S9C16P8-Scleroderma (Adnexa)

S9C16P8-1: There is a loose fibrous matrix in the area between the red arrows near the center of the field. In this area, the blue represents mucinous matrix and the yellow could be either interstitial cells or elastica (colloidal iron). Collagen bundles are coarsened; the individual fibrils are red. In an area near the center of the field (top red arrow), collagen bundles are fibrillated. The loose fibrous tissue elsewhere in this area may be a result of fissuring of collagen bundles, or of accretive growth of new collagen bundles.

S9C16P8-2: The sclerosing process of morphea involves the perifollicular sheaths; this type of fibrosis may eventuate in follicular atrophy. In this field, there is perifollicular fibrosis with widening of the perifollicular sheath. The follicle is bifid.

S9C16P8-3: The sclerosing process in morphea also involves the adventitia of sweat glands. As the process progresses, the sweat glands first become dilated as in this field. A myoepithelial layer is not represented. Basement membranes are coarsened and hyalinized. Eventually, this process will progress to complete atrophy of sweat glands.

S9C16P8-4: With a PAS stain, the basement membrane of this sweat gland is thickened; the glands are dilated.

S9C16P8-5: Green arrows identify a pattern of collagenous ring-binding. Collagen bundles, cut in cross section, are outlined by concentrically arranged fibrous bands. The bands are separated from the collagen bundle by a clear space, but it would seem that this pattern is a marker for accretive fibrosis. It is relatively peculiar and seen mostly in lesions of morphea.

S9C16P8-6: Plasma cells are a common feature of the perivascular and interstitial infiltrates in lesions of morphea. In this field, a perivascular infiltrate is rich in plasma cells. Streaked collagen bundles are present at the bottom of the field.

 

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