11 Integumentary System Flashcards
Malignant tumor that commonly arises in skin (can also occur in mucosal surfaces, esophagus, meninges, eye)
Melanoma
Large cells with expanded, irregular nuclei containing peripherally clumped chromatin and prominent eosinophilic nucleoli
Melanoma
Spread of nested and single-cell melanoma cells within the epidermis
Radial growth phase
nodular aggregates of infiltrating tumor cells within the dermis
Vertical growth phase
Melanoma RFs
Sun exposure and hereditary predisposition (CDKN2A, BRAF or NRAS, PTEN, c-KIT tyrosine kinase)
Cell origin of melanoma
Melanocytes
RFs for melanoma development
Intermittent exposure to UV radiation
Susceptibility genes
beta-catenin mutation
Caucasian race
Usual site of metastasis for this tumor
Liver, lungs, bones, brain
Give the prognosis factors of melanoma
Breslow thickness, mitoses, regression, TILs, gender, location, sentinel node micrometastasis
Neoplasm of melanocyes
Activating mutations int eh components of the Ras pathway
Melanocytic nevus / pigmented nevus/ benign nevus or mole
Deep dermal and sometimes subcutaneous growth around
Identical to ordinary acquired nevi
Present at birth, large variants have increased melanoma risk
Congenital nevus
Non-nested dermal infiltration, often with associated fibrosis
Highly dendritic, heavily pigmented nevus cells
Black-blue nodule, confused with melanoma
Blue nevus
Fascicular growth
Large, plum cells with pink-blue cytoplasm fusiform cells
Common in children, red-pink nodule, confused with hemangioma
Spindle and epitheloid cell nevus (Spitz nevus)
Lymphocytic infiltration surrounding nevus cells
Identical to ordinary acquired nevi
Host immune response against nevus cells and surrounding normal melanocytes
Halo nevus
Which histologic type of nevus is considered precursor of malignant melanoma
Dysplastic nevus - risk factor for melanoma
Common benign epidermal tumor
Seborrheic keratosis/ basal cell papilloma, brown wart, senile wart
Seborrheic keratosis pathogenesis
Mutations in FGFR3 (receptor tyrosine kinase)
Leser-Trelat sign
Paraneoplastic syndrome which includes seborrheic keratoses in large numbers
Leser-Trelat sign
Composed of sheets of small cells resembling normal epidermal basal cells
Exophytic, sharply-demarcated neoplasms
Seborrheic keratosis
SK characteristic features
Hyperkeratosis
Horn cysts
Invagination cysts
Exuberant keratin production at the surface
Hyperkeratosis
Small, intraepithelial keratin-filled cysts
Horn cysts
Horn cysts which communicate with the surface
Pseudohorn cysts
Invaginations of keratin into the main mass
Invagination cysts
What is the clinical/appearance of this lesion that makes it appearr as a wart
Round, flat coin-like waxy plaques
Tan to dark brown papule or nodule
Squamoproliferative disorders caused by HPV
Verrucae
Most common type of wart
Growth is characterized by hypertrophy of dermal papillae, markedly papillomatous epidermis
Verrruca vulgaris
Cytopathic effect of HPV
Vacuolated keratinocytes (koilocytes), which have a small shrunken nucleus surrounded by perinuclear haloes
What are the morphologic characteristics that differentiates it from seborrheic keratosis
Very pointed papillomatous projections of the epidermis with a thin long column of parakeratosis
Viral cytopathic changes
Most common invasive cancer in humans
Basal cell carcinoma
Basal cell Ca mutations
PTCH, TP53
Pearly papules containing prominent dilated subepidermal blood vessels with telangiectasias
Cords/islands of variably basophilic tumor cells with hyperchromatic nuclei
Peripheral palisading
Basal cell carcinoma
2 patterns of basal cell carcinoma
Multifocal growths
Nodular lesions
Originate from epidermis, may extend over several square centimeters or more of skin surface
Multifocal growths
Grows downward deeply into the dermis
Nodular lesions
Common sites of predilection of basal cell carcinoma
Head > trunk > penis, vulva, perianal skin
State a familial syndrome exhibiting basal cell carcinoma
Gorlin syndrome (nevoid basal cell carcinoma syndrome) - AD
Flesh-colored, dome-shaped nodule
Arises from the infundibulum of a hair follicle and located in the dermis
Epidermal inclusion cyst
