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Dr. Murrahs class > Chapter 10: Epithelial Pathology PART 1 > Flashcards

Chapter 10: Epithelial Pathology PART 1 Flashcards

1
Q

___ is the benign proliferation of stratified squamous epithelium that results from a papillary mass

A

squamous papilloma

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2
Q

squamous papilloma is caused by ___

A
  • human papillomavirus (HPV)
    • DNA virus of the papovavirus subgroup
    • types 6 and 11
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3
Q

what is the mode of transmission of squamous papilloma caused by HPV?

A

unknown

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4
Q

what is the virulence and infectivity rate of squamous papilloma caused by HPV?

A

extremely low virulence and infectivity rate

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5
Q

___ is the ability of a virus to overcome the body’s defenses and cause disease

A

virulence

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6
Q

___ is the ability of a virus to establish infection from one person to another horizontally

A

infectivity

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7
Q

squamous papilloma affts 1 in ___ people

A

250

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8
Q

what are the sites of predilection of squamous papilloma?

A

tongue, lips, and hard palate

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9
Q

how does squamous papilloma present clinically?

A
  • painless
  • usually pedunculated
  • exophytic
  • pointed or blunted projections
  • white, red, or mucosal colored
  • enlarges rapidly to 5mm, then stabilizes
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10
Q

what is the differential diagnosis of squamous papilloma?

A
  • verucca vulgaris
  • condyloma acuminatum
  • verruciform xanthoma
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11
Q

what is the treatment/prognosis for squamous papilloma?

A

conservative surgical excision is curative

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12
Q
A

squamous papilloma

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13
Q
A

squamous papilloma

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14
Q
A

squamous papilloma

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15
Q

verruca vulgaris is commonly called a ___

A

wart

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16
Q

verruca vulgaris is caused by which HPV types?

A

2, 4, 6, 40

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17
Q

is verruca vulgaris contagious?

A

yes

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18
Q

verruca vulgaris is extremely common on what part of the body?

A

the skin

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19
Q

verruca vulgaris is frequently discovered in what type of patient, and where on the body?

A

children on skin of the hands

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20
Q

what is the clinical presentation of verruca vulgaris?

A
  • painless papule or nodule
  • papillary projections or a rough, pebbly surface
  • oral lesions are almost always white
  • cutaneous lesions are skin-colored, yellow, or white
  • can be pedunculated or sessile
  • maximum size is about 5mm
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21
Q

___ lesions are commonly multiple or clustered

A

verruca vulgaris

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22
Q

what is the differential diagnosis for verruca vulgaris?

A

same as squamous papilloma

  • condyloma acuminatum
  • verruciform xanthoma
  • squamous papilloma
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23
Q

what is the treatment/prognosis of verruca vulgaris?

A
  • oral lesions are surgically excised
  • recurrences are possible
  • no chance of malignant transformation
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24
Q

condyloma acuminatum is also known as ___

A

venereal wart

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25
Q

condyloma acuminatum is caused by what virus? what types?

A

HPV

  • type 2, 53, 54
  • types 6 and 11 - most common
  • types 16, 18, and 31 - high risk
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26
Q

condyloma acuminatum is considered a ___ transmitted disease

A

sexually

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27
Q

condyloma acuminatum makes up ___% of all STDs

A

20

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28
Q

incubation of condyloma acuminatum occurs in what time frame after sexual contact?

A

1-3 months

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29
Q
A

squamous papilloma

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30
Q
A

verruca vulgaris

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31
Q
A

verruca vulgaris

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32
Q
A

intraoral verruca vulgaris

notice the color - this one is white, whereas a squamous papilloma would be more mucosal-colored

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33
Q
A

verruca vulgaris

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34
Q
A

condyloma acuminatum

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35
Q
A

condyloma acuminatum

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36
Q

what is the clinical presentation of condyloma acuminatum?

A
  • painless
  • sessile
  • mucosal colored
  • well-demarcated
  • exophytic
  • short, blunted surface projection
  • characteristically clustered with other condyloma
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37
Q

what is the average size of condyloma acuminatum?

A

1-1.5cm

this is twice as large as papilloma or verruca vulgaris

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38
Q

what is the differential diagnosis of condyloma acuminatum?

A

same as squamous papilloma

  • verruca vulgaris
  • squamous papilloma
  • verruciform xanthoma
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39
Q

what is the treatment/prognosis of condyloma acuminatum?

A
  • conservative surgical excision
  • recurrences are possible
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40
Q

in the anogenital area, condyloma acuminatum cases that are caused by HPV-16 or HPV-18 are at increased risk for ___

A
  • malignant transformation to squamous cell carcinoma
    • this has not been demonstrated in oral lesions
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41
Q

multifocal epithelial hyperplasia is also called ___

A

heck’s disease

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42
Q

multifocal epithelial hyperplasia is caused by what virus?

A

HPV types 13 and 32

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43
Q

what is the clinical presentation of multifocal epithelial hyperplasia?

A
  • appears in childhood
  • multiple lesions
  • painless
  • flattened or rounded papules which cluster
  • can appear cobblestoned
  • mucosal colored
  • might have slight papillary surface change
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44
Q

what is the treatment/prognosis of multifocal epithelial hyperplasia?

A
  • spontaneously regresses
  • may perform conservative surgical excision
  • risk of recurrence is minimal
  • no risk of malignant transformation
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45
Q
A

multifocal epithelial hyperplasia

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46
Q
A

multifocal epithelial hyperplasia

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47
Q
A

multifocal epithelial hyperplasia

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48
Q

___ are benign, localized proliferations of respiratory mucosa

A

sinonasal papillomas

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49
Q

what are the 3 distinct patterns of sinonasal papillomas?

A
  • fungiform
  • inverted
  • cylindrical cell
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50
Q

50% of sinonasal papillomas arise from ___; where are the rest from?

A
  • lateral nasal wall
  • the rest are from the septum and sinuses
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51
Q

can sinonasal papillomas present as multiple lesions?

A

yes

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52
Q

what is the etiology of sinonasal papillomas?

A

it is unclear

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53
Q
A

fungiform sinonasal papilloma

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54
Q
A

inverted sinonasal papilloma

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55
Q

which sinonasal papilloma arises almost exclusively on the nasal septum?

A

fungiform

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56
Q

what is the treatment of fungiform sinonasal papilloma? what is the recurrence?

A
  • complete surgical excision
  • recurrence is common (1/3)
57
Q

what is the risk for malignant transformation of fungiform sinonasal papilloma?

A

minimal to no risk

58
Q

inverted sinonasal papilloma is also called ___

A

inverted schneiderian papilloma

59
Q

which sinonasal papilloma is the most common of the 3 types?

A

inverted

60
Q

which sinonasal papilloma has the greatest potential for destruction and transformation?

A

inverted

61
Q

what is the male:female ratio of inverted sinonasal papillomas?

A

3:1 M>F

62
Q

what is the most common location of inverted sinonasal papillomas?

A

lateral nasal wall or sinus

63
Q

which sinonasal papilloma has significant growth potential?

A

inverted

64
Q

what is the recurrence of inverted sinonasal papillomas after surgery?

A

75% recur after conservative surgery; 15% after aggressive surgery

65
Q

up to 25% of ___ will undergo malignant transformation into squamous cell carcinoma

A

inverted sinonasal papillomas

66
Q

cylindrical cell sinonasal papilloma is also called ___

A

oncocytic schneiderian papilloma

67
Q

which is the most rare of the 3 types of sinonasal papillomas?

A

cylindrical cell sinonasal papilloma

68
Q

where do cylindrical cell sinonasal papillomas usually occur?

A

on the lateral nasal wall

69
Q

how is cylindrical cell sinonasal papilloma treated?

A

same as inverted papilloma - surgically

70
Q

what is the risk for recurrence and malignant transformation of cylindrical cell sinonasal papillomas?

A

lower than that of inverted papilloma

71
Q

___ is virally-induced epithelial hyperplasia

A

molluscum contagiosum

72
Q

molluscum contagiosum is caused by ___

A

DNA poxvirus

73
Q

how does molluscum contagiosum clinically present?

A
  • typically seen in children
  • painless
  • skin-colored
  • sessile
  • papules
  • smooth surfaced
74
Q

what is the average size of a molluscum contagiosum lesion?

A

3mm

75
Q

molluscum contagiosum is more prevalent among ___ patients

A

immunocompromised

76
Q

what is the histopathology of molluscum contagiosum?

A

contains molluscum bodies, aka henderson-paterson bodies

77
Q
A

molluscum contagiosum

78
Q
A

molluscum contagiosum

79
Q

what is the treatment/prognosis of molluscum contagiosum?

A
  • spontaneous remission occurs in 9 months
  • treated to decrease risk of transmission
  • removed by curettage or cryotherapy
80
Q

what is the potential for malignant transformation of molluscum contagiosum?

A

no potential

81
Q

___ is a hyperplastic condition which is largely an oral disease of unknown cause (likely trauma)

A

verruciform xanthoma

82
Q

verruciform xanthoma is characterized by ___ in the epithelium

A

lipid-laden histiocytes

83
Q

is verruciform xanthomas associated with a disorder?

A

no

84
Q

what is the clinical presentation of verruciform xanthoma?

A
  • most common on gingiva
  • painless
  • sessile (slightly elevated)
  • papillary or roughened surface
  • mucosal, white, yellow, or red in color
  • can have multiple lesions
85
Q

what is the size of verruciform xanthoma lesions?

A

smaller than 2cm

86
Q

what is the differential diagnosis of verruciform xanthoma?

A

same as squamous papilloma

87
Q

histology for verruciform xanthoma is positive for ___

A

xanthoma cells - lipid-laden histiocytes

88
Q

what is the treatment/prognosis for verruciform xanthoma?

A
  • conservative surgical excision
  • recurrence is rare
  • no risk of malignant transformation
89
Q

histology is positive for lipid-laden histiocytes

A

verruciform xanthoma

90
Q

histology is positive for lipid-laden histiocytes

A

verruciform xanthoma

91
Q

___ are extremely common skin lesions of older people that do not occur in the mouth (develop on the skin of the face, trunk, and extremities), and there are typically multiple lesions

A

seborrheic keratosis

92
Q

seborrheic keratosis is an acquired, benign proliferation of ___ of unknown etiology

A

epidermal basal cells

93
Q

seborrheic keratosis lesions become more prevalent with ___

A

age

94
Q

seborrheic keratosis start as ___ macules, and appear ___ skin

A
  • small, tan to brown
  • stuck onto
95
Q

what is the size of seborrheic keratosis lesions?

A

usually less than 2cm in diameter

96
Q

___ is a form of seborrheic keratosis that occurs in 30% of african americans

A

dermatosis papulosa nigra

97
Q

how is dermatosis papulosa nigra inherited? what does it look like clinically? where is it found?

A
  • autosoma dominant
  • multiple, 2mm black papules
  • found scattered around the zygomatic and periorbital region
98
Q

what is the treatment/prognosis of seborrheic keratosis?

A
  • seldom removed except for esthetics
  • no malignant potential
99
Q

sudden appearance of numerous seborrheic keratoses with pruritus has been associated with ___, which is called ___

A
  • internal malignancy
  • leser-trelat sign
100
Q
A

seborrheic keratosis

101
Q
A

seborrheic keratosis

102
Q
A

seborrheic keratosis

103
Q
A

dermatosis papulosa nigra

104
Q

ephelis is also known as a ___

A

freckle

105
Q

___ is a common hyperpigmented macule of the skin

A

ephelis

106
Q

what is ephelis caused by?

A

an increase in melanin production without an increase in the number of melanocytes

107
Q

ephelis is more prominent in what populations?

A

children, and people with light skin and light hair

108
Q

ephelis can become more pronounced with exposure to what?

A

the sun

109
Q

ephelis is closely associated with a history of ___

A

painful childhood sunburns

110
Q

how does ephelis clinically appear?

A

as light brown macules in variable numbers

111
Q

what is the treatment of ephelis? what can prevent it?

A
  • no treatment necessary
  • sunscreen use can prevent new or darkening of lesions
112
Q
A

ephelis

113
Q

actinic lentigo is a benign brown macule that results from ___

A

chronic UV light damage to the skin

114
Q

actinic lentigo affects more than ___% of caucasians older than age ___

A
  • 90%
  • 70
115
Q

actinic lentigo is common on what parts of the body?

A

dorsal surface of hands, face, and arms

116
Q

T or F:

actinic lentigo presents as irregularly pigmented tan macules with well-demarcated, regular borders

A

false

they are uniformly pigmented tan macules with well-demarcated but irregular borders

117
Q

do actinic lentigo lesions change in color intensity with UV light exposure, like ephelis?

A

no

118
Q

what is the treatment for actinic lentigo?

A

no treatment except for esthetics

119
Q

does actinic lentigo undergo malignant transformation?

A

no

120
Q
A

actinic lentigo

121
Q
A

actinic lentigo

122
Q

what is lentigo simplex?

A

a benign cutaneous melanocytic hyperplasia (increase in number of melanocytes)

123
Q

what is the cause of lentigo simplex?

A

unknown cause

124
Q

where on the body does lentigo simplex typically occur?

A

on skin not exposed to sunlight

125
Q

what age patient does lentigo simplex occur in most commonly

A

can happen at any age but is most common in children

126
Q

lentigo simplex appears as a macule smaller than ___ with a ___ color

A
  • 5mm
  • uniform brown color
127
Q

does the color intensity of lentigo simplex change with sunlight?

A

no

128
Q

lentigo simplex is indistinguishable from ___

A

nonelevated melanocyte nevus

129
Q

what is the treatment of lentigo simplex? do these lesions undergo malignant transformation?

A

treatent is not required, and the lesions do not undergo malignant transformation

130
Q

___ is acquired, symmetrical, hormonally-driven hyperpigmentation of the sun-exposed skin of the face

A

melasma

131
Q

melasma is classically associated with ___

A

pregnancy

132
Q

what population is at greater risk of melasma?

A

dark-complected women

133
Q

how does melasma clinically present?

A

bilateral light brown macules which vary in size

134
Q

describe pigmentation of melasma over time

A

it can remain faint or it can darken over time

135
Q

is melasma difficult to treat?

A

yes

136
Q

what is necessary for the clinical management of melasma?

A

using sunscreen and/or avoiding the sun

137
Q

is there a risk of malignant transformation of melasma?

A

no

138
Q
A

lentigo simplex

139
Q
A

melasma

Dr. Murrahs class (17 decks)

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