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Integument > Benign Neoplasms > Flashcards

Benign Neoplasms Flashcards

1
Q

What are the layers of the skin

A

epidermis
dermis
hypodermis

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2
Q

what is the epidermis

A

provides a waterproof barrier
melanocytes in the lower level

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3
Q

What is the dermis

A

connective tissue, hair follicles and sweat glands

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4
Q

what is hypodermis

A

adjacent to fat and connective tissues (subcutaneous tissues)

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5
Q

give in details the layers of the skin

A

stratum cornea
EPIDERMIS
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale
DERMIS
papillary dermis
reticular dermis
hypodermis

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6
Q

seborrheic keratosis

A

most common benign tumor
hyperkeratotic lesion of the epidermis (appears on the surface of the skin)

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7
Q

where is seborrheic keratosis most common

A

on the trunk but can appear on the extremities, face, and scale

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8
Q

what is the clinical appearance of seborrheic keratosis

A

variable from brown to black
well-circumscribed borders and a rough surface
2mm-3cm

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9
Q

What is a kind of epidermal neoplasm

A

dermatosis papulose nigra

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10
Q

what is the appearance of dermatosis papulose nigra

A

multiple small black or brown papules common found on the face of dark-skinned people

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11
Q

what is the sign of dermatosis papulose nigra

A

the leser-trelat sign

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12
Q

what is the leser-trelat sign(s)

A

multiple seborrhric keratosis lesions
underlying malignancy
consideration of a paraneoplastic disorder
may resolve with treatment of the malignancy

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13
Q

what is the histology of dermatosis papulose nigra

A

acanthosis (benign overgrowth of stratum spinosum)
horn pseudo-cyst + string sign

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14
Q

acrochordon is also known as

A

skin tag

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15
Q

acrochordon (skin tag) is a

A

common, small, benign neoplasm

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16
Q

acrochordon (skin tag) is located where

A

dermis and epidermis

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17
Q

acrochordon (skin tag) is seen how clinically

A

skin colored and brownish

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18
Q

how does acrochordon (skin tag) differ from seborrheic keratosis

A

acrochordon (skin tag) is 2-5mm in size vs 2mm-3cm

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19
Q

acrochordon (skin tag) is commonly found where

A

in skin folds (neck, axillae, groin)

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20
Q

skin tags can be associated with what

A

metabolic syndromes (obesity, dyslipidemia, hypertension, insulin resistance, and elevated c-reactive protein levels)

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21
Q

are skin tags harmful

A

no - in adults
yes - in children

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22
Q

what are pediatric skin tags indicative of

A

nevoid basal cell carcinoma syndrom

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23
Q

skin tags are composed of what

A

a fibrovascular core and covered by squamous epithelium

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24
Q

central core lesions are composed of

A

loose collagen with increased blood vessels because they are composed of a fibrovascular core

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25
Q

larger lesions may have a central core of what

A

adipose tissue

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26
Q

epidermal cyst are

A

the most common type of cutaneous cyst

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27
Q

epidermal cyst commonly occur

A

on the back, face and chest

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28
Q

epidermal cyst are usually caused by

A

keratin plugging the follicle leading to cystic dilation = entrapment of keratin debris

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29
Q

multiple epidermal inclusion cysts can be seen in what syndrome

A

Gardner Syndrome

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30
Q

what is gardner syndrome

A

gardner syndrome is a variant of familial adenomatous polyposis (FAP)

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31
Q

Cysts that are unusual in number or location (fingers or toes) lead to

A

screening of colon cancer

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32
Q

what are the clinical features of epidermal cysts

A

discrete, freely movable cyst or nodule
may have a central punctum

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33
Q

what are microscopic features of epidermal cysts

A

the lining is composed of stratified squamous epithelium with a granular layer

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34
Q

sebaceous tumors have what kind of clinical appearance

A

solitary small, yellow, lobulated papules on the forehead or cheeks

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35
Q

what are examples of multiple sebaceous tumors can occur as part of what

A

muir-torre syndrome

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36
Q

muir-torre syndrome

A

is an autosomal disorder that is most commonly due to the mutation in MSH2 mismatch repair gene

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37
Q

what are the microscopic features of sebaceous glands

A

vacuolated, bubbly, mature sebocytes

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38
Q

sebaceous adenoma

A

rare benign tumor of sebaceous glands

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39
Q

sebaceous adenomas occur where

A

70% on the head
30% on the neck, trunk, extremities

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40
Q

Muir-Torre syndrome is also reffered to as lynch syndrome

A

lynch syndrome

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41
Q

lynch syndrome

A

variant of nonpolyposis colorectal cancer syndrome
mutation of different syndrome that includes MSH2

42
Q

what is the most common gene syndrome in muirr-torre syndrome?

A

MSH2

43
Q

sebaceous cells have what kind of stain

A

lighter

44
Q

basal cells have what kind of stain

A

darker

45
Q

sebaceous tumors are often clinically mistaken for what

A

basal cell carcinoma

46
Q

what differentiates sebaceous tumors from basal cell carcinoma

A

papules with teleangiclasia

47
Q

the central sebocytes are

A

white/mature

48
Q

the peripheral sebocytes are

A

pink/grey

49
Q

what causes the difference in color between central and peripheral sebocytes

A

the amount of staining that they receive - peripheral gets more

50
Q

sweat gland tumors occur

A

within the gland

51
Q

what are the two types of lesions involved in sweat gland tumors

A

eccrine lesions
apocrine lesions

52
Q

what type of lesion is the most common in regard to sweat gland tumors

A

eccrine

53
Q

what type of lesion is rare and found in body folds in regard to sweat gland tumors

A

apocrine

54
Q

what is the clinical description of eccrine (poroma)

A

benign sessile nodule
red
scaly

55
Q

what are the 3 types of eccrine (poroma)

A

poroma , both epidermis and dermis
hidroacanthoma simplex, within the epidermis
dermal duct tumor, limited to the dermis (on one thats found there)

56
Q

what are the types of cylindroma

A

sporadic
hereditary

57
Q

hereditary cylindroma

A

is a variant of Brook-spiegler syndrome caused by germline mutations in the cylidnromatosis tumor suppressor gene (CYLD)

58
Q

hereditary cylindroma has what kind of pattern

A

jig-saw
appear blue basaloid from H&E staining

59
Q

hereditary cylindroma has what kind of cells

A

2
large with pale staining
small with dark stain

60
Q

Syringoma

A

benign sporadic tumor that arises from the intradermal eccrine sweat duct

61
Q

Syringoma appears as

A

small papules often on the face

62
Q

hair follicle tumors are characterized by

A

the depth of the hair follicle starting from the base

63
Q

infundibulum

A

from the epidermal surface to the opening of the sebaceous duct

64
Q

isthmus

A

from the opening of the sebaceous duct to the inerstion of the arrector pili muscle (trichomela)

65
Q

inferior follicle

A

from the insertion of the arrector pili to the hair bulb

66
Q

germinative matrix

A

cluster of proliferative round blue cells that make up the hair bulbs - give rise to the hair shaft

67
Q

hair papilla aka dermal or mesenchymal papilla

A

connective tissue and capillary loop, minimal cell division

68
Q

trichoepithelioma

A

benign hair follicle tumors
present as small-fleshed colored papules in adults
forms the hair follicle

69
Q

2 cases of trichoepithelioma

A

sproadic
familial

70
Q

sporadic trichoepithelioma

A

cases are associated with MFT (multiple familial trichoepithelioma)

71
Q

MFT (multiple familial trichoepithelioma) is associated with

A

suppression of chromosome 9 - the tumor suppression gene

72
Q

trichoepithelioma can be seen histologically as

A

small horn cyst filled with keratin
dense pink fibrous stroma
papillary mesenchymal bodies

73
Q

trichilemmoma

A

common benign follicular proliferation
wart like appearance
associated with cowden syndrome

74
Q

trichilemmoma is associated with what gene mutation

A

PTEN

75
Q

how do you confirm glycogen in trichilemmoma

A

PAS staining

76
Q

cutaneous spindle cell neoplasms

A

composed of spindle cells
benign lesions are more common that malignant tumors

77
Q

what are some of the most common primary cutaneous sarcomas

A

dermatofibrosarcoma protuberans (most common)
leiomyosarcoma
pleomorphic dermal sarcoma

78
Q

Schwannoma

A

benign peripheral nerve sheath tumor composed of Schwann cells

79
Q

schwann cells produce what

A

the myelin sheath around peripheral nerves

80
Q

describe dense cellular areas of schwannoma

A

antoni A
haphazard arrangement of bland cells with spindle and oval nuclei

81
Q

describe loose cellular areas of schwannoma

A

antoni B
less dense cellular areas
loose edematous and mucinous stroma with birillar collagen
vessels are prominant

82
Q

neurofibroma

A

benign nerve sheath tumor in the peripheral nervous system

83
Q

multiple lesion of neurofibroma are called

A

NF1

84
Q

NF1 is cause by

A

inactivation of NF1 gene

85
Q

inactivation of NF1 gene causes what

A

abnormal functioning of RAS pathwayw

86
Q

what are the subtypes of neurofibroma

A

plexiform = irregularly expanded nerve bundles with nodular appearance
diffuse cutaneous = large plaque elevation
superficial cutaneous = pedunculated nodules (sporadic)

87
Q

what is the histopathology of neurofibroma

A

encapsulated lesion in the dermis , usually sparing a later of the dermis below the Grenz zone

88
Q

what is the grenz zone

A

layer of dermis below the epidermis

89
Q

what are the main findings of NF1

A

cafe au lait spots
axillary freckling
iris Lisch nodules

90
Q

what is responsible for NF1

A

heterozygous pathogenic varients

91
Q

What is NF2

A

bilateral schawanomas

92
Q

NF2 is considered what kind of disease

A

adult
may be uncrecognized in children

93
Q

Dermatofibroma is

A

is the ideopathic benign proliferation of fibroblasts

94
Q

Dermatofibroma appears as

A

gradually over months and is asymptomatic

95
Q

Dermatofibroma is more common in

A

women

96
Q

Dermatofibroma’s diagnosis is supported ny

A

fitzpatrick’s sign

97
Q

fitzpatrick’s sign is

A

dimpling or retraction of the lesion beneath the skin with lateral compression

98
Q

multiple Dermatofibromaa are rare but may arise in what population subset

A

immunocopromised

99
Q

histologically, Dermatofibroma is

A

ill-defined
short spindled and ovoid cells arranged as pinwheels

100
Q

what inflammatory cells are involved with Dermatofibroma

A

foamy macrophages, touton giant cells, and siderophages

101
Q

Dermatofibroma may metastsize to

A

lungs
lymph nodes
or soft tissue

Integument (6 decks)

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