50 yo M. Floor of mouth mass. Look closely at cytoplasm. Diagnosis?
WSI digital slide (a FANTASTIC EXAMPLE of this entity!): https://t.co/HEg5mbW4nf.
Answer ✅ https://t.co/qRRLnq3BRL
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A 12-year-old girl presented with chronic recurrent bilateral eyelid lesions, intermittent dysphagia, and oligomenorrhea. Examination showed a right upper eyelid pedunculated “woody” conjunctival membrane and left lower eyelid nodule surrounded by pseudomembrane. Ligneous conjunctivitis was confirmed with low plasminogen antibody and activity levels and a homozygous c.112A>G mutation in the PLG gene. Intravenous plasminogen infusions led to prompt resolution of eyelid lesions, dysphagia, and restoration of her menstrual cycle. Plasminogen deficiency type 1 is a rare autosomal recessive disorder, causes mucosal pseudomembranes in multiple organ systems, and may require systemic treatment.
From “Ligneous Conjunctivitis Treated with Intravenous Human Plasminogen” by Ori Saban, MD and Gerami D. Seitzman, MD. Published by Ophthalmology online on February 17, 2025.
https://t.co/CRQ8pu6ZLU
A 38-year-old man with a history of kidney transplantation presented with a 2-week history of burning lesions on his tongue.
Karakioulaki, Meropi, and Franziska Schauer. New England Journal of Medicine, December 14, 2024, NEJMicm2410115. https://t.co/rc7B7g8huu.
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A 50 year old gentleman presented with headache and nasal obstruction found to have a large nasal mass with intracranial extension. A biopsy followed by tumor resection was performed.
What is your opinion?
#Pathology#Pathtwitter#PathX#ENTpath#HeadNeckpath
H&E: Sorry @DrAhmedKalebi No pseudoepitheliomatous hyperplasia. @OkelloAliker
Any differential? Any IHC/molecular you would like to have?
I should also mention that the patient is immune compromised.
leiomyoma
Leiomyomas are benign tumors of smooth muscle that most commonly occur in the uterus, gastrointestinal tract, and skin. Leiomyomas of the oral cavity are rare. Most of these probably have their origin from vascular smooth muscle (as in this case)
Inverted follicular keratosis
▫️Benign, endophytic follicular tumor with characteristic presence of squamous eddies
▫️Most commonly on the head and neck (~90% of cases) with predilection for cheeks and lips
▫️Multiple lesions may be associated with Cowden syndrome.