Palisade (pathology)

Palisade (Pathology)

File:Palisade histopathology.jpg

Palisade histopathology

Palisade is a term used in pathology to describe a specific histopathological finding characterized by the arrangement of cells in a palisade-like pattern. This pattern is observed in various pathological conditions and can provide important diagnostic clues. In this article, we will explore the concept of palisade in pathology, its significance, and its association with different diseases.

Definition

In pathology, palisade refers to the arrangement of cells in a linear or parallel fashion, resembling a palisade fence. This pattern is typically observed in histological sections under a microscope. The cells are aligned side by side, with their long axes perpendicular to the basement membrane or the surface of the tissue.

Histopathological Features

The palisade pattern is characterized by the following histopathological features:

1. Linear arrangement: The cells are aligned in a linear or parallel fashion, forming a palisade-like structure.

2. Nuclear orientation: The nuclei of the cells are oriented in a parallel manner, usually perpendicular to the basement membrane or the surface of the tissue.

3. Cytoplasmic features: The cytoplasm of the cells may exhibit specific characteristics depending on the underlying pathology. For example, in certain conditions, the cytoplasm may appear eosinophilic or vacuolated.

Significance

The presence of palisade pattern in histopathological sections can provide valuable diagnostic information. It is often associated with specific diseases or conditions, helping pathologists in making accurate diagnoses. Some of the notable associations include:

1. Basal cell carcinoma: Palisading of tumor cells is a characteristic feature of basal cell carcinoma, a common type of skin cancer. The palisade arrangement is observed in the peripheral cells surrounding the tumor nests.

2. Schwannoma: Schwannomas, benign tumors arising from Schwann cells, frequently exhibit palisading of the tumor cells. This finding is helpful in distinguishing schwannomas from other types of nerve sheath tumors.

3. Granuloma annulare: Palisading histiocytes are a hallmark feature of granuloma annulare, a benign inflammatory skin condition. The palisade arrangement is seen around the central necrotic area of the granuloma.

4. Rheumatoid nodules: In rheumatoid arthritis, the formation of rheumatoid nodules can occur. These nodules often exhibit a palisade arrangement of fibroblasts and histiocytes.

Diagnostic Approach

When encountering a palisade pattern in histopathological sections, it is important to consider the clinical context and other associated findings. The pattern alone may not be sufficient for a definitive diagnosis, but it can guide further investigations and help narrow down the differential diagnosis.

Immunohistochemical staining and additional histopathological features can aid in confirming the underlying pathology. For example, in basal cell carcinoma, immunostaining for specific markers like Ber-EP4 can be used to support the diagnosis.

Conclusion

The palisade pattern is a significant histopathological finding observed in various pathological conditions. Its presence can provide important diagnostic clues and guide further investigations. Understanding the significance of palisade arrangement in different diseases is crucial for accurate diagnosis and appropriate management.

References

1. Weedon D. Weedon's Skin Pathology. 4th ed. Churchill Livingstone; 2015.

2. Kumar V, Abbas AK, Aster JC. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Elsevier; 2014.

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