Lab Dermatopathology video Flashcards Preview

MSK Week 1 > Lab Dermatopathology video > Flashcards

Flashcards in Lab Dermatopathology video Deck (60):
1

What is a nevus

mole

2

Types of Nevi

Junctional Compound Intradermal

3

Junctional Nevi

Tend to be flat with nests at the junction of the epidermis and dermis

4

Compound Nevi

Typically a central raised area surrounded by flat with nests at the junction of the epidermis and dermis as well as in the dermis

5

Intradermal Nevi

Nests in the dermis only that often protrude

6

Clinical Dysplastic Nevi signs

Typically larger, flat and pebbly or target-like with irregular pigmentation and border

7

Under histology, what might we see a dysplastic nevi doing?

Cytologically it grows radially (sideways) getting larger with darker nuclei

8

Vertical growth?

Sign of dysplasia in Nevi growth,it is a growth into the dermis, usually presenting as a nodule

9

ABCs of tumor

A - Assymetry B - Border C - Color D - Diameter (larger typically) E - Evolving or changing

10

Causes of dysplastic Nevi

1. Many sunburns in life 2. 10-15% had familial connections with it 3. Mutations that inhibit the RB tumor supressor gene are common in familial and sporadic melanomas. 40% have CDKN2A abnormalities

11

Age, location, description for Seborrheic Melanoma

Middle aged or older, typically presents on the trunk head and neck and presents as a round, flat, waxy lesion that varies in size with mild inflammation underneath

12

Fibroepithelial polyp alternative names

Also called Acrochordon, skin tag, and squamos papilloma

13

Age, location, description of fibroepithelial polyp

Middle aged folks, usually on neck, trunk, and face, and typically flesh colored, bag-ike with a thin stalk

14

Basic idea of the epidermal inclusion cyst

Keratin buildup

15

When we see "trich" in the name, what do we know?

Involves hair

16

Basic idea of the dermoid cyst

multiple epidermal appendages

17

Basic idea od Steatocystoma

Sebaceous gland

18

Cylindroma

Adnexal tumor making it uncommon. Jigsaw puzzle piece look with basaloid proliferations, common on the forehead

19

Trichoepithelioma

Epithelial proliferation of the hair shaft, this is an uncommon adnexal tumor

20

Sebaceous adenoma pilomatrixoma

Adnexal tumor in the sebaceous gland that is calcified, shows up blue on a stain and the cells lose their nuclei

21

Actinic Keratosis

Prcursor to SCC caused by sun damage to skin. Usually small, less than 1cm with a rough sandpaper consistency, sometimes with a cutaneous horn Hyperkeratosis seen on histology

22

Squamos Cell Carcinoma

Second most common tumor on sun exposed skin 5% metastasize Presents as a red scaling plaque with full thickness dysplasia. They can become invasive, turning nodular and may ulcerate

23

Keratocanthoma

Cup shaped, well differentiated SSC that often regresses spontaneously. Labeled as controversial for whatever reason

24

Basal Cell carcinoma

Most common type of sun exposed skin cancer that is slow growing. Also rarely metastasizes. Presents as pearly papules that may ulcerate or appear melonocytic, making it easily confused with moles. Histologically presents as islands of basophillic cells, hyperchromatic nuclei.

25

Basal Cell Nevus or "Gorlin Syndrome"

Multiple BCC before the age of 20 with possible systemic changes such as intracranial calcification, cleft lip/palate, and vertebral/rib abnormalities. This is an autosomal dominant condition involving the PTCH - 2hit gene

26

Dermatofibroma

Also called benign fibrous histocytoma. Presents in adults, particularly on the legs Firm brown papules, thought to be related to trauma and altered collagen. Presents on histology as non-encapsulated, presence of spindle cells with overlying epidermal hyperplasia with collagen "traps."

27

Dermatofibrosarcoma Protuberans

Flesh colored nodule that is firm and goes down into the fat with a radial spoke look on histology

28

Mycosis Fungoides

Cutaneous T cell lymphoma that usually presents in patients over 40 on the trunk as scaly patches, plaques, or nodules that can become ulcerated

29

Sezary Syndrome

Posible result of Mycosis Fungoides where malignant T cells in the blood cause diffuse erythroderma

30

Mastocytosis

Rare dermal tumor involved with increased mast cells. In children, it only affects the skin, causing urticaria and lesions that appear shortly after birth. In adults however, we see a systemic disease with a poor prognosis. Morphology of this is variable, but presents typically with ovoid uniform balls and fried egg on histology. Use Giemsa to locate mast cells.

31

Acute inflammatory dermatoses

Acute inflammation process that causes urticaria via mast cell degranulation and microvascular hyperpermeability. We see this as wheals that can be puritic with superficial perivascular infiltrate

32

"To boil over"

Eczema

33

Eczema

Red, papulovesicular with crusted oozing lesions, puritic that can develop in to raised scaling plaques with hyperkeratosis.

34

Acute contact dermatitis

Puritic, edematous, oozing plaques that can blister. Tis is an impetiginization hat presents with acanthosis and increased keratin layers with spongiosis. Noted clinically with intraepidermal collection of vesicles

35

Erythema multiforme

Uncommon hypersensitivity to drug or infection. Clinically it varies, but we see macules, papules, vesicles, targetoid and eroded centers

36

Conditions associated with erythema multiforme

Herpes simples Typhoid Leprosy Coccidiomycosis

37

Drugs that can cause erythema multiforme

Sulfonamides PCN barbiturates antimalarials

38

Psoriasis

A chronic inflammatory dermatosis that is well demarcated, salmon colored plaque with silver color from scaling

39

Histology of psoriasis

Extensive parakeratosis, thinned stratum granulosum, Auspitz sign munro microabcesses epidermal hyperplasia

40

Auspitz sign

Associated with psoriasis, appearence of multiple bleeding points when scale is lifted

41

Munro microabscesses

Associated with psoriasis, neutrophils appear beneath the stratum corneum

42

Pemphigus Vulgaris

Blistering disease where autoantibodies cause breaking of intercellular attachments of epidermis. Basal layer acatholysis with ulcerated mucosal blister and eroded plaques. Typically presents on the scalp, face, axilla, and groin

43

Staining for Pemphigus Vulgaris

We'd see immunoglubuilin deposition along plasma membrane with a reticular or fish net pattern

44

Bullous Pemphigoid

Typically in older patiens, presents as dense bullae , large up to 2cm or more that do not rupture easily. Typically on inner thighs, flexor forearms, and 10-15% of people have oral lesions. The DEJ hemidesmosomes are attacked in this condition. No acantholysis, important in distinguishing against Vulgaris.

45

Histology of Bullous pemphigoid

Subepidermal nonacontholytic-linear deposits of immunoglobulin and complement along the epidermal-dermal junction

46

Panniculitis

AKA Erythema Nodosum. This is an inflammatory reaction that affects the connective tissue between fat lobules. These are very painful erythematous plaques and you need a deep biopsy to learn more.

47

Q image thumb

Actinic Keratosis

 

48

Q image thumb

Acute contact dermatitis

 

Note the intraepidermal collections of vesicles

49

Q image thumb

Acute inflammatory Dermatosis

 

Note the whealing puritis and perivascular involvement

50

Q image thumb

Basal Cell Carcinoma

51

Q image thumb

Bullae Pemphigoid

 

Note in the histology how the upper epidermis is pulled off

52

Q image thumb

Dermatofibroma

Note the collagen nests

 

53

Q image thumb

Dermatofibrosarcoma Protuberans

 

Note the radial appearence on histology

54

Q image thumb

Erythema Multiforme

55

Q image thumb

Mastocytosis

 

Note the ovoid, uniform appearence and the Mast cell stainong on the right side Giemsa stain

56

Q image thumb

Mycosis Fungoides

Note the erythematous and ulcerated plaques

57

Q image thumb

Panniculitis

58

Q image thumb

Pemphigus Vulgaris

Note the eroded plaques

59

Q image thumb

Psoriasis

Note the silver scaling with pustules and erythema and thinned stratum granulosum

60

Q image thumb

Seborrheic Keratosis

Note how closely it resembles a melanoma