Dermatopathology 05

Question 1

What is the condition being seen here?

Answer 1

seborrheic keratosis

fly stuck on a wall appearance

Question 2

What is the condition evidenced in this image?

Answer 2

fibroepithelial polyp

Question 3

How are epithelial or follicular inclusion cysts formed?

Answer 3

formed by invagination and cystic expansion of epidermis or a hair follicle

Question 4

Follicular inclusion Cyst?

Answer 4

Wen

Question 5

What is an epithelial or follicular inclusion cyst?

Answer 5

traumatic rupture of large cysts that can spill keratin into the dermis leading to an extensive and painful granulomatous inflammatory response

Question 6

What is the condition being seen here?

Answer 6

actinic keratosis

Question 7

Understand this slide.

Answer 7

Understand slide.

Question 8

What condition is being seen here?

Answer 8

Dermatofibrosarcoma Protuberans

Question 9

What are some associations of Adnexal (appendage) tumors?

Answer 9

1. May be associated with Mendelian patterns of inheritance and occur as multiple disfiguring lesions
2. Association between multiple trichilemmomas and Cowden syndrome

Question 10

What is Cowden syndrome?

Answer 10

germline loss of function mutations in PTEN associated with an increased risk of endometrial cancer, breast cancer, facial tricheilemmomas, hypertrichosis, gingival fibrzomatosis, oral mucosal papillomas, small bowel and colonic hamartomatous polyps (non-Peutz Jegher’s)

Question 11

Where are Ecrine promos mostly found?

Answer 11

mostly on palms and soles (numerous sweat glands)

Question 12

What are the clinical features of cylindromas?

Answer 12

forehead and scalp “Turban tumor)

Question 13

What is the appearance of Cylindromas on histology?

Answer 13

Islands of basaloid cells fit together like pieces of a jigsaw puzzle within a fibrous dermal matrix

Question 14

Pathology of Cylindromas?

Answer 14

May be dominantly inherited, appear early in life, inactivating mutations in the tumor suppressor gene CYLD

Question 15

What appendageal areas do cylindromas affect?

Answer 15

ductal (apocrine or eccrine) differentiation

Question 16

What are syringomas?

Answer 16

lesions with eccrine differentiation, multiple, small, tan papules in the vicinity of the lower eyelids

Question 17

What are trichoepitheliomas?

Answer 17

proliferation of basaloid cells that forms primitive structures resembling hair follicles

Question 18

What are sebaceous adenomas associated with?

Answer 18

• Associated with internal malignancy in Muir-Torre syndrome (subset of HNPCC)

Question 19

How do sebaceous adenomas appear on histology?

Answer 19

• Lobular proliferation of sebocytes with peripheral basaloid cells and mature sebocytes in the central portion, characterized by frothy or bubbly cytoplasm due to lipid vesicle content

Question 20

Pathogenesis of pilomatricomas?

Answer 20

• Associated with activating mutations in CTNNB1 (gene encoding β-catenin)
• Wnt signaling through β-catenin is critical for early hair development and regulates hair growth and maintenance

Question 21

What is pilomatricomas?

Answer 21

Adnexal tumor showing abnormality in follicular differentiation

Question 22

Where are apocrine carcinomas typically found?

Answer 22

in axilla and scalp

Question 23

Describe urticaria pigmentos in mastocyosis.

Answer 23

Multiple and widely distributed lesions

Round to oval, red-brown, non-scaling papule and small plaques

Question 24

Describe solitary mastocytoma.

Answer 24

pink to tan-brown nodule that may be pruritic or show blister