Benign Neoplasms Flashcards
What are the layers of the skin
epidermis
dermis
hypodermis
what is the epidermis
provides a waterproof barrier
melanocytes in the lower level
What is the dermis
connective tissue, hair follicles and sweat glands
what is hypodermis
adjacent to fat and connective tissues (subcutaneous tissues)
give in details the layers of the skin
stratum cornea
EPIDERMIS
stratum lucidum
stratum granulosum
stratum spinosum
stratum basale
DERMIS
papillary dermis
reticular dermis
hypodermis
seborrheic keratosis
most common benign tumor
hyperkeratotic lesion of the epidermis (appears on the surface of the skin)
where is seborrheic keratosis most common
on the trunk but can appear on the extremities, face, and scale
what is the clinical appearance of seborrheic keratosis
variable from brown to black
well-circumscribed borders and a rough surface
2mm-3cm
What is a kind of epidermal neoplasm
dermatosis papulose nigra
what is the appearance of dermatosis papulose nigra
multiple small black or brown papules common found on the face of dark-skinned people
what is the sign of dermatosis papulose nigra
the leser-trelat sign
what is the leser-trelat sign(s)
multiple seborrhric keratosis lesions
underlying malignancy
consideration of a paraneoplastic disorder
may resolve with treatment of the malignancy
what is the histology of dermatosis papulose nigra
acanthosis (benign overgrowth of stratum spinosum)
horn pseudo-cyst + string sign
acrochordon is also known as
skin tag
acrochordon (skin tag) is a
common, small, benign neoplasm
acrochordon (skin tag) is located where
dermis and epidermis
acrochordon (skin tag) is seen how clinically
skin colored and brownish
how does acrochordon (skin tag) differ from seborrheic keratosis
acrochordon (skin tag) is 2-5mm in size vs 2mm-3cm
acrochordon (skin tag) is commonly found where
in skin folds (neck, axillae, groin)
skin tags can be associated with what
metabolic syndromes (obesity, dyslipidemia, hypertension, insulin resistance, and elevated c-reactive protein levels)
are skin tags harmful
no - in adults
yes - in children
what are pediatric skin tags indicative of
nevoid basal cell carcinoma syndrom
skin tags are composed of what
a fibrovascular core and covered by squamous epithelium
central core lesions are composed of
loose collagen with increased blood vessels because they are composed of a fibrovascular core
larger lesions may have a central core of what
adipose tissue
epidermal cyst are
the most common type of cutaneous cyst
epidermal cyst commonly occur
on the back, face and chest
epidermal cyst are usually caused by
keratin plugging the follicle leading to cystic dilation = entrapment of keratin debris
multiple epidermal inclusion cysts can be seen in what syndrome
Gardner Syndrome
what is gardner syndrome
gardner syndrome is a variant of familial adenomatous polyposis (FAP)
Cysts that are unusual in number or location (fingers or toes) lead to
screening of colon cancer
what are the clinical features of epidermal cysts
discrete, freely movable cyst or nodule
may have a central punctum
what are microscopic features of epidermal cysts
the lining is composed of stratified squamous epithelium with a granular layer
sebaceous tumors have what kind of clinical appearance
solitary small, yellow, lobulated papules on the forehead or cheeks
what are examples of multiple sebaceous tumors can occur as part of what
muir-torre syndrome
muir-torre syndrome
is an autosomal disorder that is most commonly due to the mutation in MSH2 mismatch repair gene
what are the microscopic features of sebaceous glands
vacuolated, bubbly, mature sebocytes
sebaceous adenoma
rare benign tumor of sebaceous glands
sebaceous adenomas occur where
70% on the head
30% on the neck, trunk, extremities
Muir-Torre syndrome is also reffered to as lynch syndrome
lynch syndrome
lynch syndrome
variant of nonpolyposis colorectal cancer syndrome
mutation of different syndrome that includes MSH2
what is the most common gene syndrome in muirr-torre syndrome?
MSH2
sebaceous cells have what kind of stain
lighter
basal cells have what kind of stain
darker
sebaceous tumors are often clinically mistaken for what
basal cell carcinoma
what differentiates sebaceous tumors from basal cell carcinoma
papules with teleangiclasia
the central sebocytes are
white/mature
the peripheral sebocytes are
pink/grey
what causes the difference in color between central and peripheral sebocytes
the amount of staining that they receive - peripheral gets more
sweat gland tumors occur
within the gland
what are the two types of lesions involved in sweat gland tumors
eccrine lesions
apocrine lesions
what type of lesion is the most common in regard to sweat gland tumors
eccrine
what type of lesion is rare and found in body folds in regard to sweat gland tumors
apocrine
what is the clinical description of eccrine (poroma)
benign sessile nodule
red
scaly
what are the 3 types of eccrine (poroma)
poroma , both epidermis and dermis
hidroacanthoma simplex, within the epidermis
dermal duct tumor, limited to the dermis (on one thats found there)
what are the types of cylindroma
sporadic
hereditary
hereditary cylindroma
is a variant of Brook-spiegler syndrome caused by germline mutations in the cylidnromatosis tumor suppressor gene (CYLD)
hereditary cylindroma has what kind of pattern
jig-saw
appear blue basaloid from H&E staining
hereditary cylindroma has what kind of cells
2
large with pale staining
small with dark stain
Syringoma
benign sporadic tumor that arises from the intradermal eccrine sweat duct
Syringoma appears as
small papules often on the face
hair follicle tumors are characterized by
the depth of the hair follicle starting from the base
infundibulum
from the epidermal surface to the opening of the sebaceous duct
isthmus
from the opening of the sebaceous duct to the inerstion of the arrector pili muscle (trichomela)
inferior follicle
from the insertion of the arrector pili to the hair bulb
germinative matrix
cluster of proliferative round blue cells that make up the hair bulbs - give rise to the hair shaft
hair papilla aka dermal or mesenchymal papilla
connective tissue and capillary loop, minimal cell division
trichoepithelioma
benign hair follicle tumors
present as small-fleshed colored papules in adults
forms the hair follicle
2 cases of trichoepithelioma
sproadic
familial
sporadic trichoepithelioma
cases are associated with MFT (multiple familial trichoepithelioma)
MFT (multiple familial trichoepithelioma) is associated with
suppression of chromosome 9 - the tumor suppression gene
trichoepithelioma can be seen histologically as
small horn cyst filled with keratin
dense pink fibrous stroma
papillary mesenchymal bodies
trichilemmoma
common benign follicular proliferation
wart like appearance
associated with cowden syndrome
trichilemmoma is associated with what gene mutation
PTEN
how do you confirm glycogen in trichilemmoma
PAS staining
cutaneous spindle cell neoplasms
composed of spindle cells
benign lesions are more common that malignant tumors
what are some of the most common primary cutaneous sarcomas
dermatofibrosarcoma protuberans (most common)
leiomyosarcoma
pleomorphic dermal sarcoma
Schwannoma
benign peripheral nerve sheath tumor composed of Schwann cells
schwann cells produce what
the myelin sheath around peripheral nerves
describe dense cellular areas of schwannoma
antoni A
haphazard arrangement of bland cells with spindle and oval nuclei
describe loose cellular areas of schwannoma
antoni B
less dense cellular areas
loose edematous and mucinous stroma with birillar collagen
vessels are prominant
neurofibroma
benign nerve sheath tumor in the peripheral nervous system
multiple lesion of neurofibroma are called
NF1
NF1 is cause by
inactivation of NF1 gene
inactivation of NF1 gene causes what
abnormal functioning of RAS pathwayw
what are the subtypes of neurofibroma
plexiform = irregularly expanded nerve bundles with nodular appearance
diffuse cutaneous = large plaque elevation
superficial cutaneous = pedunculated nodules (sporadic)
what is the histopathology of neurofibroma
encapsulated lesion in the dermis , usually sparing a later of the dermis below the Grenz zone
what is the grenz zone
layer of dermis below the epidermis
what are the main findings of NF1
cafe au lait spots
axillary freckling
iris Lisch nodules
what is responsible for NF1
heterozygous pathogenic varients
What is NF2
bilateral schawanomas
NF2 is considered what kind of disease
adult
may be uncrecognized in children
Dermatofibroma is
is the ideopathic benign proliferation of fibroblasts
Dermatofibroma appears as
gradually over months and is asymptomatic
Dermatofibroma is more common in
women
Dermatofibroma’s diagnosis is supported ny
fitzpatrick’s sign
fitzpatrick’s sign is
dimpling or retraction of the lesion beneath the skin with lateral compression
multiple Dermatofibromaa are rare but may arise in what population subset
immunocopromised
histologically, Dermatofibroma is
ill-defined
short spindled and ovoid cells arranged as pinwheels
what inflammatory cells are involved with Dermatofibroma
foamy macrophages, touton giant cells, and siderophages
Dermatofibroma may metastsize to
lungs
lymph nodes
or soft tissue
