Chapter 10: Epithelial Pathology PART 1 Flashcards
1
Q
___ is the benign proliferation of stratified squamous epithelium that results from a papillary mass
A
squamous papilloma
2
Q
squamous papilloma is caused by ___
A
- human papillomavirus (HPV)
- DNA virus of the papovavirus subgroup
- types 6 and 11
3
Q
what is the mode of transmission of squamous papilloma caused by HPV?
A
unknown
4
Q
what is the virulence and infectivity rate of squamous papilloma caused by HPV?
A
extremely low virulence and infectivity rate
5
Q
___ is the ability of a virus to overcome the body’s defenses and cause disease
A
virulence
6
Q
___ is the ability of a virus to establish infection from one person to another horizontally
A
infectivity
7
Q
squamous papilloma affts 1 in ___ people
A
250
8
Q
what are the sites of predilection of squamous papilloma?
A
tongue, lips, and hard palate
9
Q
how does squamous papilloma present clinically?
A
- painless
- usually pedunculated
- exophytic
- pointed or blunted projections
- white, red, or mucosal colored
- enlarges rapidly to 5mm, then stabilizes
10
Q
what is the differential diagnosis of squamous papilloma?
A
- verucca vulgaris
- condyloma acuminatum
- verruciform xanthoma
11
Q
what is the treatment/prognosis for squamous papilloma?
A
conservative surgical excision is curative
12
Q
A
squamous papilloma
13
Q
A
squamous papilloma
14
Q
A
squamous papilloma
15
Q
verruca vulgaris is commonly called a ___
A
wart
16
Q
verruca vulgaris is caused by which HPV types?
A
2, 4, 6, 40
17
Q
is verruca vulgaris contagious?
A
yes
18
Q
verruca vulgaris is extremely common on what part of the body?
A
the skin
19
Q
verruca vulgaris is frequently discovered in what type of patient, and where on the body?
A
children on skin of the hands
20
Q
what is the clinical presentation of verruca vulgaris?
A
- painless papule or nodule
- papillary projections or a rough, pebbly surface
- oral lesions are almost always white
- cutaneous lesions are skin-colored, yellow, or white
- can be pedunculated or sessile
- maximum size is about 5mm
21
Q
___ lesions are commonly multiple or clustered
A
verruca vulgaris
22
Q
what is the differential diagnosis for verruca vulgaris?
A
same as squamous papilloma
- condyloma acuminatum
- verruciform xanthoma
- squamous papilloma
23
Q
what is the treatment/prognosis of verruca vulgaris?
A
- oral lesions are surgically excised
- recurrences are possible
- no chance of malignant transformation
24
Q
condyloma acuminatum is also known as ___
A
venereal wart
25
condyloma acuminatum is caused by what virus? what types?
HPV
* type 2, 53, 54
* types 6 and 11 - most common
* types 16, 18, and 31 - high risk
26
condyloma acuminatum is considered a ___ transmitted disease
sexually
27
condyloma acuminatum makes up \_\_\_% of all STDs
20
28
incubation of condyloma acuminatum occurs in what time frame after sexual contact?
1-3 months
29
squamous papilloma
30
verruca vulgaris
31
verruca vulgaris
32
intraoral verruca vulgaris
notice the color - this one is white, whereas a squamous papilloma would be more mucosal-colored
33
verruca vulgaris
34
condyloma acuminatum
35
condyloma acuminatum
36
what is the clinical presentation of condyloma acuminatum?
* painless
* sessile
* mucosal colored
* well-demarcated
* exophytic
* short, blunted surface projection
* characteristically clustered with other condyloma
37
what is the average size of condyloma acuminatum?
1-1.5cm
this is twice as large as papilloma or verruca vulgaris
38
what is the differential diagnosis of condyloma acuminatum?
same as squamous papilloma
* verruca vulgaris
* squamous papilloma
* verruciform xanthoma
39
what is the treatment/prognosis of condyloma acuminatum?
* conservative surgical excision
* recurrences are possible
40
in the anogenital area, condyloma acuminatum cases that are caused by HPV-16 or HPV-18 are at increased risk for \_\_\_
* malignant transformation to squamous cell carcinoma
* this has not been demonstrated in oral lesions
41
multifocal epithelial hyperplasia is also called \_\_\_
heck's disease
42
multifocal epithelial hyperplasia is caused by what virus?
HPV types 13 and 32
43
what is the clinical presentation of multifocal epithelial hyperplasia?
* appears in childhood
* multiple lesions
* painless
* flattened or rounded papules which cluster
* can appear cobblestoned
* mucosal colored
* might have slight papillary surface change
44
what is the treatment/prognosis of multifocal epithelial hyperplasia?
* spontaneously regresses
* may perform conservative surgical excision
* risk of recurrence is minimal
* no risk of malignant transformation
45
multifocal epithelial hyperplasia
46
multifocal epithelial hyperplasia
47
multifocal epithelial hyperplasia
48
\_\_\_ are benign, localized proliferations of respiratory mucosa
sinonasal papillomas
49
what are the 3 distinct patterns of sinonasal papillomas?
* fungiform
* inverted
* cylindrical cell
50
50% of sinonasal papillomas arise from \_\_\_; where are the rest from?
* lateral nasal wall
* the rest are from the septum and sinuses
51
can sinonasal papillomas present as multiple lesions?
yes
52
what is the etiology of sinonasal papillomas?
it is unclear
53
fungiform sinonasal papilloma
54
inverted sinonasal papilloma
55
which sinonasal papilloma arises almost exclusively on the nasal septum?
fungiform
56
what is the treatment of fungiform sinonasal papilloma? what is the recurrence?
* complete surgical excision
* recurrence is common (1/3)
57
what is the risk for malignant transformation of fungiform sinonasal papilloma?
minimal to no risk
58
inverted sinonasal papilloma is also called \_\_\_
inverted schneiderian papilloma
59
which sinonasal papilloma is the most common of the 3 types?
inverted
60
which sinonasal papilloma has the greatest potential for destruction and transformation?
inverted
61
what is the male:female ratio of inverted sinonasal papillomas?
3:1 M\>F
62
what is the most common location of inverted sinonasal papillomas?
lateral nasal wall or sinus
63
which sinonasal papilloma has significant growth potential?
inverted
64
what is the recurrence of inverted sinonasal papillomas after surgery?
75% recur after conservative surgery; 15% after aggressive surgery
65
up to 25% of ___ will undergo malignant transformation into squamous cell carcinoma
inverted sinonasal papillomas
66
cylindrical cell sinonasal papilloma is also called \_\_\_
oncocytic schneiderian papilloma
67
which is the most rare of the 3 types of sinonasal papillomas?
cylindrical cell sinonasal papilloma
68
where do cylindrical cell sinonasal papillomas usually occur?
on the lateral nasal wall
69
how is cylindrical cell sinonasal papilloma treated?
same as inverted papilloma - surgically
70
what is the risk for recurrence and malignant transformation of cylindrical cell sinonasal papillomas?
lower than that of inverted papilloma
71
\_\_\_ is virally-induced epithelial hyperplasia
molluscum contagiosum
72
molluscum contagiosum is caused by \_\_\_
DNA poxvirus
73
how does molluscum contagiosum clinically present?
* typically seen in children
* painless
* skin-colored
* sessile
* papules
* smooth surfaced
74
what is the average size of a molluscum contagiosum lesion?
3mm
75
molluscum contagiosum is more prevalent among ___ patients
immunocompromised
76
what is the histopathology of molluscum contagiosum?
contains molluscum bodies, aka henderson-paterson bodies
77
molluscum contagiosum
78
molluscum contagiosum
79
what is the treatment/prognosis of molluscum contagiosum?
* spontaneous remission occurs in 9 months
* treated to decrease risk of transmission
* removed by curettage or cryotherapy
80
what is the potential for malignant transformation of molluscum contagiosum?
no potential
81
\_\_\_ is a hyperplastic condition which is largely an oral disease of unknown cause (likely trauma)
verruciform xanthoma
82
verruciform xanthoma is characterized by ___ in the epithelium
lipid-laden histiocytes
83
is verruciform xanthomas associated with a disorder?
no
84
what is the clinical presentation of verruciform xanthoma?
* most common on gingiva
* painless
* sessile (slightly elevated)
* papillary or roughened surface
* mucosal, white, yellow, or red in color
* can have multiple lesions
85
what is the size of verruciform xanthoma lesions?
smaller than 2cm
86
what is the differential diagnosis of verruciform xanthoma?
same as squamous papilloma
87
histology for verruciform xanthoma is positive for \_\_\_
xanthoma cells - lipid-laden histiocytes
88
what is the treatment/prognosis for verruciform xanthoma?
* conservative surgical excision
* recurrence is rare
* no risk of malignant transformation
89
histology is positive for lipid-laden histiocytes
verruciform xanthoma
90
histology is positive for lipid-laden histiocytes
verruciform xanthoma
91
\_\_\_ are extremely common skin lesions of older people that do not occur in the mouth (develop on the skin of the face, trunk, and extremities), and there are typically multiple lesions
seborrheic keratosis
92
seborrheic keratosis is an acquired, benign proliferation of ___ of unknown etiology
epidermal basal cells
93
seborrheic keratosis lesions become more prevalent with \_\_\_
age
94
seborrheic keratosis start as ___ macules, and appear ___ skin
* small, tan to brown
* stuck onto
95
what is the size of seborrheic keratosis lesions?
usually less than 2cm in diameter
96
\_\_\_ is a form of seborrheic keratosis that occurs in 30% of african americans
dermatosis papulosa nigra
97
how is dermatosis papulosa nigra inherited? what does it look like clinically? where is it found?
* autosoma dominant
* multiple, 2mm black papules
* found scattered around the zygomatic and periorbital region
98
what is the treatment/prognosis of seborrheic keratosis?
* seldom removed except for esthetics
* no malignant potential
99
sudden appearance of numerous seborrheic keratoses with pruritus has been associated with \_\_\_, which is called \_\_\_
* internal malignancy
* leser-trelat sign
100
seborrheic keratosis
101
seborrheic keratosis
102
seborrheic keratosis
103
dermatosis papulosa nigra
104
ephelis is also known as a \_\_\_
freckle
105
\_\_\_ is a common hyperpigmented macule of the skin
ephelis
106
what is ephelis caused by?
an increase in melanin production without an increase in the number of melanocytes
107
ephelis is more prominent in what populations?
children, and people with light skin and light hair
108
ephelis can become more pronounced with exposure to what?
the sun
109
ephelis is closely associated with a history of \_\_\_
painful childhood sunburns
110
how does ephelis clinically appear?
as light brown macules in variable numbers
111
what is the treatment of ephelis? what can prevent it?
* no treatment necessary
* sunscreen use can prevent new or darkening of lesions
112
ephelis
113
actinic lentigo is a benign brown macule that results from \_\_\_
chronic UV light damage to the skin
114
actinic lentigo affects more than \_\_\_% of caucasians older than age \_\_\_
* 90%
* 70
115
actinic lentigo is common on what parts of the body?
dorsal surface of hands, face, and arms
116
T or F:
actinic lentigo presents as irregularly pigmented tan macules with well-demarcated, regular borders
false
they are uniformly pigmented tan macules with well-demarcated but irregular borders
117
do actinic lentigo lesions change in color intensity with UV light exposure, like ephelis?
no
118
what is the treatment for actinic lentigo?
no treatment except for esthetics
119
does actinic lentigo undergo malignant transformation?
no
120
actinic lentigo
121
actinic lentigo
122
what is lentigo simplex?
a benign cutaneous melanocytic hyperplasia (increase in number of melanocytes)
123
what is the cause of lentigo simplex?
unknown cause
124
where on the body does lentigo simplex typically occur?
on skin not exposed to sunlight
125
what age patient does lentigo simplex occur in most commonly
can happen at any age but is most common in children
126
lentigo simplex appears as a macule smaller than ___ with a ___ color
* 5mm
* uniform brown color
127
does the color intensity of lentigo simplex change with sunlight?
no
128
lentigo simplex is indistinguishable from \_\_\_
nonelevated melanocyte nevus
129
what is the treatment of lentigo simplex? do these lesions undergo malignant transformation?
treatent is not required, and the lesions do not undergo malignant transformation
130
\_\_\_ is acquired, symmetrical, hormonally-driven hyperpigmentation of the sun-exposed skin of the face
melasma
131
melasma is classically associated with \_\_\_
pregnancy
132
what population is at greater risk of melasma?
dark-complected women
133
how does melasma clinically present?
bilateral light brown macules which vary in size
134
describe pigmentation of melasma over time
it can remain faint or it can darken over time
135
is melasma difficult to treat?
yes
136
what is necessary for the clinical management of melasma?
using sunscreen and/or avoiding the sun
137
is there a risk of malignant transformation of melasma?
no
138
lentigo simplex
139
melasma
