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c14t3P1: Centrally, and to the right, rounded nests of cells are loosely spaced in a fibrous matrix; focally, the matrix is laminated. In the right lower corner, an interface with the reticular dermis is represented; the lesion in this field shows a level III pattern. There are mild infiltrates of lymphoid cells at the advancing margin. To the left, the pattern is different; broad fascicles of cells are loosely spaced in a fibrous matrix. There is some degree of cellular pleomorphism in this population of cells. To the left, the pattern qualifies as an intermediate neoplasia (a grade of neoplasia based on nesting patterns). To the right, the pattern is minimal deviation with nevus-like qualities.
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c14t3P2: the intermediate pattern is represented at higher magnification.
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c14t3P3: in still other areas, the patterns are solid; the pattern is high grade (a grade of neoplasia based on nesting patterns). Cells show variation in nuclear size and outlines; nuclei are hyperchromatic. The cells are “epithelioid.”
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c14t3P4: in this area, tumor cells infiltrate a partially obliterated muscular vessel.
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c14t3P5: this field is near the dermal-epidermal interface. Cytologic features are high-grade. Some of the defects in the nests of tumor cells contain condensed fibrin. A red arrow identifies a Kamino body. A blue identifies a rounded acidophilic body which more closely resembles a “colloid” body.
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c14t3P6: were it not for the melanin pigment, the pattern in this field might suggest the possibility of atypical fibroxanthoma. The cellular features are pleomorphic.
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c14t3P7: in this lesion, the differential diagnosis would include atypical fibroxanthoma; there are storiform patterns.
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c14t3P8: for the patterns in this lesion, the differential diagnosis would include a sarcoma. In the past, patterns of this type were sometimes characterized as melanosarcoma. The lesion is pleomorphic. it is broadly fasciculated.
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