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10: Epithelial Pathology Flashcards

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1
Q

papilloma HPV types

A

6, 11

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2
Q

RRP what is

A

Recurrent respiratory papillomatosis

6, 11

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3
Q

sinonasal papilloma HPV types

A

6, 11

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4
Q

focal epithelial hyperplasia aka

A

Heck disease, HPV 13, 32

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5
Q

heck disease what is

A

focal epithelial hyperplasia, HPV 13, 32

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6
Q

oropharyngeal SCC HPV type

A

16

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7
Q

conjunctival papilloma HPV type

A

6, 11, 16

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8
Q

verruca vulgaris aka

A

common wart, HPV 2

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9
Q

verruca plana HPV type

A

3, 10

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10
Q

palmoplantar wart HPV type

A

1, 4

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11
Q

butchers wart HPV type

A

2, 7

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12
Q

condyloma acuminatum aka

A

venereal wart, types 6, 11

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13
Q

veneral wart aka

A

condyloma acuminatum types 6, 11

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14
Q

cervical SCC HPV types

A

16, 18

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15
Q

papillomatosis HPV and association

A 
HPV 6 and 11
nevus unius lateris
acanthosis nigricans
focal dermal hypoplasia (Goltz Gorlin)
Down syndrome
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16
Q

RRP what is

A

reucrrent repiratory papillomatosis
larynx –> hoarsenss
juvenile onset 2/2 maternal genital warts
adult onset

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17
Q

sinonasal papilloma how common, location, variants

A

10-25% of all sinonasal tumors
1/2 in lateral nasal wall
remainder in maxillary and ethmoid

inverted papilloma most common variant, greatest potential for malignancy

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18
Q

inverted papilloma

A

most common variant of sinonasal papilloma

greatest potential for malignancy

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19
Q

greatest potential for malignancy in sinonasal papillomas

A

inverted papilloma

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20
Q

cutaneous horns in which entities

A 
SCC
BCC
verruca vulgaris
Seb K 
actinic keratosis
trichoep
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21
Q

molluscum contagiosum cause, location, histo, prognosis

A

pox virus
skin of necj, face (particularly eyelid), trunk, genitals
Henderson-Paterson bodies – Molluscum bodies
most cases spontanesous remission

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22
Q

henderson paterson bodies

A

molluscum bodies

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23
Q

patterson kelly aka

A

= Plummer Vinson Syndrome
 Iron def
 Esophageal webbing = fibrous scar
 Malignant transformation

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24
Q

plummer vinson syndrome aka

A

paterson kelly
 Iron def
 Esophageal webbing = fibrous scar
 Malignant transformation

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25
 Iron def  Esophageal webbing = fibrous scar  Malignant transformation
plummer vinson
26
verruciform xanthoma histo and IHC
xanthoma cells: PAS+, diastase resistant granules | CD68+ (KP1), cathepsin
27
seborrheic keratosis aka
senile wart, basal cell proliferation
28
Dermatosis papulosa nigra:
Variant of seb k found in blacks above zygoma and eyelids. | Seb k are adenoid and acantholytic type
29
Variant of seb k found in blacks above zygoma and eyelids
Dermatosis papulosa nigra: | Seb k are adenoid and acantholytic type
30
Leser-Trelat sign:
Sudden appearance of multiple Seb k indicates malignancy
31
Sudden appearance of multiple Seb k
Leser-Trelat sign: indicates malignancy
32
Inverted follicular keratosis of Helwig
= Irritated seb K
33
= Irritated seb K
Inverted follicular keratosis of Helwig
34
types of seb k
1- Acanthotic (solid) 2- Hyperkeratotic (papillomatosis) 3- Reticulated ( adenoid) 4- Clonal : intraepidermal nests of basaloid cells resembling Borst-Jadassohn phenomenon 5- Irritated: heavy inflammatory cell infiltrate and lichenoid features
35
: intraepidermal nests of basaloid cells resembling Borst-Jadassohn phenomenon seb k
clonal
36
heavy inflammatory cell infiltrate and lichenoid features seb k
irritated
37
mutations in seb k and where else?
= FGFR3 + PIK3CA | also in actinic lentigo
38
actinic lentigo mutations and where else?
= FGFR3 + PIK3CA | also in seb k
39
bowenoid actinic keratosis histo
Full epithelial thickness of dysplasia
40
Oral submucous fibrosis presentation
 Trismus |  Stomatopyrosis: intolerance to spicy food
41
trismus and intolerance to spicy food
Oral submucous fibrosis |  Stomatopyrosis: intolerance to spicy food
42
ephelis aka and genetics
(freckle): MC1R gene
43
MC1R mutation
Ephelis (freckle):
44
FGFR3 + PIK3CA
Seb K and actinic lentigo
45
ephelis clinical
 Increase in melanin deposition |  Color changes with sun exposure
46
ephelis vs melanocytic nevus
ephelis no elevation above skin
47
ephelis vs lentigo simplex
ephelis not as dark
48
ephelis vs lentigo simplex
ephelis no elongation of rete ridges | lentigo pigmented hockey sticks/dirty socks
49
actinic lentigo aka
Lentigo solaris ; Age spot; liver spot; senile lentigo
50
liver spot aka
Actinic Lentigo; Lentigo solaris ; Age spot; liver spot; senile lentigo
51
actinic lentigo where, who (age sex), related entities, histo
 Occurs on skin not mouth  White older men >70 yrs  Freckles are more prone to develop Actinic Lentigo  Maybe a precursor to Seb K  No change in color intensity with UV light exposure  Elongation of rete ridges
52
lentigo simplex vs melanocytic nevus
single lesion - identical
53
lentigo simplex what, where, who and how
```  Melanocytic hyperplasia  Skin not exposed to sunlight  Does not darken with the sun  Increase in both melanin production and number  Elongation of rete ridges  Children ```
54
multiple lentigo simplex
1-LEOPARD 2-Peutz Jeghers syndrome 3-Lentiginosis profusa
55
melasma aka and what is
Mask of pregnancy; Chloasma Acquired, symmetrical hyperpigmentation on sun exposed skin of face and neck Unknown cause Proliferation of # and production
56
melanotic macule aka, what, where
focal melanosis Increase in deposition of melanin, perhaps melanocytes Not affected by the sun Most common site is the lower lip > BM >gingiva > palate
57
lesions on skin unexposed to sun
lentigo simplex, melanotic macule
58
melanoacanthoma what is, who, where
Benign, acquired pigmentation of dendritic cells | F> M / Most common site BM but can occur anywhere
59
congenital nevus where, size(s)
``` Most common trunk and extremities  15% in H&N  Small= <1.5 cm  Medium = 1.5-20 cm  Large = > 20 cm ```
60
developmental nevi
``` NBCC Nevus Flammeus Epidermal nevus WSN Nevus sebaceous ```
61
congenital nevus genetics
NRAS
62
sutton disease
Major aphthous ulcer
63
halo nevus aka, where, what, why, prognosis
Leukoedema Acuisitum Centrifugum ; Sutton Nevus  Skin of trunk  Hypopigmentation due to a destruction of the melanocytes by the immune system  Develops from a recent excision of a melanoma  Most regress and require no treatment
64
Hypopigmentation due to a destruction of the melanocytes by the immune system
halo nevus | from a recent excision of a melanoma
65
spitz nevus aka, where, who
Benign juvenile melanoma; spindle and epitheliod nevus  Extremities or face  Childhood
66
spitz nevus genetics and histo
 HRAS mutation |  Kamino bodies
67
melanoma aka and genetics
acquired nevus, BRAF
68
congenital nevus genetics
NRAS
69
blue nevus genetics
GNAQ
70
spitz nevus genetics
HRAS
71
BRAF
melanoma
72
NRAS
congenital nevus
73
GNAQ
blue nevus
74
HRAS
spitz nevus
75
blue nevus aka and types
Dermal Melanocytoma: Jadasshon-Tieche nevus 1 - common blue nevus 2 - cellular blue nevus
76
common blue nevus where
 2nd most common nevus  Predilection to dorsa of hand and feet, scalp, face  Mucosal lesions on palate
77
cellular blue nevus where
 More than 50% arise in sacrococcygeal or buttock region
78
tyndal effect
``` long wavelength (red & yellow) tend to be absorbed more by tissue Short wavelength (blue) tend to be reflected ```
79
long wavelength (red & yellow) tend to be absorbed more by tissue
``` Short wavelength (blue) tend to be reflected tyndal effect ```
80
Keratoacanthoma aka and from where
self-healing carcinoma ; Pseudocacinoma ; SCC-KA type | Infundibulum of hair
81
types of keratoacanthoma
```  Abortive KA = Involutes 4-6 wks  Subungual KA = nail bed  Mucosal KA = mucosa  Giant KA = >2-3 cm  Keratoacanthoma centrifugum marginatum = peripheral growth, central scarring ```
82
syndromes with multiple keratoacanthomas
 Muir-Torre syndrome: Seb neoplasm + GI malignancy + KA |  Xeroderma pigmentosa: AK + SCC + BCC
83
Muir-Torre syndrome
Seb neoplasm + GI malignancy + KA
84
Xeroderma pigmentosa
AK + SCC + BCC
85
Seb neoplasm + GI malignancy + KA
Muir-Torre syndrome
86
AK + SCC + BCC
Xeroderma pigmentosa
87
syndromes with early onset of keratoacanthoma
 Ferguson-Smith syndrome : nodular lesions / Scottish descents  Witten-Zak syndrome : variable lesion size
88
scottish descent with multiple nodular keratoacanthomas
Ferguson-Smith syndrome
89
late onset of keratoacanthoma syndrome
Gryzbowski syndrome : hundreds of papules +GI malignancy
90
Gryzbowski syndrome
hundreds of papules keratoacanhtoma +GI malignancy
91
hundreds of papules keratoacanhtoma +GI malignancy
Gryzbowski syndrome
92
verrucous carcinoma aka
; Snuff Dipper’s pouch ; Ackerman’s Tumor
93
Oral florid papillomatosis
previous name for verrucous carcinoma
94
NUT midline carcinoma mutation
Fairly new entity / gene mutation chromosome # 15q14
95
gene mutation chromosome # 15q14
NUT midline carcinoma
96
Nasopharyngeal Carcinoma (NPC) : location, who, presentation
 Most common site is lateral wall of nasopharynx (fossa of Rosenmὕller)  Asian M  1 st sign in most cases is an enlarged LN
97
most common skin cancer
BCC
98
most common overall cancer
BCC
99
BCC aka and genetics
``` rodent ulcer 1- Hedgehog signaling pathway (PTCH = 9q22) 2- SMO 3- TP53 4- BER-EB4 = positive BCC negative in peripheral ameloblastoma ```
100
BCC vs ameloblastoma
BER-EB4 = positive BCC | negative in peripheral ameloblastoma
101
merkel cell tumor cause, origin, IHC, symptoms, who gets it
``` Polyomavirus Merkel cells are mechanoreceptors CD20 perinuclear dot AEIOU o Asymptomatic o Expanding rapidly o Immunosuppression o Old age ```
102
CD20 perinuclear dot
merkel cell tumor
103
polyomavirus tumor
merkel cell
104
most common type of BCC
Solid/Nodular (noduloulcerative) 70% cases
105
sclerosing BCC what is
(Morpheaform): insidious lesion mimics scar tissue / Invasion has occurred
106
metatypical BCC
mixed features with basaloid and squamous
107
mixed features with basaloid and squamous
metatypical BCC
108
morpheaform BCC
insidious lesion mimics scar tissue / Invasion has occurred | aka sclerosing
109
BCC on skin of trunk with threadlike margins
superficial BCC
110
most common melanoma
superficial
111
melanoma with greatest vertical grwowth
nodular
112
lentigo maligna where, who, aka
``` (Hutchinson freckle) o Radial growth 15 yrs o Sun exposed areas o Melanoma in situ o Elderly ```
113
hutchinson freckle aka
``` entigo maligna o Radial growth 15 yrs o Sun exposed areas o Melanoma in situ o Elderly ```
114
most common oral melanoma
Acral lentiginous melanoma (mucosal lentigenous melanoma)
115
most common melanoma in black people
Acral lentiginous melanoma (mucosal lentigenous melanoma)
116
Acral lentiginous melanoma (mucosal lentigenous melanoma) location in mouth
80% in palate and maxillary alveolus
117
Acral lentiginous melanoma (mucosal lentigenous melanoma) location generally
Feet, subungual area, mucous membrane
118
sign of melanoma on hands
nail pigmentation
119
NUT midline Carcinoma genetics
15q19 BRD4-NUT
120
15q19
NUT midline Carcinoma BRD4-NUT
121
BRD4-NUT
15q19 NUT midline Carcinoma
122
9q22
PTCH BCC
123
PTCH Ca
9q22 BCC
124
BRAF-MAPK pathway
melanoma
125
melanoma genetics
BRAF-MAPK pathway
126
Seb K & Actinic lentigo genetics
FGFR3 and PIK3CA
127
FGFR3 and PIK3CA
Seb K & Actinic lentigo
128
papilloma HPV
6 and 11
129
papillomatosis how presents
extensive coalescing papillary lesions
130
extensive coalescing papillary lesions
papillomatosis
131
oral papillomatosis associations
acanthosis nigricans, Goltz-Gorlin, nevus unius lateris
132
types of laryngeal papillomatosis
juvenile onset (aggressive) and adult onset
133
verruca vulgaris hpv
2, 4, 6, 40
134
cutaneous horn present in which entities
verruca vulgaris, seb ker, actinic keratosis, SCC
135
condyloma acuminatum hpv
2, 6, 11, 53, 54
136
multifocal epithelial hyperplasia aka and why
heck disease, HPV 13 and 32
137
HPV 13
heck
138
HPV 32
Heck
139
sinonasal papillomas kinds and causes
fungiform (6 and 11), inverted (low HPV), cylindrical (low HPV)
140
highest malignancy among sinonasal papillomas
inverted, up to 25%
141
inverted papilloma IHC
CD44+
142
risk factors for prolonged molluscum contagiosum
HIV, atopic dermatitis, Dariers disease
143
molluscum bodies aka and what is
henderson paterson, bloated keratinocytes with viral inclusions
144
henderson paterson aka and what is
molluscum bodies | bloated keratinocytes with viral inclusions
145
bloated keratinocytes with viral inclusions
molluscum bodies, henderson paterson
146
verruciform xanthoma seen in association with what
lichen planus, lupus, pemphigus, warty dyskeratoma, GVHD, dysplasia, SCC
147
VX histo and IHC
granules are PAS+ diastase resistant, CD68+ and cathepsin B+
148
AD seb ker - who, where, histo type
dermatosis papulosa nigra, black people, zygoma and periorbital; adenoid and acantholytic
149
seb ker genetics
FGFR3 and PIK3CA
150
types of seb ker
acanthotic, hyperkeratotic, adenoid
151
inverted follicular keratosis of helwig what is and special histo
seb ker altered by trauma | whorled epithelium due to metaplasia of lesional cells -- squamous eddies
152
squamous eddies what is
whorled epithelium due to metaplasia of lesional cells | inverted follicular keratosis of helwig (irritated seb ker)
153
irritated seb ker
inverted follicular keratosis of helwig | whorled epithelium due to metaplasia of lesional cells -- squamous eddies
154
sudden onset of multiple itchy seb kers
leser-trelat | internal malignancy
155
leser trelat sign
sudden onset of multiple itchy seb kers | indicates internal malignancy
156
sebaceous hyperplasia association
cyclosporine, corticoids, hemodyalisis, Muir-Torre syndrome
157
muir torre syndrome what is
visceral malignancies, sebaceous adenomas/carcinomas, keratoacanthomas
158
ephelis what is and genetics
MC1R mutation, freckle
159
MC1R mutation
ephelis (freckle)
160
melasma settings
pregnancy, oral contraceptives, hormonal replacement therapy
161
very large congenital nevus
bathing trunk nevus aka garment nevus
162
bathing trunk nevus aka and what is
garment nevus | very large congenital nevus
163
risks of congenital nevus
increased risk of developing neurocutaneous melanosis (melanotic neoplasms of CNS) 3-15% transformation into melanoma
164
congenital nevus --> melanoma risk
3-15% transform
165
most common soft tissue mass of the soft palate
squamous papilloma
166
goltz gorlin aka
focal dermal hypoplasia -- assoc with papillomatosis
167
when is juvenile onset laryngeal papillomatosis aggresive?
with HPV 11
168
juvenile onset laryngeal papillomatosis presentation and cause
can obstruct airway, related to maternal history of genital warts, hoarseness
169
risks with laryngeal papillomatosis
in smokers and history of radiation can progress into SCC
170
prominent granular cell layer, elongated rete ridges converge to center of lesion (cupping effect)
verruca vulgaris
171
blunter broader epithalial projections
condyloma acuminatum
172
when does anogenital condyloma acuminatum progress into SCC
with high risk HPV 16, 18, 31
173
HPV in condyloma acumiatum
2, 6, 11, 53, 54
174
heck's disease HLA
DR4
175
HLA DR4 epithelial condition association
heck disease
176
mitosoid cell what is and in what
cell with altered nucleus that looks like a mitotic figure; in heck
177
where are rete ridges in heck
epithelial is acanthotic upward; rete ridges at level of normal epithelium
178
schneiderian papillomas are what
sinonasal papillomas
179
aka for fungiform sinonasal papilloma
exophytic, everted, septal
180
fungiform sinonasal papilloma where, what, malignant potential
HPV 6, 11 nasal septum no malignant potential
181
inverted sinonasal papilloma where, what, malignant potential
most common HPV 6, 11, 16, 18 lateral nasal wall and sinuses (usually maxillary) MONOCLONAL! Cd44 + (vs papillary SCC) most aggressive and up to 25% SCC transformation
182
most common sinonasal papilloma
inverted
183
most aggressive sinonasal papilloma
inverted actually monoclonal 25% --> SCC
184
papilloma on nasal septum
prolly fungiform
185
papilloma on lateral nasal wall
inverted or cylindrical (oncocytic)
186
papillary SCC vs inverted sinonasal papilloma
papilloma is CD44+
187
least common sinonasal papilloma
cylindrical or oncocyti
188
HPV in cylindrical sinonasal papilloma and aka
aka oncocytic | no HPV
189
hybrid or mixed sinonasal papilloma
inverted + cylindrical
190
cylindrical sinonasal papilloma aka, where, what, malignant potential
aka oncocytic no HPV assoc lower aggression/malignant potentil lateral nasal wall and sinuses (usually maxillary)
191
are sinonasal polyps neoplastic?
no; non-neoplastic proliferations composed of epithelial and stromal elements
192
multiple inflammatory sinonasal polyps in children concern for
cystic fibrosis
193
multiple inflammatory sinonasal polyps in adults why
inflammatory: history of rhinitis, allergy, aspirin intolerance, diabetes
194
inflammatory sinonasal polyps how many and where
multiple, bilateral
195
antrochoanal sinonasal polyp where, how many
arise in antrum, extend to nasal cavity, 90% single
196
antrochoanal sinonasal polyp vs inflammatory
antrochoanal pedunculated, less inflamed | inflammatory - sessile, highly inflamed myxoid/gelatinous stroma, can have charcot-leyden crystals
197
charcot leyden crystals
asthma -- in inflammatory sinonasal polyps
198
single sinonasal polyp likely what kind
antrochoanal
199
molluscum what kind
pox, DNA
200
when does molluscum resolve
6-9 months
201
how common is dermatosis papulosa nigra
30% of black ppl
202
secretory nature of sebaceous glans
holocrine
203
sebaceous hyperplasia associations
cyclosporing, corticoids, hemodyalisis, Muir_torre syndrome
204
sebaceous hyperplasia vs BCC
sebaceous expresses sebum on ceompression
205
rhinopyma what i, who, histo
hypertrophy of sebaceous glands of nasal dome pts with long standing acne rosacea enlarged bumpy nasal dome facial flushing with drinking hot liquids, alcohol, spicy foods, histo: hyperplasia of sebaceous glands
206
hypertrophy of sebaceous glands of nasal dome
rhinopyma | pts with long standing acne rosacea
207
long standing acne rosacea presentation
rhinopyma | hypertrophy of sebaceous glands of nasal dome
208
age spots on sun exposed skin of older people
actinic lentigo
209
actinic lentigo age and where
older people, UV damage, sun exposed skin | more common in people with freckles on face
210
multiple simple lentigines what to consider
lentiginosis profusa, Peutz Jeghers, and LEOPARD
211
LEOPARD components
lentigines (multiple), ECG abnormalities, Ocular hypertelorism, Pulmoary stenosis, Abnormal genitalia, Retarded growth, Deafness
212
lentigo simplex sun or no
skin not exposed to sunlight
213
melasma associations
pregnancy, oral contraceptives, hormonal replacement therapy
214
oral melanotic macule mechanism and role of sun
unrelated to sun | focal increase in melanin and possibly # of melanocytes
215
laugier Hunziker syndrome
pigmentation of lips and buccal mucosa an longitudinal melanonychia (linear pigmentation of nail)
216
pigmentation of lips and buccal mucosa and longitudinal melanonychia (linear pigmentation of nail)
laugier Hunziker syndrome
217
longitudinal melanonychia
(linear pigmentation of nail) laugier Hunziker syndrome
218
(linear pigmentation of nail)
longitudinal melanonychia | laugier Hunziker syndrome
219
oral melanoacanthoma race gender cause
almost exclusively in black ppl, F predilection | reactive
220
progression of acquired melanocytic nevus
junctional (pigmented macule), compount (less pigmented papule), intradermal/intramucosal (papillary, hair, no pigment)
221
can acquired nevus go away
yes
222
cells in acquired nevus by depth
type A - superficial, epithelioid B - middle, lymphocyte like C - deeper, spindle
223
risks of congenital nevus
3-15% --> melanoma
224
halo nevus cause
hypopigmented halo bc melanocytes destroyed by immune system, seen in pts with recent melanoma excision
225
kamino bodies where what
eosinophilic globoid in spitz nevus
226
histo spitz nevus
epithelioid and spindle cells, similar to melanoma but young age and small size
227
spitz nevus IHC
S100+, NSE+
228
color reflection effect in blue nevi
Tyndall
229
combined nevus
blue nevus + overlying melanocytic nevus
230
blue nevus + overlying melanocytic nevus
combined nevus
231
LAMB syndrome
lentigines, atrial and mucocutaneous myxomas, blue nevi (subset of Carney complex)
232
balloon cell nevus histo
large, pale, polyhedral balloon cells (clear cells)
233
oculodermal melanocytosis aka, cause, look, distribution
aka nevus of Ota diffuse distribution of proliferating melanocytes unilateral facial and/or ocular slate-blue pigmentation follow trigeminal V1/V2
234
unilateral facial and/or ocular slate-blue pigmentation | follow trigeminal V1/V2
oculodermal melanocytosis aka nevus of Ota
235
nevus of Ota aka, cause, look, distribution
oculodermal melanocytosis diffuse distribution of proliferating melanocytes unilateral facial and/or ocular slate-blue pigmentation follow trigeminal V1/V2
236
dysplastic nevus where, histo
light-exposed areas, premalignant, melanocytes show nuclear atypia, may be syndrome associated
237
dysplasia in leukoplakia %
5-25%
238
sanguinaria associated keratosis where
mx vestibulr or alveolar mucosa
239
leukoplakia ffrom microorganisms
syphilis - dorsal tongue leukoplakia; candida, hpv
240
dorsal tongue leukoplakia
syphilis
241
leukoplakia progression
thin (mild) --> thick (homogeneous) --> nodule/granular --> verrucous
242
PVL look, starting point, demographic, risks and how soon
multiple lesions, starts in gingiva and spreads to other areas, non smoking females (4:1) clinically can become similar to verrucous carcinoma, transforms into SCC withint 8 y
243
erythrileukoplakia why red
read areas atrophic and can't make keratin
244
dysplasias --> SCC risks by grade and how soon
``` 2-4y: mild 4% mod 10% sev 35% erythroleuko 47% ```
245
erythroplakia locations
most are FOM, tongue, soft palate
246
smokeless tobacco keratosis progression
painless gingival recession, possible with bone destruction
247
smokeless tobacco keratosis mucosa look
thin gray white plaque with blending borders on the area where tobacco is placed
248
parakeratin pointed projections above epithelial layers name and in what what else under basement membrane
chevroning in smokeless tobacco keratosis can have amyloid like areas around BMs and blood vessels
249
which smokeless tobacco/snugg higher risk of SCC
dry (vs moist)
250
when would smokeless tobacco keratosis resolve after cessation
2 week s
251
oral submucosal fibrosis demographic and look
pale and marble like stuff mucosa -- betel quid users
252
betel quid other name
areca nut
253
oral submucosal fibrosis chief complaint
trismus and pain when eating spicy foods | more in BM, SP and retromolar are
254
trismus and pain when eating spicy foods indicator of
oral submucosal fibrosis
255
betel chweres mucosa look and risk
brown red but not precanceorus
256
nicotine stomatitis resolves how soon
within 1 month after discontinuation
257
actinic keratosis risk factors
sun damage in light skinned persons | immunosuppresion, albinism, xeroderma pigemtosum, Cockayne sundrome, Bloom syndrome, Rothmund-Thompson syndrome
258
full thickness dysplasia in actinic keratosis name
bowenoid actinic keratosis
259
bowenoid actinic keratosis
full thickness dysplasia
260
risks with actiniv keratosis
10% progress to SCC
261
dysplasia in oral submucous fibrosis how often and what other risks/how often
dysplasia in 10-15% of cases | near 8% progress into SCC
262
actinic cheilitis occupation
outdoor -- farmers, sailors
263
actinic cheilitis risks
6-10% SCC progression
264
keratoacanthoma causes
UV(95% on sun exposed skin), HPV (26 or 37), tar, immunosuppression, trauma
265
HPV in keratoacanthoma
26 or 37
266
keratoacanthoma phases and when
growth 6 wks stationary 6 wks involution 6-2 months
267
how soon does keratoacanthoma involute
6-12 months
268
ferguson smith
multiple non involutin keratoacanthomas, earli life, hereditary (AD 9q22-31)
269
multiple non involutin keratoacanthomas, earli life, hereditary
ferguson smith
270
9q22-31
ferguson smith | multiple non involutin keratoacanthomas, earli life, hereditary
271
eruptive grzybowski
100s of small keratoacanthomas in skin and upper digestive tract; sign of internal malignancy
272
100s of small keratoacanthomas in skin and upper digestive tract
eruptive grzybowski | sign of internal malignancy
273
keratoacanthoma histo
center of lesion is crater like and keratin filled; surrounding epithelium constricts neck of the lesion. downward proliferation isehs adjacent tissues and its extent is regular (inverted cup)
274
center of lesion is crater like and keratin filled; surrounding epithelium constricts neck of the lesion. downward proliferation isehs adjacent tissues and its extent is regular (inverted cup
keratoacanthoma
275
plummer vinson aka
paterson kelly -- increased risk of SCC of esophagus, oropharynx, and posterior mouth
276
SCC gender , deaths per year, new cases per year, % of all cancers in US
8th M/15th F 5300 deaths 35k new cases 3% of all cancers
277
esophageal webs are
intertwining fibrous bands of scar in esophagus, higher malignancy rate
278
increased risk dorsal tongue scc which infection
tertiary syphilis
279
HPV SCC of oropharynx types
16, 18, 31, 33
280
locations for SCC in mouth
tongue, FOM, soft palate, gingiva, cheek, labial mucosa, hard palate
281
gingival SCC where and who
posterior md, similar to PG or IFH, least associated with tobacco,, most common in F
282
SCC distant met sites
lung, liver, bones
283
desmoplasia aka and what is
scirrhous change; dense fibrosis in CT induced by SCC cells
284
dense fibrosis in CT induced by SCC cells
desmoplasia
285
orall SCC risks for what else
synchronous (33%) or metachronous (66%, within 3years) cancers of upper aerodigestive tract, esophagis, stomacj, lunh
286
verrucous carcinoma aka
ackermans tumor
287
verrucous carcinoma associations and from what
smokeless tobacco, may arise from PVL
288
verrucous carcinoma survival
90% with surgery without neck dissection
289
papillary SCC location and look
oropharynx, hypopharynx, larynx, sinonasal tract-worst prognosis exophytic, looks like papilloma with fibrovascular cores DYSPLASTIC epithelium
290
papillary SCC histo and causes
looks like CIS, not hyperkeratotic, not highly invasive | HPV 6, 11, 16, 18
291
spindle cell carcinoma aka
pseudosarcoma, sarcomatoid SCC
292
ackermans tumor aka
verrucous carcinoma
293
spindle cell ca which component is invasive
spindle
294
spindle cell ca location
oral cavity and larynx
295
spindle cell ca reason
dysfunctional cadherin-catenin complex | 1/3 develop as recurrence after RT for well-diff SCC (dedifferentiation)
296
spindle cell ca IHC
CK+ (AE1/AE3, CAM 5.2)
297
spindle cell ca predictor of prognosis
depth of invasion, not size
298
adenosquamous ca location
posteriorly
299
adenoid squamous cell carcinoma why the look and where
acantholysis -- not true glandular structures | mostly on lip
300
basaloid SCC where
larynx, pyriform sinus, base of tongue
301
basaloid SCC histo look
``` superficial SCC (well diff or in situ) + basaloid epithelium comedonecrosis common ```
302
comedonecrosis which SCC, which Ca
basaloid SCC, SNUC (sinonasal undifferentiated carcinoma)
303
wood dusts exposure which ca
sinonasal adenoca, intestinal type more in men sporadic more in women
304
second most common glandular sinonasal malignancy
sinonasal adenoca intestiinal type | after adenoid cystic ca
305
most common glandular sinonasal malignancy
adenoid cystic ca
306
sinonasal adenoca intestinal type location
ethmoid sinus in menm | nasal cavity and mx sinus in women
307
sinonasal adenoca intestinal type histo
glands lined with pleomorphic columnar cells in back to back pattern
308
histo types of sinonasal adenoca intestinal type
papillary, colonic, solid, mucinous, mixed
309
sinonasal adenoca intestinal type IHC
CD20, CDX2 | CK variable
310
glands lined with pleomorphic columnar cells in back to back pattern
sinonasal adenoca intestinal type
311
sinonasal adenoca non intestinal type grades and features
high hrade: Males, mx sinus, markedly atypical and pleomorphic low grade - no sex predilection, nasal cavity
312
sinonasal adenoca non intestinal type histo
small glands lined with a single layer of uniform cells (seromucinous carcinoma), back to back
313
small glands lined with a single layer of uniform cells but malignant
sinonasal adenoca non intestinal type histo
314
sinonasal undifferentiated carcinoma origin, causative associations
schneiderian membrane or olfactory epithelium | some cases associated with smoing, EBV, and radiation (weak)
315
sinonasal undifferentiated carcinoma histo
nests, trabeculae, ribbons of medium sized polygonal cells with organoid appearance comedonecrosis common
316
nests, trabeculae, ribbons of medium sized polygonal cells with organoid appearance comedonecrosis common
sinonasal undifferentiated carcinoma histo (SNUC)
317
SNUC IHC
sinonasal undifferentiated carcinoma CD (7, 8, 19) negative for synapto/chromo
318
olfactory neuroblastoma aka, what age
esthesioneuroblastoma rare <10yo (unlike usual neuroblastoma) bimodal peaks (15 and 50) most in adults
319
olfactory neuroblastoma histo
nests of round cells separated by fibrovascular septa, may have neurofibrillary stroma true rosettes (Flexner-Wintersteiner) and pseudorosettes (Homer Wright)
320
Flexner-Wintersteiner
true rosettes in olfactory neuroblastoma
321
Homer Wright
pseudorosettes in olfactory neuroblastoma
322
olfactory neuroblastoma types
A - nasal cavity B - external to paranasal sinus C - beyond nose and paranasal sinuses
323
olfactory neuroblastoma IHC
CD56, NSE, synapto, chromo
324
neuroendocrine ca aka on location
oat cell ca in lung | carcinoid tumor in HI
325
most common non squamous tumor of the larynx and risk factor
tobacco related | MDNEC (atypical carcinoid tumor) -- Mills scheme
326
Mills scheme types of carcinoids
WDNEC - carcinoid tumor MDNEC 0 atypical carcinoid tymor PDNEC small cell (small cell undiff) PDNEC large cell (large cell undiff)
327
salt and pepper nuclei, nuclear moldingm, crush artifact
neuroendocrine
328
neuroendocrine IHC
NSE+, chromo, synapto
329
nasopharyngeal carcinoma origin, geography
from lining epithelium of lymphoid ricj nasopharynx | high incidence in China, intermediate in SE asia, low in US
330
nasopharyngeal carcinoma associated factors
EBV, vit C def, salt fish diet (nitrosamines
331
nitrosamines malignancy
nasopharyngeal carcinoma
332
middle aged person with recurrent persistent otitis media consider
nasopharyngeal carcinoma
333
location for nasopharyngeal carcinoma
lateral wall at rosenmullers fossa
334
first sign of nasopharyngeal carcinoma
in 60%, first sign is an enlarged metastatic lymph node
335
nasopharyngeal carcinoma types
1 - keratinizing, SCC 2 - differentiated, nonkeratinizing 3 - undifferentiated, nonkeratinizing (lymphoepithelioma, lymphoepithelial carcinoma)
336
worst prognosis among nasopharyngeal carcinoma types and why
type 1 worse, prolly 2/2 response to radiation
337
lymphoepithelioma what is and types
type 3 of nasopharyngeal carcinoma (undifferentiated, nonkeratinizing) Regaud type: clusters, nests, or aggregates of neoplastic epithelial cells with lymphocytes Schminke type: dispersed tumor cells forming a syncytial net
338
: dispersed tumor cells forming a syncytial net
lymphoepithelioma Schminke type
339
clusters, nests, or aggregates of neoplastic epithelial cells with lymphocytes
lymphoepithelioma Regaud type
340
most common cancer
basal cell carcinoma
341
why does BCC pop up
mainly due to UV | also arsenic ingestion, immunosuppression, PUVA for psoriasis
342
syndromic associations for BCC (6x)
Gorlin syndrome, xeroderma pigmentosum, albinism, Rasmussen, Rombo, and Bazex-Christol-Dupre
343
BCC genetics
PTCH (9q22) + p53 + SMO
344
PTCH gene location and disease
9q22 -- BCC
345
clinical patterns of BCC
noduloulcerative (most common: telangiectatic vessels, aka rodent ulcer) pigmented (nodular with melanocytes) sclerosing (morpheaform -- mimics scar) superficial (multifocal, mimics psoriasis) syndromic (sun exposed AND non exposed areas)
346
collision tumor of BCC and SCC
basosquamous carcinoma
347
merkel cells where and what
epidermis; primarily associated with nerve endings
348
risk factors for merkel cell carcinoma
UV light and immunisuppression (transplant, HIV, lymphocytic leukemia) may be caused by the merkel cell polyoma virus
349
which virus in merkel cell carcinoma
merkel cell polyoma virus
350
merkel cell carcinoma location and look
75% facial skin | dome shaped nodule with smooth surface and telangiectasis (rarely ulcerates)
351
vowel mnemonic for merkel cell carcinoma
``` AEIOU: asymptomatic expands rapidly immunosuppressed older people UV exposed areas ```
352
merkel cell carcinoma IHC and special stains
CK20+ (perinuclear dot-like) synapto chromo NSE TTF1 to exclude lung met Grimelius stain shows granules
353
Grimelius stain
merkel cell carcinoma shows granules
354
risks with merkel cell carcinoma
25% of patietns develop additional malignancies (SCC skin, hemato, breast/ovary adenoca)
355
microcystic adnexal carcinoma aka
sclerosing sweat duct carcinoma
356
sclerosing sweat duct carcinoma aka
microcystic adnexal carcinoma
357
microcystic adnexal carcinoma behavior, location
cytologically bland but locally aggressive | plaque-like indurated lesion of upper lip
358
microcystic adnexal carcinoma histo
``` squamous/basaloid cells horn cysts in superficial portion ductal structures in deeper portions neural/vascular invasion desmoplastic stroma ```
359
``` squamous/basaloid cells horn cysts in superficial portion ductal structures in deeper portions neural/vascular invasion desmoplastic stroma ```
microcystic adnexal carcinoma
360
melanoma genetics
50-70% BRAF mutation (Ras-Raf-Erk pathway)
361
BRAF mutation what and pathway
melanoma! | Ras-Raf-Erk pathway
362
(Ras-Raf-Erk pathway)
BRAF - melanoma
363
most common melanoma
superficial spreading
364
which melanoma can be amelanotic
nodular
365
which melanoma is in situ and from what
lentigo maligna -- from hutchinson's freckle
366
most common melanoma in oral cavity
acral lentiginous melanoma
367
most common melanoma in black people
acral lentiginous melanoma
368
types of melanoma
superficial spreading, lentigo maligna, nodular, acral lentiginous
369
superficial spreading melanoma location
intercapsular area in males, back of leg in female
370
melanoma IHC
HMB45, Melan A, Mart -1 , Fontana-Masson, S100
371
how is melanoma prognosis graded
Breslow classification: depth of invasion associated with poorer prognosis for skin lesions
372
Breslow classification
for melanoma | prognosis ~ depth of invasion
373
which labs/ presentation associated with poorer melanoma of skin prognosis
elevated serum lactic dehydrogenase (LDH) and ulceration
374
which locations associated with poorer prognosis for skin melanoma
interscapular Back posterior and lateral Neck posterior upper Arm Scalp BNAS
375
which demographic etter prognosis for melanoms
women and pts <50yo
376
survival for oral melanoma | which is better, which is worse
13-22% survival better for younger worse for amelanotic
377
how to ddx spitz nevus from melanoma
spitz more in childhood, pink, and small size
378
spitz nevus IHC
S100+ and NSE+
379
combined nevus
blue nevus + melanocytic nevus
380
blue nevus + melanocytic nevus
combined nevus
381
pale and marble-like stiff mucosa
oral submucosal fibrosis
382
betel chewers mucosa
brown red, not pre-cancerous; and lichenoid lesions
383
risk factors for actiic keratosis
immunosuppression, albinism, xeroderma pigmentosum, Cockayne syndrome, Bloom syndrome, Rothmund Thompson syndrome
384
bowenoid actinic keratosis
actinic keratosis + CIS
385
actinic keratosis + CIS
bowenoid actinic keratosis
386
origin of keratoacanthoma
from hair follicle infundibulum
387
what arises from hair follicle infundibulum
keratoacanthoma
388
multiple keratoacanthomas that don't involute
Ferguson Smith
389
hundrend of keratoacanthomas in skin and upper digestive tract
Eruptive Grzybowski; sign of internal malignancy
390
wood and leather exposure predisposes to what and where
sinonasal intestinal type adenocarcinoma (maxillary sinus)
391
nasopharyngeal carcinoma arises from
lining epithelium of lymphoid-ricj nasopharynx
392
lining epithelium of lymphoid-ricj nasopharynx gives rise to
nasopharyngeal carcinoma
393
factors associated with nasopharyngeal carcinoma
EBV, vitamin def, salt fish diet (nitrosamines)
394
which BCC is multifocal
superficial
395
which BCC is sclerosing
morpheaform
396
which BCC is on sun exposed and nonexposed skin
syndromic
397
which BCC has melanocytes
pigmented
398
which BCC is telangiectatic and ulcerated
nodular aka rodent ulcer
399
mohs micrographic surgery
uses frozen sections to ensure complete removal of BCC/SCC
400
which surgery uses frozen sections to ensure complete removal of BCC/SCC
mohs micrographic surgery
401
which melanoma has no radial phase
nodular

OP - Yield (19 decks)

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