Rapidly Growing Hemorrhagic Papule
A 49-year-old Caucasian woman with a history of invasive well-differentiated squamous cell carcinoma (SCC) showing perineural invasion that was diagnosed by biopsy 2 weeks prior presented for Mohs micrographic surgery of the cheek. First-stage sections yielded changes of wound repair at low power (Fig. 24.1), and a vaguely rounded structure surrounded by chronic inflammation (including primarily lymphocytes) was noted in the deeper dermis. At intermediate-power examination (Fig. 24.2), the rounded silhouette of the structure shows a complex internal structure consisting of multiple fenestrated foci. At high-power examination (Fig. 24.3), the channels contain hyperchromatic nuclei that are in turn surrounded by and invested in a myxoid stroma.
KeywordsOrganizing thrombus Masson’s lesion