RAC932Good: My report "Dense lichenoid band with pigment incontinence is typical for lichen planus." Patient w South Asian name & pigmented skin on bx. Nice saw toothing, wedge-shaped hypergranulosis & dense lichenoid band with pigment incontinence. Occasional Civatte bodies = textbook case.

Yes. I'm mentioned before the paper that was described in had no "control" groups. Even saw a simulant in a follicular SCC today by coincidence. RAC9327. I could not seen any elastic or collagen entrapment so this might all be in situ.

Yes. I comment: "widespread rather monontonous lymphoid aggregates, ?CLL". Don't usually request IHC (usually there is a known history but they can investigate if not). A ? is a good way to put ball in clinicians court. What about the "sign" - you've not mentioned that yet.

All correct but you missed something else (probably).

AI: Histology: Under a microscope, they are characterized by large, eosinophilic (pink-staining) or basophilic inclusion bodies (accumulations of viral material) within the cells, which are a classic feature of HPV-1 infection.

This is just verruca vulgaris / plantaris. I'll post the IHC so you can see was a viral wart looks like on p16 & p53.

Hm! Not myrmecia .... see here...

My thoughts: VW don't have thick basaloid peripheries w high-NC ratio & incipient acantholysis, note shouldering crowded cells on adnexa. parakeratosis from dips (from tips in VW) No koilocytes. NOT hr-HPV (wrong patterns). Don't think null p16 & high p53 are c/w lr-HPV VW.

Good thoughts. p16x2, Ki67 & p53.

Lets hope future advances will make targeted screening safer for the majority.

So sorry to hear that. Yes unlucky. I'm sure you would not want many to die or be harmed of over-treatment too.

In the case of prostate the majority are so slow growing they won't cause symptoms in the life-time of the man and can still be treated if they cause symptoms down the line. Aggressive cases like Chris Hoy are relatively rare and hard to pick up without harming many (by screening).

You can request a test from your doctor. Just be very careful to weigh up the pros and cons for yourself. Treatment of low-risk cancers causes a lot of harm. The art of medicine is to balance harm from treatment with harm from disease. For prostate more harm comes from screening.

It's not about cost. But harm done from screening tests in over-treating many relatively harmless types of cancer that would not affect the life of most affected. Many prostate cancers are relatively low grade & early treatment causes more harm than good (to many). It is hard to understand.

Agree. I do hope people understand this message. Must be very confusing for most people without medical/statistics degrees.

It must be very confusing. Unfortunately the balance of harm to many (from diagnosis & treatment of essentially harmless types of prostate cancer) simply outweigh the smaller benefits to a few. The evidence for other cancers like breast, cervix, colorectal (fewer harmless) is in favour of screening.

I appreciate there is a single atypical mitotic figure but you should note multinucleation. When a multinucleate cell divides it's mitosis will be atypical. I reported it as a poroma. One more image here (nice coffee-bean).

RAC3910: x4 more images at request of @rishiagrawal.bsky.social