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Dermatopathology Flashcards

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1
Q

Four things that spindle cell tumors could be

A

SCC Melanoma Tumors of nerve derivation Tumors of muscle derivation

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2
Q

What is this tumor and three pearls.

A

nevus sebaceous

palliomatosis with acanthosis

Sebacesous glands attaching to epidermis

may be underlying apocrine glands

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3
Q

Name this tumor and 4 pearls

A

Merkel Cell carcinoma

dense blue dermal infiltrate

usually no epidermal connection

Nuclear molding

CD 20+ paranuclear dots Synaptophysin +

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4
Q

What are the three most common mets to the skin

A

Breast Prostate Lung

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5
Q

What is this tumor and 4 pearls

A

sebaceous carcinoma

  1. malignant epithelial cells with sebaceous differentitation.
  2. EMA stain +
  3. Usually around eyelids
  4. Cytoplasmic vacuoles indenting nuclei
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6
Q

What is this tumor and three pearls.

A

nevus sebaceous

palliomatosis with acanthosis

Sebacesous glands attaching to epidermis

may be underlying apocrine glands

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7
Q

Name this tumor and 3 pearls

A

MF 1. CD4+ 2. Pautrier Microabscesses in epidermis 3. Epidermotropism of lymphocytes without spongiosis

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8
Q

Name this tumor and 4 pearls

A

Merkel Cell carcinoma

dense blue dermal infiltrate

usually no epidermal connection

Nuclear molding

CD 20+ paranuclear dots Synaptophysin +

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9
Q

What is this tumor and 4 pearls

A

sebaceous carcinoma

  1. malignant epithelial cells with sebaceous differentitation.
  2. EMA stain +
  3. Usually around eyelids
  4. Cytoplasmic vacuoles indenting nuclei
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10
Q

Name this tumor and 4 pearls

A

Trichoepithelioma

Dermal proliferation of basaloid cells with no epi connection

stromal stromal clefting

Papillary mesechymal bodies

may have calcified cysts

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11
Q

Name this tumor and 3 pearls

A

Poroma

Tumor arises from epidermis

Plate like squamous cells

May have many cyst like stuctures

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12
Q

Three things small blue cell tumors could be.

A

Merkel cell Lymphoma/Leukemia Mets such as lung cancer

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13
Q

What are the five Clark’s levels

A
  1. in situ 2. in papillary dermis 3. in papillary reticular dermal interface 4. Reticular Dermis 5. SubQ fat
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14
Q

What is this tumor with two pearls?

A

Solar lentigo

Even pigmentation without atypical cells

Delicate rete ridge projections that look like puppy feet.

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15
Q

What is this tumor with three pearls

A

Poroma

Tumor arises from epidermis

Plate like squamous cells

May have many cyst like stuctures

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16
Q

Name this tumor and 3 pearls

A

MF 1. CD4+ 2. Pautrier Microabscesses in epidermis 3. Epidermotropism of lymphocytes without spongiosis

Bonus lymphocytes intercalulated with basal cells

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17
Q

What is this tumor and 4 pearls

A

sebaceous carcinoma

  1. malignant squamous cells with sebaceous differentitation.
  2. EMA stain +
  3. Usually around eyelids
  4. Cytoplasmic vacuoles indenting nuclei
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18
Q

Name this tumor and 4 pearls

A

Trichoepithelioma

Dermal proliferation of basaloid cells with no epi connection

stromal stromal clefting

Papillary mesechymal bodies

may have calcified cysts

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19
Q

Name this tumor and 2 pearls

A

Fibroepithelioma of Pinkus

  1. anastomosing basaloid cells
  2. Loose Myxoid Stroma
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20
Q

Name this tumor and 4 pearls

A

Cylindroma

Puzzle like pattern

Hylinized stroma

well circuscribed

Ductal differentiation

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21
Q

Name this tumor and 3 pearls

A

MF 1. CD4+ 2. Pautrier Microabscesses in epidermis 3. Epidermotropism of lymphocytes without spongiosis

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22
Q

What does this stain show?

A

CK20 + paranuclear dotting for merkel cell carcinoma

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23
Q

What is this tumor and 4 pearls

A

sebaceous carcinoma

  1. malignant epithelial cells with sebaceous differentitation.
  2. EMA stain +
  3. Usually around eyelids
  4. Cytoplasmic vacuoles indenting nuclei
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24
Q

What is this and three other things in differential

A

Pagets disease of nipple EMA +

R/O melanoma in situ

Bowen’s disease

Sebaceous carcinoma

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25
When breadloafing a specimen what percent of the margin is checked?
\<1%
26
What are the two times you see stratum lucidum.
acral skin rubbed skin - also warts
27
Name this tumor and 4 pearls
Merkel Cell carcinoma dense blue dermal infiltrate usually no epidermal connection Nuclear molding CD 20+ paranuclear dots Synaptophysin +
28
Two finding histologically in MF.
-pautrier Microabscesses -abnormal T lymphocytes tagging along the basal layer in the epidermis without spongiosis, becoming more atypical higher in the epidermis. bonus CD4 +
29
Name this tumor and 4 pearls
Dermatofibroma look for dell cellular blue nodule in dermis roots of spindle cells going in dermis
30
Name this tumor and 3 pearls
Dermatofibroma look for dell cellular blue nodule in dermis roots of spindle cells going in dermis
31
Name this tumor and 4 pearls
Cellular Dermatofibroma look for dell cellular blue nodule in dermis roots of spindle cells going in dermis Look for Giant Touton cells
32
Name this tumor and 4 pearls
DFSP sieve like infiltration of the fat or honeycombing Storiform pattern CD 34 +
33
Name this tumor and 2 pearls
Desmoplastic Melanoma 1. spindle cells without pigment 2. Cellular pleomorphism
34
Name this tumor and 2 pearls
Desmoplastic Melanoma 1. spindle cells without pigment 2. Cellular pleomorphism
35
Name this tumor and two pearls
Intradermal nevus 1, nests of bland melanocytes 2. no deep mitotic figures
36
What are Kamino bodies
eosinophilic globules found in spitz nevi usually just beyond the tips of the dermal papilla. They are made from basement mebrane components so are PAS positive.
37
What is this tumor and four pearls
Spitz Nevus Nevus cells are spindle shaped and seem to enlongate out stream up in the papillary dermis They are sharply circumscribed Maturation of cells in the deeper dermis becoming smaller Kamino bodies may be present
38
What is this and 4 pearls
Spitz Nevus Nevus cells are spindle shaped and seem to enlongate out stream up in the papillary dermis They are sharply circumscribed Maturation of cells in the deeper dermis becoming smaller Kamino bodies may be present
39
40
41
What varient of DFSP is positive for melanin
Bednar varient +Fontana-Masson stain (Melanin) and + CD34 stain
42
what are these pallisaded spindle cells with this pattern calls and what tumor are they associated?
Verocay Bodies (Schwannoma) S100+
43
What is going on in the basal layer here of this tumor?
Basaloid follicular induction over a dermatofibroma
44
What does induction refer to in regards to dermatopathology
hyperplasia in nearby non-tumoral epithelial structures like basaloid follciular induction with underlying dermatofibroma
45
What type of glands are these in the eyelid.
Meibomian glands these are free (not associated with follicles) modified sebaceous glands. found on the inner aspect of the eyelid
46
In the eyelid what gland is this?
Glands of Zies modified sebaceous glands associated with follicles of the eyelashes
47
What is this gland in the eyelid
modified lacrimal gland
48
What gland in the eyelid is this?
Moll's gland a modified apocrine gland
49
what is this bluesh substance in this basal cell carcinoma?
Mucin
50
what is this tumor
chondroid syringoma ductal structures Dhondroid looking stroma
51
This is going on in the lower leg what is happening?
Chronic venous insufficency look for vertically oriented vessels and scar like changes
52
What two features might make you think desmoplastic trichoepithelioma over a morpheaform bcc
calcification horn cysts
53
What is this in the eyelid
lacrimal duct
54
what is this tumor
basaloid follicular hamartoma
55
What is this?
trichostasis spinulosa retained hair follicles (inside a follicle)
56
what is this stuff
monsels solution
57
What tumor is this
Atypical Fibroxanthoma (AFX) if dermal only, Pleimorphic Dermal scarcoma if SubQ dermal tumor abutting the epidermis fast growing very pleiomorphic spindle cells giant multinuclated cells
58
What is this tumor
Syringocystadenoma papilliferum epidermal attachments of endophytic ductal structures lined with cuboidal cells.
59
What is this tumor
sebaceous carcinoma
60
What is this tumor
sebaceous carcinoma
61
Name three lesions that can show the Borst-Jadassohn effect
well defined nests of cells in acantholyic epidermis SCC Bowen's disease Clonal Seb Ker Hidroacanthoma (an epidermal poroma)
62
63
what is this effect known as
Borst-Jadassohn effect Nests of cells in a clonal seb Ker can also be in SCC bowens and hidroacanthoma (an epidermal varient of Poroma)
64
65
what is this called and what condition is it associated with?
Chornoid lamella Porokeratosis There is a column of parakeratois with focal loss of granular layer
66
what is this tumor
syringoma
67
What is this tumor
mucinous carcinoma nests of basal cells floating in mucin separated by thin trabeculae
68
What is this tumor
mucinous carcinoma nests of basaloid cells floating in mucin separated by trabeculae
69
what tumor is this
MAC Microcystic Adenexal Carcinoma Cysts and calcifications DEEP (unlike syrigoma) Tadpole like ducts deep
70
what tumor is this
Adenoid cystic carcinoma Looks like a sponge with mucin in the holes (ducts) normal parotoid gland cells to left (usually arises out of a salivary gland , lacrimal, breast)
71
What is this tumor and the key features
sebaceous carcinoma atypical basaloid cells scattered sebocytes withmitoses necrosis and squamous metaplasia
72
What is this tumor and what is it associated with?
sclerotic fibroma Cowdens disease tricholemmomas acral keratoses oral papilomatosis
73
what is this tumor
mucinous carcinoma nests of Basloid cells floating in pools of mucin pools are separated by thin trabeculae eyelid most common location (scalp neck axillae trunk)
74
what is this tumor
Microcystic Adenexal carcinoma paisly tie pattern with cysts deep hard to tell from desmoplatic trichoepitheloma without deep bx
75
What is the average depth of perineural involvement across all body sites ?
2.7 mm
76
What is the average perineural depth of involvement on the head depth wise.
2.2 mm
77
What is the depth average for perineural involvement on the back?
4.3 Mesusured from the granular layer to the middle of the most superior nerve involved.
78
What is this tumor
merkel cell carcinoma small blue cells groupsed in sheets or trabecular pattern
79
What is this tumor
trichoadenoma multiple dermal cysts that have a granular layer (as opposed to seb kers which have more keratinocytes and less cysts) cystic spaces may look like infundibular portions of hair follicles Solid epithelial islands may be interspersed among the cyst like structures
80
when staining for melanoma with MART 1 what are three features used to determine + margins
Melanocytes above the Dermoepidermal Junction Confluence of nine or more adjacent melanocytes Nests of 3 or more atypical melanocytes
81
82
What is this condition?
Spiny keratoderma (inherited AD no problem) (aquired over age 50) check for internal malignancy These are not arsenical keratoses as seen below
83
Why is breslow thickness not useful in oral melanoma for prognosis.
There is an absense of a granular layer.
84
What is this tumor
blue nevus spindled melanocyts with melanophages look for sclerotic collagen GNAQ & GNA11 mutations (like uveal melanoma)
85
What is this tumor
blue nevus spindled melanocyts with melanophages look for sclerotic collagen GNAQ & GNA11 mutations (like uveal melanoma)
86
87
in melanoma what are the three most important prognostic factors on histopathologic exam
1. Breslow thickness 2. Mitotic rate (corolates strongly with breslow thickness) 3. Ulceration
88
What is this tumor and what two features may it share with melanoma
Spitz nevus Look for large junctional nests raining down well circumscribed May share with melanona the below Pagetoid spread Mitoses (usually upper dermis not lower)
89
What is this tumor
Bapoma (BAP1 inactivated Spitzoid nevus) Dermal neoplasms Melanocytes have pink glassy cytoplasm with sharp borders. associated with multiple other cancers
90
What is this lesion called. found mostly in young adult females
Reed nevus (benign) Pigmented spindle cell nevus structureless central area with radical streaming starburst pattern
91
What does aluminum choride do to collagen bundles?
turns them a magenta color
92
When cells are frozen what disappears first?
nuclei

Derm Surg questions (26 decks)

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