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HealthCert Education > Module 8: Melanoma > Flashcards

Module 8: Melanoma Flashcards

1
Q

Diffuse reticular/ Patchy reticular - B v M

A

M - disorganized

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2
Q

Central hypo/ hyperpigmentation - B v M

A

M - off centre

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3
Q

Non- specific (structureless or featureless or homogenous) - B v M

A

M - heterogeneous hues or completely structureless

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4
Q

Peripheral globules and central reticular/ central globules and peripheral reticular - B v M

A

M - disorganized. Included asymmetric starburst

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5
Q

Globular - B v M

A

M - disorganized

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6
Q

Multi-component (symmetric)
2 component nevus
B v M

A

M Multi-component - 3 or more structures distributed asymmetrically

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7
Q

MM specific structures - sensitivity, 1-3

A

Regression structures
Atypical network
BWV

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8
Q

MM specific structures - specificity, 99% (4)

A

Streaks
Cystalline
BWV
Regression s

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9
Q

MM specific structures - odds ration, 1-4

A

Peripheral brown structureless
Crystalline
Atypical network
Regression structures

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10
Q

MM specific structures

A
  1. Atypical network (included grey angulated lines)
  2. Irregular Streaks (focal irregular - pseudopods & or radial streaming)
  3. Negative pigment network
  4. Crystalline (short white lines)
  5. Atypical dots and granules
  6. Atypical (irregular) blotch
  7. Blue white veil over raised areas
  8. Regression structures (BWV over flat area, peppering, scar)
  9. Atypical vessels
  10. Peripheral tan/ brown structureless areas
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11
Q

Atypical network is associated with ….

A

Superficial spreading melanoma

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12
Q

Angulated lines - description

A

Form zig zag pattern and polygonal structures (rhomboids)

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13
Q

Angulated lines Sens and Sp?

A

Not known but almost always MM

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14
Q

Angulated lines histopath correlation

A

NYD

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15
Q

Angulated lines most commonly seen

A

Sun damaged skin of face

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16
Q

Angulated lines also seen

A

Chronic sun damaged skin upper torso/ extremities

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17
Q

Histopath correlated irregular streaks/ pseudopods?

A

confluent junctional nests of pigmented melanocytes

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18
Q

confluent junctional nests of pigmented melanocytes associated with what type of growth

A

radial growth

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19
Q

confluent junctional nests of pigmented melanocytes associated with what type of melanoma …

A

superficial spreading

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20
Q

definition of negative network

A

serpiginous interconnecting hypo pigmented lines that surround irregularly shaped pigmented strcutures, which resemble elongated and curvilinear globules.

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21
Q

is pigment network seen with P or NP Dermoscopy?

A

both

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22
Q

In white benign lesions can you see negative pigment

A
  1. Spitz nevus.

2. CMN

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23
Q

Crystalline structures - definition

A

Short white lines only seen with polarizing Dermoscopy

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24
Q

Crystalline structures - cause

A

birefringent properties of collagen > polarized light to randomize it polarization rapidly

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25
Q

White reflective structures

A
  1. Crystalline (shiny white lines/ streaks) MM, spitz, LPLK
  2. Shiny white blotches/ patches/ areas (white clods) & strands BCC
  3. Rosettes AK, SCC, Actinic damaged skin
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26
Q

White reflective structures are predictive of ….

A

Thicker melanoma

Invasive melanoma

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27
Q

What type of collagen is expressed in malignant but not benign melanocyte tumors

A

Collagen XVII

28
Q

Predictor of thicker MM > 0.75

A 
Blue grey areas
Vessels
Abrupt cutoff
> 4 colors
Blue white veil
> 2 structures
29
Q

Predictor of thicker MM & +SLNB

A

Blotch

Ulceration.

30
Q

Negative predictor of thicker MM & +SLNB

A

Atypical network

31
Q

Predictor of thicker MM & distant mets

A

Shiny white streaks

Milky red areas.

32
Q

In which non-melanocytes lesions do you see crystalline structures

A
  1. DF.
  2. BCC
  3. LPLK
33
Q

Dots defn

A

Small round structures, diam < 0.1 mm

34
Q

Black dots =

A

Pigment in the stratum corneum/ upper epidermis

35
Q

Brown dots =

A

small nests at or near the Dermoscopy-epidermal jn

36
Q

Blue grey dots =

A

free melanin in dermis or in macrophages

37
Q

Red dots =

A

dotted vessels

38
Q

I brown dot on network corresponds to …

A

pigment nests within rete

39
Q

Typical/ regular black or brown dots

A

Central OR

Situated on network lines, or in holes

40
Q

Black or brown Dots asymmetrical

A

Located focally at periphery

Not associated with network lines

41
Q

Black or brown Dots situated in holes of network known as …

A

Target globules

42
Q

Globules defn

A

Symmetrical, round to oval well dermarcated structure > 0.1mm diamanté’s

43
Q

Brown globules =

A

nests at or below DR junction in papillae to upper reticular dermis. (Most common)

44
Q

Black globules =

A

heavily melanized nests

45
Q

Blue globules =

A

nests in deeper dermis

46
Q

White globules =

A

ballon cell nests

47
Q

Red globules =

A

vascular structures

48
Q

Typical/ regular globules

A

Uniform size, shape, color

Symmetrically distributed throughout lesion or at peripheral or in the centre

49
Q

Atypical globules

A

Asymmetrically distributed.
Often aggregated focally.
When reddish in colour, highly suggestive melanoma.

50
Q

Significance of tiered globules

A

Atypical pattern

51
Q

What is a large concentration of melanin in stratum corneum called?

A

Black lamella

52
Q

Botch - definition.

A

Large concentration of melanonin
throughout epidermis +/- dermis
Visually obscures underlying structures.

53
Q

Typical blotch

A

Single
Central
Homogenous

54
Q

Atypical blotch

A

Peripheral
Asymmetric
> 1

55
Q

Blue white veil (raised) definition

A

Focal, irregular, indistinct, confluent, blue pigmentation.
Overlying white ground-glass haze
Pigmentation cannot occupy entire lesions.

56
Q

Blue white veil histopath

A

Aggregation of heavily pigmented cells/ melnanin in the dermis. (Blue color)
In combination with compact orthokeratosis.

57
Q

Blue white veil in nevus

A

blue hue (not veil)
centrally located
rainy and homogenous
usually only with NPD (orthokeratosis)

58
Q

Blue white veil in melanoma

A

Asymmetrical/ focal or diffuse throughout lesion
Differing hues (heterogeneous)
Both with NPD and PD

59
Q

Regression structures - name them

A
  • Peppering - fine grey particles
  • Depigmented area (scar like depigmentation) - structureless area that is white in color. Lighter in color as compared to lesion, and background skin color.
    The combination creates blue white veil - on palpation it will be flat.
60
Q

Peppering in nevus

A

usually symmetrical
< 10% lesion
uncommon to have scarring

61
Q

Peppering in melanoma

A

+/- scarring
asymmetrically located
involves > 50% lesion area

62
Q

Vascular structures, nodular lesion, nevus

A

Comma vessels
IDN
CMN

63
Q

Vascular structures, nodular lesion, melanoma

A 
Dotted
Glomerular
serpentine/ linear
polymorphous
milky red
64
Q

Vascular structures, flat lesions, nevus

A

Monomorphous dotted “target network” vessels. (In CMN can be polymorphous)
Milky red

65
Q

Vascular structures, flat lesions, melanoma

A 
Dotted
Globular
Serpentine/ linear
Milky-red
(polymorphous)
66
Q

Peripheral tan/ brown structureless areas - dermatophatology

A
  • Flattening of rete ridges at DEJ
  • Melanocytes arranged predominantly as solitary units + less melanin
  • Pagetoid scatter of melanocytes
67
Q

Melanoma specific structures

A
  1. Atypical network incl angulated lines.
  2. Streaks (pseudopods and radial streaming)
  3. Negative pigment network
  4. Shiny white lines (Chrysallis/ crustalline)
  5. Atypical dots and globules.
  6. Off-centered blotch.
  7. Peripheral tan structureless area
  8. Blue-white veil overlying raised areas.
  9. Regression structures.
  10. Atypical vascular structures.

HealthCert Education (24 decks)

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