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What’s new in the fifth edition

The purpose of this chapter is to provide selected highlights of new information (or, in some cases, revitalized old information) that has become available in the realm of dermatopathology, along with the page number where each one (and its references) can be found in this volume. It is not intended to be a comprehensive summation of all such information, and of course individual readers may disagree…

Sarcomatoid (spindle cell) squamous cell carcinoma of the penis

Definition Squamous cell carcinoma with a malignant spindle cell or heterologous sarcomatoid component Clinical features Usually manifests as a white-gray, mixed exophytic and endophytic mass on the glans penis You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Squamous cell carcinoma, cuniculatum

Definition A variant of verrucous carcinoma corresponding to a low-grade verruciform squamous cell carcinoma characterized by deeply infiltrating and interconnected tumor nests forming a burrowing pattern Clinical features Epidemiology Rare, with only a few bona fide cases reported Not related to HPV infection You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member.…

Squamous cell carcinoma, pseudoglandular

Definition Highly aggressive squamous cell carcinoma composed of infiltrative solid tumor nests with central acantholysis as a prominent feature, simulating a glandular lumen Clinical features Epidemiology Rare, with only a few cases reported You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Squamous cell carcinoma, pseudohyperplastic variant

Definition A well-differentiated squamous cell carcinoma (SCC) of the penis with endophytic growth that preferentially involves the foreskin and usually arises in association with lichen sclerosus Clinical features You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Squamous cell carcinoma, papillary

Definition A variant of squamous cell carcinoma (SCC) with verruciform growth pattern, not associated with HPV infection Clinical features Epidemiology Accounts for 5%–15% of penile SCC Affects patients in fifth and sixth decades of life Not associated with HPV infection You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Squamous cell carcinoma, verrucous

Definition A subtype of well-differentiated squamous cell carcinoma (SCC) with broad papillary fronds and pushing base; no apparent association with HPV infection Clinical features You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Lymphoepithelioma-like carcinoma

Definition HPV-related poorly differentiated squamous cell carcinoma morphologically similar to its nasopharyngeal counterpart, characterized by an intense inflammatory response surrounding tumor nests Clinical features Epidemiology Rare variant with only a few cases reported Associated with HPV infection; unlike its nasopharyngeal counterpart, it is not associated with Epstein-Barr virus infection. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become…

Clear cell squamous cell carcinoma

Definition HPV-related penile squamous cell carcinoma characterized by an aggressive clinical behavior and a clear cell morphology Clinical features Epidemiology Rare, with only a few cases reported You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Squamous cell carcinoma, warty-basaloid

Definition HPV-related squamous cell carcinoma composed of variable proportions of warty and basaloid carcinomas, either separately or intermingled. Clinical features Epidemiology Relatively frequent variant, its epidemiological features similar to other HPV-related penile tumors such as pure warty and basaloid carcinomas You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Penile warty (condylomatous) carcinoma

Definition A form of squamous carcinoma with exophytic and papillomatous growth pattern resembling condylomas but with malignant cytological features Strongly associated with high-risk human papillomavirus infection Clinical features Epidemiology 5%–10% of penile carcinomas and 20%–30% verruciform tumors Most commonly involves the glans, coronal sulcus, and foreskin Age distribution similar to conventional squamous carcinoma You’re Reading a Preview Become a Clinical Tree membership for Full access and…

Squamous cell carcinoma, papillary-basaloid

Definition HPV-related squamous cell carcinoma characterized by exophytic papillae lined by basaloid cells, a variant of basaloid carcinoma Clinical features Epidemiology Unusual tumors, with only a few reported cases Patients with invasive tumors are older compared to those with noninvasive lesions. You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in…

Basaloid squamous cell carcinoma

Definition An aggressive variant of squamous cell carcinoma (SCC) with basaloid features; HPV-related Clinical features Epidemiology Accounts for 5%–10% of penile SCC Most patients are 50–59 years old Associated with HPV (HPV16 most common) You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Squamous cell carcinoma of the penis, usual type

Definition Invasive squamous cell carcinoma (SCC) with a varying degree of keratinization that cannot be classified as other histologic subtypes morphologically; also termed typical, conventional, or SCC, not otherwise specified (NOS) Clinical features You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Differentiated penile intraepithelial neoplasia

Definition Non-HPV-related premalignant precursor lesion of the penis characterized by cytologic atypia and abnormal epithelial maturation in the squamous epithelium lining the glans, coronal sulcus, or foreskin, with no extension beyond the basal lamina. Clinical features Epidemiology Similar to invasive squamous cell carcinoma of the penis Not associated with HPV infection You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited…

Squamous hyperplasia of the penis

Definition Benign thickening of squamous epithelium without atypia Clinical features You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Peyronie disease

Definition Localized fibrotic disorder of the penile tunica albuginea Clinical features You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here

Pseudoepitheliomatous keratotic micaceous balanitis

Definition A rare form of balanitis characterized by silvery white plaque with micaceous scaling on glans penis Clinical features Epidemiology Close to 25 cases reported Unknown etiology and pathogenesis Usually seen above 50 years of age (mean age at diagnosis, 63) Often associated with a previous adult circumcision, usually for acquired phimosis, or occasionally in uncircumcised men Often a history of prior trauma or previous disease…

Lichen sclerosus et atrophicus (balanitis xerotica obliterans)

Definition Atrophic condition of the epidermis and dermal connective tissue involving the genital and perianal skin of both males and females; involvement of the glans penis and prepuce is termed balanitis xerotica obliterans Clinical features You’re Reading a Preview Become a Clinical Tree membership for Full access and enjoy Unlimited articles Become membership If you are a member. Log in here