1. Benign Epithelial Neoplasms, Melanocytic Lesions Flashcards Preview

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Flashcards in 1. Benign Epithelial Neoplasms, Melanocytic Lesions Deck (49)
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1

Etiology of Squamous Papilloma

HPV 6, 11

2

Histo of Squamous Papilloma

Epithelial projections, each with fibro-vascular CT cores

3

Differential Diagnosis of Squamous Papilloma (5)

  • Verruca Vulgaris
  • Condyloma Acuminatum
  • Heck Ds - Focal Epithelial Hyperplasia 
  • Verrucous Carcinoma
  • Cowden Sx 

4

Children who bite nails or suck fingers with warts

Verruca Vulgaris

5

Etiology of Verruca Vulgaris 

HPV 2

6

Histo of Verruca Vulgaris

Young lesions have kiolocytes - clusters of clear cells with shrunken raisin-like nuclei in the granular cell layer

  • Kiolocytes = virally infected cells

 

7

Etiology of Condyloma acuminatum 

HPV 6, 11, 16, 18

8

History of oral sex with a partner having venereal warts

Condyloma acuminatum

9

Histology of Condyloma Acuminatum

  • Large papilloma with koilocytes and keratin filled crypts between projections 
  • Acanthotic epithelium forming blunted projections with thin CT cores
    • papillary projectes are more blunted and broader than SP and VV

10

Etiology of Heck Disease (Multifocal Epithelial Hyperplasia)

  • HPV 13, 32
  • Producing multiple acanthotic papules
    • Inside of lips, cheeks, and sides of tongue
  • Mostly in Native American Children
    • Also in immunosuppressed HIV pts
  • Tends to resolve

11

  • A slow growing squamous carcinoma characterized by exophytic papillary growth
  • Much larger than any papilloma

Verrucous Carcinoma

12

Describe Cowden Syndrome - Multiple Hamartoma Sx (7)

  • Multiple papules on gingiva, tongue, buccal mucosa
  • Multiple small hair follicle tumors
  • Macrocephaly
  • Intestinal polyps, don't become malignant 
  • Keratosis of palms and soles
  • Early development of malignant tumors of breast and thyroid
  • Autosomal Dominant 

13

  • Benign lesion that imitates SCCA clinically and histologically, but spontaneously resolves
  • Firm fleshy epithelial growth with a central keratin plug

Keratoacanthoma

14

How long does a cycle of a Keratoacanthoma take?

4 weeks to 1 year

15

Histo of Keratoacanthoma

  • Arises from hair follicle epithelium
    • Seen on upper and lower lips
  • Pseudoepitheliomatous Hyperplasia - looks similar to SCCA

16

Appearance of multiple Keratoacanthomas is seen in several inherited syndromes and is associated with what?

Internal Malignancies 

17

Describe Seborrheic Keratosis (4)

  • Skin only - never oral cavity
  • Soft, sessile, waxy friable growth - can be partially scraped off
  • Common after age 40
  • Never becomes malignant 

18

Etiology of Seborrheic Keratosis

  • Autosomal Dominant 

or

  • Somatic mutation due to UV light 

19

Sign of Leser-Trelat

  • A sudden shower of Seborrheic Keratosis
  • Indicator of undiagnosed internal malignancy (usually stomach cancer)

20

Micro of Seborrheic Keratosis

Exophytic growth of basal cells showing hyperkeratosis, acanthosis, papillomatosis

21

  • Shows increased melanin in basal layer (epidermis) with no increase in melanocytes
  • Darkens with UV light

Ephelis (Freckle)

22

  • Flat, brown, macule on lip, gingiva, or palate, no larger than 7mm
  • Histo looks like a freckle but Not UV activated
  • No malignant potential 

Oral Melanotic Macule 

23

  • Benign, brown macule that is considered a hallmark of photodamaged skin
  • No change in color intensity is seen after UV light 
  • No malignant transformation
  • Linear increase in melanocytes 

Actinic Lentigo (Liver Spot)

24

  • Benign localized proliferation of melanocytes
  • Symmetrical brown or flesh colored (differentiate from melanomas) 
  • Intraoral lesions are uncommon but the sites the can be seen are - palate, buccal mucosa, gingiva, lips
  • Diameter of < 6mm
  • Most regress slowly with age

Nevus (Mole)

25

Junctional Nevus

  • Theques of nevus cells are confined to the junction of the epithelium and CT - intraepithelial 
  • Always present as a macule

26

Compound Nevus

  • Nevus cells are present along the junctional area-epithelium and within the CT

27

Intradermal / Intraoral Nevus

  • Nevus cells are found only within the CT
  • Presents as a papule

28

  • Uncommon, benign proliferation of melanin producing spindle cells within the dermis 
  • Common on skin of Black and Asain children - Mongolian Spot
  • Located on butt or lower back
  • Mimics bruise of child abuse
  • Oral lesions almost always found on the hard palate
    • small, symmetrical blue macule or papule

Blue Nevus

29

Where do you see Racial Pigmentation?

  • Attached gingiva 
  • Fungiform papillae of tongue

30

What do Cafe-au-lait Spots resemble in Neurofibromatosis?

Smooth borders like the coast of California