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HealthCert Education > Module 8: Melanoma > Flashcards

Module 8: Melanoma Flashcards

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1
Q

Diffuse reticular/ Patchy reticular - B v M

A

M - disorganized

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2
Q

Central hypo/ hyperpigmentation - B v M

A

M - off centre

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3
Q

Non- specific (structureless or featureless or homogenous) - B v M

A

M - heterogeneous hues or completely structureless

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4
Q

Peripheral globules and central reticular/ central globules and peripheral reticular - B v M

A

M - disorganized. Included asymmetric starburst

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5
Q

Globular - B v M

A

M - disorganized

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6
Q

Multi-component (symmetric)
2 component nevus
B v M

A

M Multi-component - 3 or more structures distributed asymmetrically

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7
Q

MM specific structures - sensitivity, 1-3

A

Regression structures
Atypical network
BWV

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8
Q

MM specific structures - specificity, 99% (4)

A

Streaks
Cystalline
BWV
Regression s

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9
Q

MM specific structures - odds ration, 1-4

A

Peripheral brown structureless
Crystalline
Atypical network
Regression structures

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10
Q

MM specific structures

A
  1. Atypical network (included grey angulated lines)
  2. Irregular Streaks (focal irregular - pseudopods & or radial streaming)
  3. Negative pigment network
  4. Crystalline (short white lines)
  5. Atypical dots and granules
  6. Atypical (irregular) blotch
  7. Blue white veil over raised areas
  8. Regression structures (BWV over flat area, peppering, scar)
  9. Atypical vessels
  10. Peripheral tan/ brown structureless areas
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11
Q

Atypical network is associated with ….

A

Superficial spreading melanoma

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12
Q

Angulated lines - description

A

Form zig zag pattern and polygonal structures (rhomboids)

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13
Q

Angulated lines Sens and Sp?

A

Not known but almost always MM

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14
Q

Angulated lines histopath correlation

A

NYD

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15
Q

Angulated lines most commonly seen

A

Sun damaged skin of face

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16
Q

Angulated lines also seen

A

Chronic sun damaged skin upper torso/ extremities

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17
Q

Histopath correlated irregular streaks/ pseudopods?

A

confluent junctional nests of pigmented melanocytes

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18
Q

confluent junctional nests of pigmented melanocytes associated with what type of growth

A

radial growth

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19
Q

confluent junctional nests of pigmented melanocytes associated with what type of melanoma …

A

superficial spreading

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20
Q

definition of negative network

A

serpiginous interconnecting hypo pigmented lines that surround irregularly shaped pigmented strcutures, which resemble elongated and curvilinear globules.

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21
Q

is pigment network seen with P or NP Dermoscopy?

A

both

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22
Q

In white benign lesions can you see negative pigment

A
  1. Spitz nevus.

2. CMN

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23
Q

Crystalline structures - definition

A

Short white lines only seen with polarizing Dermoscopy

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24
Q

Crystalline structures - cause

A

birefringent properties of collagen > polarized light to randomize it polarization rapidly

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25
White reflective structures
1. Crystalline (shiny white lines/ streaks) MM, spitz, LPLK 2. Shiny white blotches/ patches/ areas (white clods) & strands BCC 3. Rosettes AK, SCC, Actinic damaged skin
26
White reflective structures are predictive of ....
Thicker melanoma | Invasive melanoma
27
What type of collagen is expressed in malignant but not benign melanocyte tumors
Collagen XVII
28
Predictor of thicker MM > 0.75
``` Blue grey areas Vessels Abrupt cutoff > 4 colors Blue white veil > 2 structures ```
29
Predictor of thicker MM & +SLNB
Blotch | Ulceration.
30
Negative predictor of thicker MM & +SLNB
Atypical network
31
Predictor of thicker MM & distant mets
Shiny white streaks | Milky red areas.
32
In which non-melanocytes lesions do you see crystalline structures
1. DF. 2. BCC 3. LPLK
33
Dots defn
Small round structures, diam < 0.1 mm
34
Black dots =
Pigment in the stratum corneum/ upper epidermis
35
Brown dots =
small nests at or near the Dermoscopy-epidermal jn
36
Blue grey dots =
free melanin in dermis or in macrophages
37
Red dots =
dotted vessels
38
I brown dot on network corresponds to ...
pigment nests within rete
39
Typical/ regular black or brown dots
Central OR | Situated on network lines, or in holes
40
Black or brown Dots asymmetrical
Located focally at periphery | Not associated with network lines
41
Black or brown Dots situated in holes of network known as ...
Target globules
42
Globules defn
Symmetrical, round to oval well dermarcated structure > 0.1mm diamanté's
43
Brown globules =
nests at or below DR junction in papillae to upper reticular dermis. (Most common)
44
Black globules =
heavily melanized nests
45
Blue globules =
nests in deeper dermis
46
White globules =
ballon cell nests
47
Red globules =
vascular structures
48
Typical/ regular globules
Uniform size, shape, color | Symmetrically distributed throughout lesion or at peripheral or in the centre
49
Atypical globules
Asymmetrically distributed. Often aggregated focally. When reddish in colour, highly suggestive melanoma.
50
Significance of tiered globules
Atypical pattern
51
What is a large concentration of melanin in stratum corneum called?
Black lamella
52
Botch - definition.
Large concentration of melanonin throughout epidermis +/- dermis Visually obscures underlying structures.
53
Typical blotch
Single Central Homogenous
54
Atypical blotch
Peripheral Asymmetric > 1
55
Blue white veil (raised) definition
Focal, irregular, indistinct, confluent, blue pigmentation. Overlying white ground-glass haze Pigmentation cannot occupy entire lesions.
56
Blue white veil histopath
Aggregation of heavily pigmented cells/ melnanin in the dermis. (Blue color) In combination with compact orthokeratosis.
57
Blue white veil in nevus
blue hue (not veil) centrally located rainy and homogenous usually only with NPD (orthokeratosis)
58
Blue white veil in melanoma
Asymmetrical/ focal or diffuse throughout lesion Differing hues (heterogeneous) Both with NPD and PD
59
Regression structures - name them
- Peppering - fine grey particles - Depigmented area (scar like depigmentation) - structureless area that is white in color. Lighter in color as compared to lesion, and background skin color. The combination creates blue white veil - on palpation it will be flat.
60
Peppering in nevus
usually symmetrical < 10% lesion uncommon to have scarring
61
Peppering in melanoma
+/- scarring asymmetrically located involves > 50% lesion area
62
Vascular structures, nodular lesion, nevus
Comma vessels IDN CMN
63
Vascular structures, nodular lesion, melanoma
``` Dotted Glomerular serpentine/ linear polymorphous milky red ```
64
Vascular structures, flat lesions, nevus
Monomorphous dotted "target network" vessels. (In CMN can be polymorphous) Milky red
65
Vascular structures, flat lesions, melanoma
``` Dotted Globular Serpentine/ linear Milky-red (polymorphous) ```
66
Peripheral tan/ brown structureless areas - dermatophatology
- Flattening of rete ridges at DEJ - Melanocytes arranged predominantly as solitary units + less melanin - Pagetoid scatter of melanocytes
67
Melanoma specific structures
1. Atypical network incl angulated lines. 2. Streaks (pseudopods and radial streaming) 3. Negative pigment network 4. Shiny white lines (Chrysallis/ crustalline) 5. Atypical dots and globules. 6. Off-centered blotch. 7. Peripheral tan structureless area 8. Blue-white veil overlying raised areas. 9. Regression structures. 10. Atypical vascular structures.

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