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Flashcards in Malignancy Deck (16)
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Bowen

Thickened epidermis
Complete replaced full thickness atypical pleomorphic cells
Numerous apoptotic keratinocytes, abnormal mitotic figures
Basement membrane intact, absent dermal invasion

1

Nodular BCC

Large atypical basaloid tumor islands
Peripheral palisading retraction clefting
Pigmented- melanin pigment tumor/stroma- dendritic melanocytes
Epidermal ulceration

2

Superficial BCC

Multifocal tumor islands high papillary dermis
Attached undersurface epidermis
Peripheral pallisading, retraction clefting

3

Morpheic

Infiltrative cords cells single-few layered thickness
Cords dissect collagen within sclerotic stroma( hyalinised- morpheic)
Perineural invasion

4

Squamous cell carcinoma

Hyperkeratosis papillomatosis
Tongues of squamous proliferations
invading dermis
Tumor cells large pale atypical keratinocytes, keratotic differentiation
(Single cell keratinisation, keratin cysts)
Infiltrative lower border, mixed inflammatory infiltrate

5

EMPD

Nested proliferation
Large Pale neoplastic Paget’s cells (with atypical nuclei)
Basal epidermis, varying levels throughout epidermis
Groups flatten basal cells. multifocal with skip areas
no dyskeratosis

6

Bowens stains

negative for CK7, EMA, CEA
positive for high molecular weight keratins

7

EMPD stains

PAS+ diastase resistant CEA EMA CK+
Alcian blue, mucicarmine
Gross cystic disease fluid protein

8

Clear cell acanthoma

-Scale-crust
-Neutrophils in epidermis, microabscesses stratum corneum
-Psoriasiform proliferation pale (“clear”)keratinocyte, sharp demarcation
- glycogen PAS-positive, diastase labile
- Perivascular lymphocytes, Dilated blood vessels edematous pale dermal papillae

9

Epidermal nevus

Hyperkeratosis, papillomatosis, acanthosis, hypergranulosis
Epidermolytic hyperkeratosis rarely
Acantholytic dyskeratosis rarely
Perivascular lymphocytes often

10

Epidermal nevus etiology

post-zygotic somatic mosaicism for mutations in the FGFR3 gene or PIK3CA gene

11

Porokeratosis

Cornoid lamella (angulated column of parakeratosis)
under which hypogranulosis
dyskeratosis keratinocytes or pale staining
Epidermis normal, hyperplastic, atrophic
Perivascular (1.109) or lichenoid (1.72) lymphocytes,

12

AK

-hyperkeratosis, ulceration
-Parakeratosis overlying atypical keratinocytes sparing epidermis over adnexa (“alternating” pink and blue hue in stratum corneum “flag sign”)
-Atypical keratinocytes deeper epithelium
loss maturation, hyperchromatism, pleomorphism, increased mitoses, dyskeratosis
-Multiple buds into papillary dermis
-Perivascular lichenoid lymphocytes, plasma cells
-Solar elastosis in the dermis

13

features of malignancy

Atypical( keratinocytes, basaloid cells)
hyperchromatic, pleomorphic,
atypical mitoses, dyskeratosis
Loss of maturation with descent
Dermis invasion, perineural

14

sebaceous neoplasms plus KA

Muir–Torre syndrome

15

KA

-Dome shaped lesion -Keratin-filled crater btw epidermal lips
-Thickened epidermis Pale, eosinophilic, glassy, well-differentiated epithelial proliferation
- squamous eddies or keratin pearls
- microabscesses neutrophils within epithelium
-mild Cytologic atypia of keratinocytes
-Elastic fibers within epithelium base
-Perivascular or lichenoid infiltrate of lymphocytes, eosinophils, plasma cells