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Dermatopathology patterns that remind us of something else:

Dr Sampurna Roy MD                        May 2016


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Pathologists look into the microscope and enter into a world of beautiful patterns and histological appearances. Some of these features closely resemble everyday objects like food, animals, art, nature etc.  

(Visit: Food for thought ! Food and pathology )

In dermatopathology there are dozens of interesting descriptive terms and metaphors related to objects we see around us. Some are beautiful others are weird and funny. We have accepted these terms for decades. New trainees and residents can easily relate to these metaphors and it makes teaching an enjoyable experience.

I have made a short list of popular skin lesions with microscopic features that remind us of something not related to pathology.

(1) Dermatofibroma with Monster cells

(visit: Pathology of Dermatofibroma )

The arrows are pointing to large, ugly, scary looking cells. We like to call them "Monster Cells"

(2) Pilomatrixoma with Ghost/Shadow cells (Visit: Pathology of Pilomatrixoma)


Boo! Nothing spooky about this Pilomatrixoma with mummified shadow cells, also known as "Ghost cells".

(3) Alopecia Areata :  Swarm of Bees Pattern


Bzzz: Lymphocytes "Buzzing" around the bulbar region. This peribulbar infiltrate is described as  swarm of bee appearance.


(4) Cylindroma - Jigsaw Puzzle like Pattern  (Visit: Pathology of Cylindroma)



 The puzzle is solved as the basaloid cells are perfectly arranged in well circumscribed islands.


(5) Acrokeratosis Verruciformis of Hopf -  Church Spire like appearance of the epidermis.

Epidermis shows hyperkeratosis, acanthosis, low papillomatosis and absence of parakeratosis. The epidermal changes resemble beautiful "church spires".


(6) Balloon cell Nevus and Balloon Cell Melanoma - Visit: Balloon Cell Nevus and Balloon Cell Melanoma


 The large, vacuolated cells in these lesions are known as "Balloon Cells".


(7) Syringoma -  Tadpole-like appearance : Visit: Pathology of Syringoma

 In syringoma the nests of cells have a comma-like tail also known as tadpole appearance. 


(8) Lymphomatoid Papulosis - Cells resembling "chunks of coal"                       

Visit: Pathology of Lymphomatoid Papulosis 

The large atypical lymphoid cells with dark hyperchromatic nuclei have been described as "chunks of coal".


This list is not complete. There are many more beautiful examples which I hope to add in future.




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Dr  Sampurna Roy  MD

Consultant Histopathologist (Kolkata - India)







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