Answer 1:
Ameloblastoma. Common. Many variants but conventionally multilocular with "soap bubble& #39; or "honeycomb appearance." Look for the reverse polarity of basal columnar cells (Vickers-Gorlin change) with subnuclear vacuolization. Different case for comparison:
Answer 2:
Spiradenoma. Basophilic nodules in the dermis with biphasic appearance. Focal duct formation. Remember the overlap with cylindroma.
Answer 3
Paraganglioma. Discussion in the tweet below. The pinned tweet on my profile dives deeper into SDH mutations. https://twitter.com/Dr_Brian_Cox/status/1291440947310419968">https://twitter.com/Dr_Brian_...
Answer 4
Carcinoma ex-pleomorphic adenoma. Malignant cells mixed with benign epithelial stromal components of PA. Note the mitoses, pleomorphism, and necrosis.
Answer 5
Pilomatricoma/Pilomatrixoma. Note the basaloid, epithelioid cells, the reparative giant cells, and the shadow or ghost cells.
Answer 6
Odontogenic keratocyst. Bonus points. If you see this with basal cell carcinoma, what syndrome are we potentially dealing with? Question/Answer: 7
Gorlin syndrome. Mutation in PTCH1 (9q22.3). Also associated with ovarian fibroma.
Answer 8:
Adenoid cystic carcinoma. Relatively bland basaloid cells surrounding ductal lumina containing blue mucinous material. Arranged in a cribriform pattern. Highly associated with perineural invasion and up to 70% can recur.
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@TristanRutland7 @ALBoothMD @PathDocBoston @ariella8 @TheKarenPinto @Sara_Jiang @AssaadAM @GeronimoJrLapac @SwikrityUMD @SanicaBheleMD @HeadandNeckPath @VandaTorousMD @kkuanMD @Gagandeepk5MD @pembeoltulu @SGottesmanMD @DrGeeONE
@TristanRutland7 @ALBoothMD @PathDocBoston @ariella8 @TheKarenPinto @Sara_Jiang @AssaadAM @GeronimoJrLapac @SwikrityUMD @SanicaBheleMD @HeadandNeckPath @VandaTorousMD @kkuanMD @Gagandeepk5MD @pembeoltulu @SGottesmanMD @DrGeeONE
@SimonRoyMD Your rad canalicular adenoma inspired this little series. https://twitter.com/SimonRoyMD/status/1299335832269094912">https://twitter.com/SimonRoyM...
For all of those who made it this far, check out some of the & #39;deeper& #39; differential(s) from the expert Dr. Sadow @PathDocBoston on adenoid cystic and subtyping ex-PA. They are in the comments below the questions.