Female 56 years

Peruvian female, 8 year history of subcutaneous induration. Skin surface appears normal.

Specimen: Right lateral distal thigh 6mm punch biopsy.

Macroscopic description:
6mm punch biopsy to 5mm depth, surface unremarkable. Separate loose fragment in the pot 5mm dimension. Punch biopsy bisected and other fragment also embedded.

Immunohistochemistry:
Fungal stains negative.

Male 42 years

Incisional ellipse biopsy - buttocks. Subcutaneous lumps on buttocks. Previous anabolic steroid injection at this site (body builder). Also increasing shortness of breath on exertion. Abnormal CXR, raised ACE.

Specimen: Incisional ellipse biopsy.

Female 68 years



Specimen: Incisional biopsy left cheek.

Macroscopic description:
EOS 21x7x8mm.

Immunohistochemistry:
Strong positivity with synaptophysin, weak positivity with chromogranin. CD45, Melan-A, S100 negative. TTF-1 strongly and diffusely positive. EMA strongly positive. CK7 and CK20 positive; CK7 stronger than CK20, both showing membrane and dot like reactivity.

Male 29 years

Punch biopsy - abdomen. 5 day history of flexural rash, abdominal folds, groin, thighs, knees, buttocks. Background erythema. AGEP? Viral exanthema? Baboon syndrome?

Macroscopic description:
4mm punch biopsy.

Immunohistochemistry:
stains for bacteria and fungi are negative.

Female 66 years

Excision - scalp. ?BCC scalp. Excised with 4mm margin to pericranium.

Macroscopic description:
A hair-bearing disk of skin, 24mm diameter x 8mm depth, bearing a pale dome-shaped lesion 14x12x7mm.

Immunohistochemistry:
for CD34 demonstrates variable staining, with abundant internodular stromal positivity and focal internodular negativity. There is strong, diffuse tumoural positivity for BCL-2.

Female 32 years

Right groin skin. Skin lesion right groin, gradually increasing in size.

Macroscopic description:
skin ellipse 55x25x15mm with underlying nodule 32mm.

Immunohistochemistry:
CD34 patchy positive.

Female 61 years

Excision biopsy. Purple erythemous patches with overlying scale and atrophy on extensor surfaces, buttocks, axilla, arm, breast.

Macroscopic description:
skin ellipse 19x10x6mm. All taken. No discrete lesion seen.

Male 75 years

Skin, excision biopsy scalp. ?SCC

Macroscopic description:
Ovoid piece of skin 26x25x24mm with central raised lesion 15x14x4mm with focal ulceration.

Immunohistochemistry:
MNF, AE1/3, S100, Melan A all negative. CD10 positive.

Female 77 years

Excision. Necrotic skin, right hemithorax.

Macroscopic description:
large area of skin to include right breast plus nipple, 1446g measuring 412x215x60mm. Areas of haemorrhage and necrosis covering the majority of the skin with areas of denudation.

Other investigation results:
swab, Streptococcus pyogenes group A.

Female 62 years

Skin punch biopsy - forearm. GP skin biopsy - multiple symmetrical flat topped violaceous macules. Assessed by dermatology and biopsy advised. ?Lichenoid or granulomatous change. Possibly morphoea.