Clinical-pathologic conference: Cutaneous paraneoplastic pemphigus associated with benign encapsulated thymoma Renee S. Hartz, MD, Associate Editor,

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Presentation transcript:

Clinical-pathologic conference: Cutaneous paraneoplastic pemphigus associated with benign encapsulated thymoma Renee S. Hartz, MD, Associate Editor, Philip J. Daroca, MD, Associate Editor The Journal of Thoracic and Cardiovascular Surgery Volume 125, Issue 2, Pages 400-406 (February 2003) DOI: 10.1067/mtc.2003.60 Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 1 Nuclear myocardial stress test. Note mass (thymic tumor) above left ventricular myocardium in left anterior oblique projection. Uptake of radioactivity is also noted beneath heart in liver. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 400-406DOI: (10.1067/mtc.2003.60) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 2 Left groin lesion. A, Gross photograph of ulcerated lesion before thymectomy. B, Photomicrograph demonstrating suprabasilar acantholytic dermatosis associated with epithelial hyperplasia and prominent dermal and intravesicular eosinophilia (hematoxylin and eosin, original magnification ×100). C, Intraepidermal vesicle in stratum spinosum contains numerous eosinophils and devitalized acantholytic keratinocytes. This focus has features of intraepidermal eosinophilic abscess (hematoxylin and eosin, original magnification ×200). D, In this ×400 (original magnification) view, suprabasilar acantholytic vesicle contains neutrophils, eosinophils, and acantholytic keratinocyte. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 400-406DOI: (10.1067/mtc.2003.60) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 3 Trunk lesions. A, Gross photograph of breast lesion. B, Histologic preparation of leg lesion shows vesical high in epidermis with few keratinocytes in roof of vesicle. Patterns in floor of vesicle are in keeping with re-epithelialization. Erythrocytes, occasional eosinophils, and granular proteinaceous material are present in vesicle. There is superficial perivascular dermal infiltrate of eosinophils and lymphocytes (hematoxylin and eosin, original magnification ×100). C, In this section of leg lesion, dermis contains prominent perivascular eosinophilic infiltrate (hematoxylin and eosin, original magnification ×400). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 400-406DOI: (10.1067/mtc.2003.60) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 4 Diagrammatic representation of surgical incision. Dotted line represents skin incision. Solid line represents sternotomy. The Journal of Thoracic and Cardiovascular Surgery 2003 125, 400-406DOI: (10.1067/mtc.2003.60) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions

Fig. 5 Thymoma. A, In low-power photomicrograph, thymoma is surrounded by thick, fibrous capsule. Neoplastic thymic epithelial cells are suspended in lymphoid stroma (hematoxylin and eosin, original magnification ×100). B, In this region, pseudorosettes of thymic epithelial cells are prominent (hematoxylin and eosin, original magnification ×200). C, In another region, epithelial component of tumor is primarily spindled (hematoxylin and eosin, original magnification ×200). The Journal of Thoracic and Cardiovascular Surgery 2003 125, 400-406DOI: (10.1067/mtc.2003.60) Copyright © 2003 American Association for Thoracic Surgery Terms and Conditions