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Benign tumors Flashcards

1
Q

What are seborrheic keratoses?

A

Round, flat, coin-like plaques that vary in diameter

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2
Q

seborrheic keratoses are rare before what age?

A

30

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3
Q

What is the treatment for seborrheic keratoses?

A

Surgery
Chemical peeling agents
Electro or cryotherapy

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4
Q

true or false: seborrheic keratoses are generally well circumscribed, unlike melanomas

A

True

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5
Q

True or false: seborrheic keratoses usually occur as a single lesion, unlike melanomas

A

Double false– seborrheic keratoses occur in multiples, and melanomas occur as singletons

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6
Q

What is the Leser-Trelat sign, and what might it indicate?

A

the explosive onset of multiple seborrheic keratoses[1] (many pigmented skin lesions), often with an inflammatory base. This can be an ominous sign of internal malignancy as part of a paraneoplastic syndrome

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7
Q

What are the histological findings of seborrheic keratoses?

A

Well defined papillations of keratin confined to the epidermis, with microcysts within them

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8
Q

What are the histological findings of pigmented seborrheic keratoses?

A

Same as seborrheic keratoses, but with a lot of pigment within the keratinocytes

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9
Q

What defines the difference in pigmentation between people

A

Difference in pigmentation in the keratinocytes–NOT in the number of melanocytes

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10
Q

True or false: the number of melanocytes does not vary much between people

A

True

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11
Q

What are fibroepithelial polyp acrochordon? What usually causes these?

A
  • Polyps on the skin that have a fibrovascular core, covered by a benign epithelium
  • Chronic rubbing of the skin
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12
Q

Polyps on the skin that have a fibrovascular core, covered by a benign epithelium = ?

A

Fibroepithelial polyp-acrochordon

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13
Q

What are the four major types of epithelial cysts?

A
  • Epidermal inclusion cysts
  • Pilar or trichilemmal cysts
  • Dermoid cysts
  • Steatocystomas
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14
Q

What is the classic appearance of epidermoid cysts?

A

Deep nodules with a central punctum

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15
Q

Deep nodule with a central punctum = ?

A

Epidermoid cysts

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16
Q

What is a follicle?

A

a small secretory cavity, sac, or gland, in particular.

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17
Q

What is an infundibulum?

A

a funnel-shaped cavity or structure.

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18
Q

What are epidermoid cysts filled with?

A

Loose Keratin

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19
Q

Sebaceous cysts = ?

A

Epidermoid cysts

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20
Q

What are trichilemmal cysts?

A

a common cyst that forms from a hair follicle. They are most often found on the scalp. The cysts are smooth, mobile and filled with keratin

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21
Q

What are dermoid cysts?

A

a teratoma of a cystic nature that contains an array of developmentally mature, solid tissues. It frequently consists of skin, hair follicles, and sweat glands

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22
Q

What is the classic presentation of a dermoid cyst?

A

Single SQ nodule present at birth on the lateral aspect of the upper eyelid

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23
Q

What are the histological characteristics of a dermoid cyst?

A

Like epidermoid cyst, but with dermal tissue components

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24
Q

What are steatocystomas?

A

AD mutation in keratin 17, resulting in multiple cysts on the body, usually in the sternal, axillae, and groin

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25
Q

What are the histological characteristics of steatocystomas?

A

Jagged area of keratin, with sebaceous structures attached to it

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26
Q

What are trichilemmomas?

A

a benign cutaneous neoplasm that shows differentiation toward cells of the outer root sheath

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27
Q

What is Cowden’s disease?

A

AD mutation in PTEN gene that predisposed for breast and thyroid CA. Presents are multiple, hamartomas, as well as trichilemmomas

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28
Q

Multiple trichilemmomas = what disease?

A

Cowden’s disease

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29
Q

What are the characteristics of trichilemmomas?

A

Lighter, clear sheets of cells with a thick BM

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30
Q

Lighter, clear sheets of cells with a thick BM = ?

A

Trichilemmomas

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31
Q

What are pilomatricomas? Where are they most commonly found on the body?

A

Benign skin tumor derived from the hair matrix

-head (cheek) and neck region, but also on UE and trunk

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32
Q

What genetic disease is associated with pilomatricomas?

A

Turner’s syndrome

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33
Q

What is the genetic mutation associated with pilomatricomas?

A

APC mutation, resulting in high beta catenin

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34
Q

What are the histological features of pilomatricomas?

A

anucleate squamous cells (called “ghost cells”), benign viable squamous cells and multi-nucleated giant cells. The presence of calcifications is common.

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35
Q

What percent of pilomatricomas occur before age 20?

A

60%

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36
Q

anucleate squamous cells (called “ghost cells”), benign viable squamous cells and multi-nucleated giant cells = ?

A

Pilomatrixoma

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37
Q

What is Birt-Hogg-Dube syndrome? Genetic cause?

A

AD mutation to BHD gene on chr 17, which encodes the protein folliculin.
-Causes susceptibility to a wide variety of cancers, and fibrofolliculomas

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38
Q

What are fibrofolliculomas? What syndrome are they seen in?

A

2 to 4 mm in diameter, dome-shaped, yellowish or skin-colored papules usually located on the head, neck, and upper trunk. They are characteristically seen in Birt–Hogg–Dubé syndrome

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39
Q

What are the two diseases in particular that Birt-Hogg-Dube syndrome is associated with?

A
  • Renal tumors

- Spontaneous pneumothorax

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40
Q

What are the gross characteristics of fibrofolliculomas?

A

Small white papules, usually located along the face

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41
Q

What are the gross characteristics of trichodiscomas?

A

Small white papules, usually located along the face

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42
Q

What are the histological characteristics of fibrofolliculomas?

A

Abortive and squeezed off follicular structures surrounded by fat cells

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43
Q

Abortive and squeezed off follicular structures surrounded by fat cells = ?

A

Fibrofolliculomas

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44
Q

What are the two skin lesions associated with Birt-Hogg-Dube syndrome?

A

Fibrofolliculomas

Trichodiscomas

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45
Q

What is a nevus sebaceous? Where on the body is it usually found? What age? Which gender?

A
  • A congenital, hairless plaque that typically occurs on the face or scalp.
  • Present at birth, affecting males and females of all races equally. The condition is named for an overgrowth of sebaceous glands in the area of the nevus.
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46
Q

What is the prognosis for nevus sebaceous?

A

In itself is benign, but secondary tumors may arise from it–usually BCC

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47
Q

True or false: all nevi are melanocytic proliferaitons

A

False–nevus sebaceous is not

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48
Q

What are the gross findings of nevus sebaceous?

A

Localized area of alopecia, with a waxy, papule

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49
Q

What are the histological findings of nevus sebaceous?

A

Abortive hair follicles, with a whole bunch of sebaceous glands attached to them

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50
Q

Localized area of alopecia, with a waxy, papule + Abortive hair follicles, with a whole bunch of sebaceous glands attached to them on histology = ?

A

Nevus sebaceous

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51
Q

How common is sebaceous hyperplasia? What causes it? What is it often misdiagnosed as?

A

Common on faces of adults from sun damage that is usually misdiagnosed as BCC

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52
Q

What are the gross characteristics of sebaceous hyperplasia?

A

Yellowish dome shaped papules

53
Q

What are the histological characteristics of sebaceous hyperplasia?

A

Tons o’ sebaceous glands

54
Q

Yellowish dome shaped papules with a central punctum + tons o’ sebaceous glands on histology = ?

A

Sebaceous hyperplasia

55
Q

What are sebaceous adenomas? What condition are they associated with? Where on the body are they usually found?

A
  • Rare, benign tumor of sebaceous glands
  • Muir–Torre syndrome
  • face and scalp of old people
56
Q

What is Muir–Torre syndrome? What is the genetic defect and inheritance pattern? What skin findings are associated with it?

A

a rare hereditary, autosomal dominant cancer syndrome that is thought to be a subtype of HNPCC.

  • Individuals are prone to develop cancers and skin lesions, such as keratoacanthomas and sebaceous tumors.
  • The genes affected are MLH1, MSH2, which are involved in DNA mismatch repair and microsatellite stability.

-Sebaceous adenomas

57
Q

What are the histological characteristics of sebaceous adenomas?

A

Lots of sebaceous glands, but it not precipitating normal sebaceous lobules, and is well differentiated

58
Q

Lots of sebaceous glands, but it not precipitating normal sebaceous lobules, and is well differentiated = ?

A

Sebaceous adenomas

59
Q

What are sebaceomas? What does it look like grossly?

A

A sebaceous structure that is intermediate in malignancy, that appears as a yellow or orange papule

60
Q

What are the histological characteristics of sebaceomas?

A

Somewhat differentiated sebaceous glands

61
Q

What are the cutaneous findings of MTS?

A

Sebaceous tumors:

  • Adenomas, sebaceomas
  • Keratoacanthomas
62
Q

What are the visceral malignancies associated with MTS?

A
  • Colon
  • Bladder
  • Endometrium
  • Breast
63
Q

What is the immunostaining technique used to diagnose MTS? What is an abnormal result?

A

Stain for MLH1 and MSH2

Loss of stain = pathologic

64
Q

What are cylindromas? Where do they most often occur on the body? What is the F:M?

A
  • Sweat gland tumors that appear as pink/red nodules
  • head and neck
  • 9:1
65
Q

What is Brooke-Spiegler syndrome? What are the tumors that can grow with this condition?

A

a condition involving multiple skin tumors including growths called spiradenomas, trichoepitheliomas, and cylindromas.

66
Q

What is the genetic inheritance and mutation of Brooke-Spiegler syndrome?

A

AD CYLD gene on chr 16

Causes NF-kappa-B pathway overactivation

67
Q

What are the histological findings of cylindromas?

A

Jigsaw puzzle

68
Q

Jigsaw puzzle histology = ?

A

Cylindromas

69
Q

What are xanthomas?

A

Benign aggregate of histiocytes with cytoplasmic lipids

70
Q

What are the five main clinical types of xanthomas? Which is the only one that has normal serum lipid levels?

A
  • Eruptive
  • Tendinous
  • Tuberous
  • Planar
  • Disseminated
71
Q

What are xanthogranulomas? What age do they typically arise? What conditions are associated with this?

A

yellow/brown papules or nodules on the head and neck region that usually arise within the first 5 years of life
-CML and NF

72
Q

What is the prognosis for xanthogranulomas?

A

They themselves are benign and spontaneously regress within several years, but may indicate underlying visceral pathology

73
Q

What are histological findings of xanthogranulomas?

A

Histiocytes in the dermis and Touton giant cells

74
Q

Histiocytes in the dermis and Touton giant cells = ?

A

JXG

75
Q

What is the age and gender that is typically affected with reticulohistiocytomas?

A

Middle aged females

76
Q

What are the two forms of reticulohistiocytomas?

A

Solitary

Multicentric

77
Q

What are the histological findings of reticulohistiocytomas?

A

Ground glass histiocytes

78
Q

Ground glass histiocytes = ?

A

reticulohistiocytomas

79
Q

What are the associations of reticulohistiocytomas?

A

CT diseases

Vasculitis

80
Q

What is the acute generalized form of LCH (letterer-Siwe disease), and who does it affect? How aggressive is it?

A

A rapidly progressing disease in which Langerhans Cell cells proliferate in many tissues, including internal organs. It is mostly seen in children under age 2, and the prognosis is poor: even with aggressive chemotherapy, the five-year survival is only 50%

81
Q

What is the multifocal chronic form of LCH (Hand-Schuller-Christian disease)? Who is it usually seen in? S/sx?

A

Seen mostly in children, multifocal unisystem LCH is characterized by fever, bone lesions and diffuse eruptions, usually on the scalp and in the ear canals. 50% of cases involve the pituitary stalk, leading to diabetes insipidus.

The triad of diabetes insipidus, exophthalmos, and lytic bone lesions is known as the Hand-Schüller-Christian triad. Peak onset is 2–10 years of age.

82
Q

What is the classic triad of symptoms for multifocal chronic LCH?

A
  • Lytic skull lesions
  • DI
  • Proptosis
83
Q

What is the treatment for multifocal LCH?

A

XRT and chemo

84
Q

What is the unifocal version of LCH (eosinophilic granuloma)?

A

A slowly progressing disease characterized by an expanding proliferation of Langerhans Cells in various bones. It is a monostotic (involving only one bone) or polyostotic (involving more than one bone) disease. It typically has no extraskeletal involvement, but rarely an identical lesion can be found in the skin, lungs, or stomach.

85
Q

What is the prognosis for unifocal LCH (eosinophilic granuloma)? Treatment?

A

most benign–relative good prognosis

Treatment = Excision or XRT

86
Q

What are the LM and EM findings of LCH?

A 
LM = Dermal infiltration of monocytes and giant cells. Crinkled appearance to nuclei
EM = Birbeck granules
87
Q

What is the immunostain for LCH?

A

CD1a

88
Q

What is benign fibrous histiocytoma (dermatofibroma)?

A

Benign, tan-brown papules, with size varying over time. Related to dermal neoplasms of fibroblasts and histiocytes

89
Q

What are the histological findings of dermatofibromas?

A

Spindle cells appearance that trap collagen bundles (“doughnut sign”)

90
Q

What is the most common CT tumor?

A

Lipomas

91
Q

What are pyogenic granulomas?

A

Hemangiomas

(This name is misleading as it is not a true granuloma. In actuality, it is a capillary hemangioma of lobular subtype which is the reason they are prone to bleeding.[4] Additionally, it is also not truly pyogenic, (“pus producing”) as the cause is hormonal or traumatic and has no association with infection or pus production.)

92
Q

What are cavernous hemangiomas?

A

Big vessel proliferation

93
Q

What are arteriovenous hemangiomas?

A

Mix of thin and thick walled vessels

94
Q

What are traumatic neuromas? S/sx?

A

A type of neuroma which results from trauma to a nerve, resulting in a disorderly proliferation of bundle of peripheral nerves
-Usually painful nodule
-

95
Q

What are the histological characteristics of traumatic neuromas?

A

haphazard neuron proliferation

96
Q

What is Morton’s neuroma? S/sx?

A

A benign neuroma of an intermetatarsal plantar nerve, most commonly of the second and third intermetatarsal spaces, which results in the entrapment of the affected nerve.

-The main symptoms are pain and/or numbness that is exacerbated by walking.

97
Q

True or false: Morton’s neuroma usually present with a large, palpable mass

A

False–usually no mass is palpable

98
Q

what are the three diseases of MEN1?

A
  • Pituitary adenomas
  • Pancreatic tumors
  • Parathyroid
99
Q

What are the three diseases of MEN2a?

A
  • Medullary thyroid CA
  • Parathyroid hyperplasia
  • Pheochromocytoma
100
Q

What are the three diseases of MEN2b?

A
  • Medullary thyroid CA
  • Mucosal neuromas
  • Pheochromocytoma
101
Q

What are the histological findings of mucosal neuromas?

A

Mucosal nodules with tiny nerve-lets

102
Q

what are palisaded encapsulated neuromas? what age range are they usually found in?

A

Solitary, painless nodules that are commonly found on the face.

middle aged to old

103
Q

What are schwannomas? Where on the body are they more prevalent?

A

a benign nerve sheath tumor composed of Schwann cells, which normally produce the insulating myelin sheath covering peripheral nerves.

104
Q

Is there an association of schwannomas with NF?

A

Per him, no, but in reality, yes.

105
Q

What is the usual presentation of schwannomas? How often do they recur?

A

Solitary, painless SQ mass

Little capacity of recurrence

106
Q

What is the antoni A type of schwannomas?

A

Cellular with nuclear palisading (verocay bodies)

107
Q

What is the antoni B type of schwannomas?

A

Schwann cells, but hypocellular, with a myxoid matrix

108
Q

Why are the blood vessels prominent with schwannomas?

A

Thick hyaline walls

109
Q

Cellular with nuclear palisading (verocay bodies)

A

Antoni A

110
Q

Schwann cells, but hypocellular, with a myxoid matrix

A

Antoni B

111
Q

What are the characteristics of neurofibromas?

A

Solitary polypoid or nodular lesion with a wide distribution

112
Q

What are the histological characteristics of neurofibromas?

A

Circumscribed, but unencapsulated, with a sheet like wavy nerve cells

113
Q

Circumscribed, but unencapsulated, with a sheet like wavy nerve cells = ?

A

neurofibroma

114
Q

What are plexiform neurofibromas?

A

a benign tumor of peripheral nerves (WHO grade I) arising from a proliferation of all neural elements, pathognomonic of neurofibromatosis type 1 (NF1). It involves single or multiple nerve fascicles that arises from major nerve branches.

115
Q

plexiform neurofibromas = what disease

A

NF1

116
Q

What are granular cell tumors?

A

a tumor that can develop on any skin or mucosal surface, but occurs on the tongue 40% of the time.

117
Q

what are the histological characteristics of granular cell tumors?

A

Proliferation of cells with granular pink cytoplasm

118
Q

Which gender usually gets granular cell tumors?

A

Females

119
Q

Are granular cell tumors fast of slow growing? Recurrence rate? Treatment?

A

Slow growing
Low recurrence
Excise

120
Q

What are the two versions of leiomyomas?

A

Pilar

Angio

121
Q

What are giant cell tumors of the tendon sheath?

A

Uncommon and usually benign lesions that arise from the tendon sheath

122
Q

Where are giant cell tumors of tendon sheaths usually found?

A

hand, feet, wrists, knees and other small joints

123
Q

What is the prognosis for giant cell tumors of the tendon sheath? Treatment?

A

Benign, but can recur

excise

124
Q

What are the histological findings of GCTTS?

A

Giant cells with PMNs in the background

125
Q

What are ganglion cysts? Where are they usually found? What causes them? S/sx?

A
  • Myxoid degeneration of a joint capsule, usually found in the wrist, hand, foot, and ankle.
  • Caused by overuse
  • Pain or weakness
126
Q

What are the histological characteristics of ganglion cysts?

A

pseudocysts-no epithelial lining

Cystic space ling by histiocytes and granulation tissue with moderate inflammation

127
Q

Cystic space ling by histiocytes and granulation tissue with moderate inflammation = ?

A

Ganglion cysts

128
Q

What are superficial fibromatosis? (hand, plantar, penis)

A

Proliferation of spindle cells in tissue of various sites:

Hand = dupuytren’s contracture

Plantar = Ledderhose dz

Penile = peyrones disease

129
Q

True or false: superficial fibromatosis usually has beta catenin mutaitons

A

False

Specialty Medicine (36 decks)

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