Dermatopathology: Pigmented Lesions Flashcards
1
Q
Which layer of skin are melanocytes normally found in?
A
Basal layer
2
Q
Does melanocyte density vary with race?
A
No
3
Q
Organelle of melanocytes that is incorporated into keratinocytes
A
Melanosome
4
Q
Autoimmune destruction of melanocytes
A
Vitiligo
5
Q
What races are affected by Vitiligo?
A
All
6
Q
Generalized form of vitiligo that affects almost the entire body
A
Vitiligo universalis
7
Q
Condition involving circumscribed amelanotic macules of skin and mucous membranes
A
Vitiligo
8
Q
10-15% of patients with generalized vitiligo have this
A
Systemic autoimmune disease
(e.g. Hashimoto’s thyroiditis, Pernicious anemia, Lupus)
9
Q
Condition where histology shows absent melanocytes
A
Vitiligo
10
Q
Inherited reduction or absence of pigmentation
A
Albinism
11
Q
Inheritance pattern of albinism
A
Autosomal recessive
12
Q
Albinism is usually due to a mutation in this
A
Tyrosinase
13
Q
Amount of melanocytes in Vitiligo
A
Absent
14
Q
Amount of melanocytes in Albinism
A
Normal numbers
15
Q
Is Vitiligo S100 positive?
A
No; absent melanocytes
16
Q
Is Albinism S100 positive?
A
Yes; melanocytes are present in normal numbers
17
Q
Patients with Albinism have increased rates of this cancer
A
Squamous cell carcinomas
18
Q
UV light induced small pigmented molecule
A
Ephelis
19
Q
Does an Ephelis occur with the sun?
A
Yes
20
Q
Localized area of non-nested melanocyte hyperplasia
A
Lentigo
21
Q
Form of Lentigo that occurs in childhood
A
Lentigo simplex
22
Q
Form of Lentigo that has no relation to sun exposure
A
Lentigo simplex
23
Q
Form of Lentigo that occurs in elderly
A
Solar lentigo
24
Q
Form of Lentigo that involves sun damaged skin
A
Solar lentigo
25
Form of Lentigo that is typically a small (<1cm) tan brown macule
Lentigo simplex
26
Form of Lentigo that is typically 1-3cm and may be confluent
Solar lentigo
27
Form of Lentigo that occurs in childhood, has no relation to sun exposure, and is typically a small (<1cm) tan brown macule
Lentigo simplex
28
Form of Lentigo that occurs in elderly, to sun damaged skin, and is typically 1-3cm and may be confluent
Solar lentigo
29
Localized hyperpigmentation of mucosal site
Mostly on lip, oral mucosa, genitals
Melanotic macule
30
Does lentigo involve nesting?
No
31
Does a melanotic macule involve nesting?
No
32
Inheritance pattern of Peutz-Jaeger Syndrome
Autosomal dominant
33
Syndrome associated with melanotic macules
Involves multiple lentigines, usually orofacial
Peutz-Jaeger Syndrome
34
Syndrome associated with melanotic macules that involves Hamartomatous GI polyps
Peutz-Jaeger Syndrome
35
Peutz-Jaeger Syndrome has increased risk of these 2 types of cancer
Intestinal and breast cancer
36
Condition involving few to dozens of hamartomatous GI polyps that are usually lobulated with arborizing smooth muscle
Peutz-Jaeger Syndrome
37
Benign neoplasm of melanocytes
Melanocytic nevus
38
Is a melanocytic nevus nested?
Yes, if at dermal-epidermal junction
39
Most melanocytic nevi have mutations in either of these 2 oncogene pathways
RAS or BRAF
40
Type of melanocytic nevus that tend to be flat
Junctional nevus
41
Type of cells that are involved with regression
CD8+ T cells
42
Halo Nevus has an increased incidence in patients with this condition
Vitiligo
43
Numerous lymphocytes infiltrating the nevus and a pale halo around it indicate this process is occurring
Regression
44
Multiple or giant congenital nevi have association with this condition
Neurocutaneous melanosis
45
These have an association with neurocutaneous melanosis
Multiple or giant congenital nevi
46
CNS symptoms of neurocutaneous melanosis are due to this
Leptomeningeal melanocytosis
47
Most common activating mutation in malignant melanoma
BRAF
48
Drug that inhibits BRAF ser/thr protein kinase
Vemurafenib
49
Vemurafenib inhibits this
BRAF ser/thr protein kinase
Is used to treat melanoma
50
Mutation in this is more common in malignant melanoma in acral sites
kit
51
Do malignant melanomas arise from benign nevi?
Most do not
52
Diameter greater than this could indicate malignant melanoma
>6mm (pencil eraser size)
53
This describes melanocytes at elevated levels of epidermis
Pagetoid
54
What are pagetoid melanocytes?
Melanocytes at elevated levels of epidermis
55
This describes melanocytes confluent along the dermo-epidermal junction
Lentiginous
56
What are Lentiginous melanocytes?
Melanocytes confluent along dermo-epidermal junction
57
Does melanoma in situ have a risk of metastasis?
No
58
What skin layer are malignant melanocytes located in melanoma in situ?
Limited to epidermis
59
Does melanoma have lentiginous or pagetoid growth?
Can have either
60
What skin layer are malignant melanocytes located in invasive melanoma?
Dermis
61
What is the most important factor of primary tumor in invasive melanoma?
Depth of invasion
62
Growth pattern of malignant melanoma along the plane of dermal-epidermal junction
Radial phase
63
Growth pattern of malignant melanoma that is downward into dermis
Vertical phase
64
Increasing depth of malignant melanoma has what effect on the ability to metastasize?
Increases
65
Vertical growth of malignant melanoma is correlated with mutations in this
p16
66
p16 mutations are correlated with this type of growth of malignant melanoma
Vertical phase
67
Form of melanoma in situ that typically involves sun damaged skin of elderly
Slowly expanding growth, may have no invasion
Lentigo maligna
68
What is the typical patient with Lentigo maligna?
Sun damaged skin of elderly
69
Does Lentigo maligna have invasion?
No; slow growing
70
What does Lentigo maligna look like?
Variable, asymmetric, but flat
Slow growing
Is a form of melanoma in situ
71
Invasive melanoma arising in Lentigo maligna
Lentigo maligna melanoma
72
What is the clinical appearance of Lentigo maligna melanoma?
Same as Lentigo maligna but with invasion
Nodular, thicker, ulcerated, rapidly changing area
73
Is Lentigo maligna related to sun exposure?
Yes, typically involves sun damaged skin of elderly
74
Is superficial spreading malignant melanoma related to sun exposure?
Yes, most arise from sun exposed skin
75
What is the prognosis of Superficial spreading malignant melanoma?
Relatively good
Tends to be more superficial, radial phase is prolonged
76
Uncommon form of invasive melanoma defined by lack of radial growth phase
Predominately invasive
Nodular melanoma
77
What defines nodular melanoma?
Lack of radial growth phase
Predominately invasive
78
Melanoma arising in palms, soles, subungual sites
Acral lentiginous melanoma
79
What population is Acral lentiginous melanoma more common in?
Non-Caucasians
80
Melanoma in palms, soles, subungual sites
c-kit may be involved
Acral lentiginous melanoma
81
S100, MelanA, Sox10, HMB45, Mart1 are markers for this
Malignant melanoma
82
Atypical nevus which does not fulfill criteria for malignancy
Dysplastic nevus
83
Can Dysplastic nevus evolve into melanoma?
It can yes
84
Multiple dysplastic nevi is a marker for what?
Increased whole body risk of melanoma
85
Dysplastic nevus syndrome is due to a mutation in this
CDKN2A (cyclic-dependent kinase inhibitor 2A)
86
CDKN2A mutation causes this condition
Dysplastic nevus syndrome
87
Patients with Dysplastic nevus syndrome have a high lifetime rate of this
Melanoma
