An EMA positive, Ber-EP4 positive immunophenotype supports sebaceous carcinoma, EMA positive, Ber-EP4 negative result supports squamous cell carcinoma and an EMA negative, Ber-EP4 positive result supports basal cell carcinoma.

Multiple morphologic variants of schwannomas have been described, including plexiform, cellular, epithelioid, ancient, and glandular schwannomas. Very rare variants of schwannoma contain gland-like structures formed by neoplastic Schwann cells. The differential diagnosis in these cases can be challenging and includes adnexal neoplasms, neurothekeoma, and vascular neoplasms. We present a case of a well-circumscribed dermal-based neoplasm, which consisted of microcystic gland-like spaces lined by flat to cuboidal cells. A small focus of spindle cells with features resembling that of the Antoni A area typical of schwannoma was present. By immunohistochemistry, the cells lining the cystic spaces and the rest of the tumor were consistent with Schwann cells. In conjunction with this case report, we shall review the concept of the glandular structures in schwannoma.

Importance: Primary cutaneous marginal zone lymphoma (PCMZL) is a low-grade malignant B-cell lymphoma that appears in the skin without any extracutaneous manifestations. Therapeutic mainstays for PCMZL have primarily included radiotherapy and surgery. Intralesional steroids have been found to resolve the lesions caused by PCMZL, but there is a dearth of literature regarding this therapy indicating that this is not a commonly favored treatment option. Observations:We present a case of 60-year-old woman who presented with PCMZL on her right eyebrow. Three years later, after two courses of radiation and one relapse, the patient presented with new lesions on both arms, consistent once again with PCMZL. At this time, therapy with nine rounds of intralesional triamcinolone was attempted. After each round of triamcinolone, gradual improvement of the lesions was noted until complete resolution occurred. Conclusions and Relevance:This case reminds practitioners that intralesional corticosteroids can be effectively and safely used to treat localized PCMZL. Intralesional steroids are less invasive, cheaper, and easier to administer than the majority of other recommended therapies for PCMZL. Thus, although they are often overlooked, intralesional corticosteroids should be more often considered when developing a treatment plan for localized PCMZL.

The prognostic value of exposing malignant melanoma poses an urgent need for an efficient, accurate screening method for metastatic cells. We propose a system for the detection of metastatic tumor cells based upon the thermo-elastic properties of melanoma. The method employs photoacoustic excitation coupled with a detection system capable of exposing cells within the circulatory system in vitro. Initial trials provided a threshold on the order of ten individual cells. Results imply the potential to assay simple blood draws for the presence of cancerous melanoma providing an unprecedented method for routine cancer screening.

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