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-625\" src=\"https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/04\/BCC.jpg\" alt=\"\" width=\"467\" height=\"344\" srcset=\"https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/04\/BCC.jpg 467w, https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/04\/BCC-300x221.jpg 300w\" sizes=\"auto, (max-width: 467px) 100vw, 467px\" \/><\/p>\n<p>Image courtesy of Thomas Habif, MD<\/p>\n<p>The above image is an erythematous 2.0 cm nodular lesion on the calf of a 52y\/o woman, Jane Doyle. Ms. Doyle\u00a0 has an unremarkable medical history, takes no medication,\u00a0 and is a full partner in the law firm of\u00a0 Elegant Barristers, LLC. Her work is primarily as a medical malpractice attorney, defending physicians. As a teenager and through college she was employed as a lifeguard at the local country club pool in Tisbury, Massachussetts. While she loved being a lifeguard, she was concerned about sun exposure and the sunburns she experienced. This lesion has been growing over the past several years and bleeds on occasion.<em>\u00a0Based on your integument knowledge, what typical and atypical histological features can be identified in Ms. Doyle&#8217;s tissue biopsy? What cell types are involved?\u00a0<\/em><strong>SEE MYSTERY SLIDE #2 (A2-4) on APOLLO<\/strong><\/p>\n<h3 style=\"text-align: center\"><span style=\"color: #ff0000\">Identified as:\u00a0<\/span><span style=\"color: #ff0000\">Basal Cell Carcinoma (BCC)<\/span><\/h3>\n<p>Structures identified (Refer to Mystery Slide A2-4 in Apollo):<\/p>\n<ul>\n<li>A predominance of basophilic cells can be seen. They share a similarity in staining appearance to the stratum basale found in the right aspect of the specimen which contains healthy skin<\/li>\n<li>Below the basophilic clusters of cells, an infiltration of inflammatory cells can be seen which likely produces a redness of the skin seen in the gross specimen<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<hr \/>\n<h3 style=\"text-align: center\">Mystery Slide Case 3: \u00a0J. Smith<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter wp-image-926 size-full\" src=\"https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/05\/Arm-Dots.jpg\" alt=\"\" width=\"600\" height=\"315\" srcset=\"https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/05\/Arm-Dots.jpg 600w, https:\/\/ubwp.buffalo.edu\/histology\/wp-content\/uploads\/sites\/108\/2019\/05\/Arm-Dots-300x158.jpg 300w\" sizes=\"auto, (max-width: 600px) 100vw, 600px\" \/><\/p>\n<p>Several small dark nodules can be seen on the ventral surface of a patient&#8217;s forearm. The patient had been sailing throughout the Caribbean on a semester-at-sea experience and partying at every port along the way. After all the fun and sun, the patient noticed he had developed three unusual skin nodules. Upon docking in Fort Lauderdale, the patient decided to see a the doctor regarding the marks. A nodule was removed and sent to pathology for histological analysis.\u00a0\u00a0<em>Based on your integument knowledge, what typical and atypical histological features can be identified in the patient&#8217;s tissue biopsy<\/em>? What cell types are involved?\u00a0<strong>SEE MYSTERY SLIDE #3 (Moore-Mystery Slide) on APOLLO<\/strong><\/p>\n<h3 style=\"text-align: center\"><span style=\"color: #ff0000\">Identified as: Normal Skin Sample with Tattoo in Dermis<\/span><\/h3>\n<p>Structures identified (Refer to Moore-Mystery Slide in Apollo):<\/p>\n<ul>\n<li>The histological sample contains tattoo ink (India ink) pigment that has been phagocytosed by histiocytes (macrophages) found in the dermis of the skin.<\/li>\n<li>Notice the colour of the melanin in the keratinocytes of the epidermis is light brown where the dye in the dermis is very dark, and looks rather different from the melanin seen in the epidermis<\/li>\n<li>This slide demonstrates why tattoos are permanent due to the injection of tattoo ink below the dividing layer of cells (epidermis) into the dermis<\/li>\n<\/ul>\n<hr \/>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>APOLLO LOGIN:\u00a0https:\/\/pthscan.med.buffalo.edu\/epmmwebportalnew\/portal.php Mystery Slide Case 1: John Smith Clinical image: courtesy of Glenn Goldman, MD., Medscape, 2018 John Smith is a 72y\/o man with ulcerated fungating growth on right temple, &hellip; <a href=\"https:\/\/ubwp.buffalo.edu\/histology\/mystery-slide-cases-integument\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Mystery Slide Cases (Integument)<\/span><\/a><\/p>\n","protected":false},"author":313,"featured_media":502,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-920","page","type-page","status-publish","has-post-thumbnail","hentry"],"_links":{"self":[{"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/pages\/920","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/users\/313"}],"replies":[{"embeddable":true,"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/comments?post=920"}],"version-history":[{"count":21,"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/pages\/920\/revisions"}],"predecessor-version":[{"id":969,"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/pages\/920\/revisions\/969"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/media\/502"}],"wp:attachment":[{"href":"https:\/\/ubwp.buffalo.edu\/histology\/wp-json\/wp\/v2\/media?parent=920"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}