Flashcards in Epithelial Tumors Deck (21)
What is a benign proliferation of squamous cells that is common in the elderly called?
How would a gross exam of Seborrheic Keratosis look like?
A raised discolored plaque usually in the extremeties or on the face, that has a classic "stuck on coin" appearance (almost like you can just peel it off).
How would Seborrheic Keratosis appear on histology and what is a key finding in the histology?
It will be a raised lesion due to proliferation of squamous cells with a hallmark circular spaces with pink keratin, called "Pseudo horn cyst."
What is the "Leser-Trelat sign?"
Sudden explosion of sebarrheic keratosis, which might indicate an underlying carcinoma of the GI tract.
What is "Acanthosis Nigricans?" Where is this seen?
Epidermal hyperplasia with darkening of the skin (resulting in "velvet like skin") often seen in the groin and axilla.
What is acanthosis nigracans associated with?
Insulin resistance and malignancy, such as gastric carcinoma.
What is a malignant proliferation of the basal cells of the epidermis called?
Basal cell carcinoma.
What are the risk factors of developing basal cell carcinoma?
Exposure to sunlight, albinism, and xeroderma pigmentosum (where you lack the enzyme needed to repair cells damaged by sunlight).
What is "xeroderma Pigmentosum?"
AR defect that results in a deficiency of enzymes required for DNA excision. Specifically, when sunlight hits DNA it forms Pyrimidine dimers, and the "Nucleotide excision repair pathway" kicks in and removes the pyrimidine dimers and repairs that defect.
What is the classic presentation of basal cell carcinoma?
Usually can be seen in the upper lip, it is a raised nodules that has ulcerations in the center as well as dilated blood vessels all around (called "telangiectasia").
How would basal cell carcinoma appear on histology?
There will be nodules of basal cells characterized by peripheral pallisading (lining up).
What is the prognosis and tx of basal cell carcinoma?
It rarely metastasizes, excellent prognosis, can be removed via surgical excision.
What is the disease process called when there is a malignant proliferation of squamous cells?
Squamous cell carcinoma.
Risk factors for sq cell carcinoma (most common)?
All based on UV sunlight exposure, such as increased sunlight exposure, albinism, xeroderma pigmentosum. Other risk factors exist.
What are the less common or additional risk factors for sq cell carcinoma?
Immunosuppression therapy (sq cell carcinoma is most common type of cancer in transplant pt's), arsenic poisoning, and chronic inflammation of skin such as scar formation from a burn wound, or a draining sinus tract.
How would sq cell carcinoma present clinically?
Presents as ulcerated, nodular mass usually on the face, particularly on the lower lip (contrast with Basal Cell carcinoma, where it will appear on the upper lip. B comes before S, so BCC appears on upper lip, SCC appears on lower).
Tx and prognosis of Sq cell carcinoma?
Like Basal cell carcinoma, low chance of metastasis, excellent prognosis, and tx is surgical excision.
What is the precursor to sq cell carcinoma and how would that present?
Actinic Keratosis, it would present as hyperkeratonic, scaly plaques on face, back and neck. It can but usually does not progress to sq cell carcinoma.
What is a VERY well differentiated Sq cell carcinoma called?
What is the progression of keratoacanthoma?
Appears extremely quickly and randomly regresses spontaneously.