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Skin & MSK > Dermatopathology: Pigmented Lesions > Flashcards

Dermatopathology: Pigmented Lesions Flashcards

1
Q

Which layer of skin are melanocytes normally found in?

A

Basal layer

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2
Q

Does melanocyte density vary with race?

A

No

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3
Q

Organelle of melanocytes that is incorporated into keratinocytes

A

Melanosome

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4
Q

Autoimmune destruction of melanocytes

A

Vitiligo

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5
Q

What races are affected by Vitiligo?

A

All

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6
Q

Generalized form of vitiligo that affects almost the entire body

A

Vitiligo universalis

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7
Q

Condition involving circumscribed amelanotic macules of skin and mucous membranes

A

Vitiligo

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8
Q

10-15% of patients with generalized vitiligo have this

A

Systemic autoimmune disease
(e.g. Hashimoto’s thyroiditis, Pernicious anemia, Lupus)

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9
Q

Condition where histology shows absent melanocytes

A

Vitiligo

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10
Q

Inherited reduction or absence of pigmentation

A

Albinism

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11
Q

Inheritance pattern of albinism

A

Autosomal recessive

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12
Q

Albinism is usually due to a mutation in this

A

Tyrosinase

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13
Q

Amount of melanocytes in Vitiligo

A

Absent

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14
Q

Amount of melanocytes in Albinism

A

Normal numbers

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15
Q

Is Vitiligo S100 positive?

A

No; absent melanocytes

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16
Q

Is Albinism S100 positive?

A

Yes; melanocytes are present in normal numbers

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17
Q

Patients with Albinism have increased rates of this condition

A

Squamous cell carcinomas

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18
Q

UV light induced small pigmented molecule

A

Ephelis

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19
Q

Does an Ephelis occur with the sun?

A

Yes

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20
Q

Localized area of non-nested melanocyte hyperplasia

A

Lentigo

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21
Q

Form of Lentigo that occurs in childhood

A

Lentigo simplex

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22
Q

Form of Lentigo that has no relation to sun exposure

A

Lentigo simplex

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23
Q

Form of Lentigo that occurs in elderly

A

Solar lentigo

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24
Q

Form of Lentigo that involves sun damaged skin

A

Solar lentigo

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25
Q

Form of Lentigo that is typically a small (<1cm) tan brown macule

A

Lentigo simplex

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26
Q

Form of Lentigo that is typically 1-3cm and may be confluent

A

Solar lentigo

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27
Q

Form of Lentigo that occurs in childhood, has no relation to sun exposure, and is typically a small (<1cm) tan brown macule

A

Lentigo simplex

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28
Q

Form of Lentigo that occurs in elderly, to sun damaged skin, and is typically 1-3cm and may be confluent

A

Solar lentigo

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29
Q

Localized hyperpigmentation of mucosal site
Mostly on lip, oral mucosa, genitals

A

Melanotic macule

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30
Q

Does lentigo involve nesting?

A

No

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31
Q

Does a melanotic macule involve nesting?

A

No

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32
Q

Inheritance pattern of Peutz-Jaeger Syndrome

A

Autosomal dominant

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33
Q

Syndrome associated with melanotic macules
Involves multiple lentigines, usually orofacial

A

Peutz-Jaeger Syndrome

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34
Q

Syndrome associated with melanotic macules that involves Hamartomatous GI polyps

A

Peutz-Jaeger Syndrome

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35
Q

Peutz-Jaeger Syndrome has increased risk of these 2 types of cancer

A

Intestinal and breast cancer

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36
Q

Condition involving few to dozens of hamartomatous GI polyps that are usually lobulated with arborizing smooth muscle

A

Peutz-Jaeger Syndrome

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37
Q

Benign neoplasm of melanocytes

A

Melanocytic nevus

38
Q

Is a melanocytic nevus nested?

A

Yes, if at dermal-epidermal junction

39
Q

Most melanocytic nevus have mutations in either of these 2 oncogene pathways

A

RAS or BRAF

40
Q

Type of melanocytic nevus that tend to be flat

A

Junctional nevus

41
Q

In the lifecycle of this pigmented lesion, one stage involves neurotization of the dermal component

A

Melanocytic nevus

42
Q

Type of cells that are involved with regression

A

CD8+ T cells

43
Q

Halo Nevus has an increased incidence in patients with this condition

A

Vitiligo

44
Q

Numerous lymphocytes infiltrating the nevus and a pale halo around it indicate this process is occurring

A

Regression

45
Q

Multiple or giant congenital nevi also have association with this condition

A

Neurocutaneous melanosis

46
Q

These have an association with neurocutaneous melanosis

A

Multiple or giant congenital nevi

47
Q

CNS symptoms of neurocutaneous melanosis are due to this

A

Leptomeningeal melanocytosis

48
Q

Greater than this many melanocytic nevi cause an 8-10 fold increased relative risk in malignant melanoma

A

> 100

49
Q

Greater than this many atypical nevi cause a 4-6 fold increased relative risk in malignant melanoma

A

> 5

50
Q

Most common activating mutation in malignant melanoma

A

BRAF

51
Q

Drug that inhibits BRAF ser/thr protein kinase

A

Vemurafenib

52
Q

Vemurafenib inhibits this

A

BRAF ser/thr protein kinase

53
Q

Mutation in this is more common in malignant melanoma in acral sites

A

kit

54
Q

Do malignant melanomas arise from benign nevi?

A

Most do not

55
Q

Diameter greater than this could indicate malignant melanoma

A

> 6mm (pencil eraser size)

56
Q

This describes melanocytes at elevated levels of epidermis

A

Pagetoid

57
Q

What are pagetoid melanocytes?

A

Melanocytes at elevated levels of epidermis

58
Q

This describes melanocytes confluent along the dermo-epidermal junction

A

Lentiginous

59
Q

What are Lentiginous melanocytes?

A

Melanocytes confluent along dermo-epidermal junction

60
Q

3 characteristics of dermal (invasive) component of malignant melanoma

A

Lack of maturation
Deep mitosis
Cellular atypia

61
Q

Does melanoma in situ have a risk of metastasis?

A

No

62
Q

What skin layer are malignant melanocytes located in melanoma in situ?

A

Limited to epidermis

63
Q

Does melanoma have lentiginous or pagetoid growth?

A

Can have either

64
Q

What skin layer are malignant melanocytes located in invasive melanoma?

A

Dermis

65
Q

What is the most important factor of primary tumor in invasive melanoma?

A

Depth of invasion

66
Q

Growth pattern of malignant melanoma along the plane of dermal-epidermal junction

A

Radial phase

67
Q

Growth pattern of malignant melanoma that is downward into dermis

A

Vertical phase

68
Q

Increasing depth of malignant melanoma has what effect on the ability to metastasize?

A

Increases

69
Q

Vertical growth of malignant melanoma is correlated with mutations in this

A

p16

70
Q

p16 mutations are correlated with this type of growth of malignant melanoma

A

Vertical phase

71
Q

Form of melanoma in situ that typically involves sun damaged skin of elderly
Slowly expanding growth, may have no invasion

A

Lentigo maligna

72
Q

What is the typical patient with Lentigo maligna?

A

Sun damaged skin of elderly

73
Q

Does Lentigo maligna have invasion?

A

No; slow growing

74
Q

What does Lentigo maligna look like?

A

Variable, asymmetric, but flat
Slow growing
Is a form of melanoma in situ

75
Q

Invasive melanoma arising in Lentigo maligna

A

Lentigo maligna melanoma

76
Q

What is the clinical appearance of Lentigo maligna melanoma?

A

Same as Lentigo maligna but with invasion
Nodular, thicker, ulcerated, rapidly changing area

77
Q

Is Lentigo maligna related to sun exposure?

A

Yes, typically involves sun damaged skin of elderly

78
Q

Is superficial spreading malignant melanoma related to sun exposure?

A

Yes, most arise from sun exposed skin

79
Q

What is the prognosis of Superficial spreading malignant melanoma?

A

Relatively good
Tends to be more superficial, radial phase is prolonged

80
Q

Uncommon form of invasive melanoma defined by lack of radial growth phase
Predominately invasive

A

Nodular melanoma

81
Q

What defines nodular melanoma?

A

Lack of radial growth phase
Predominately invasive

82
Q

Melanoma arising in palms, soles, subungual sites

A

Acral lentiginous melanoma

83
Q

What population is Acral lentiginous melanoma more common in?

A

Non-Caucasians

84
Q

Melanoma in palms, soles, subungual sites
c-kit may be involved

A

Acral lentiginous melanoma

85
Q

S100, MelanA, Sox10, HMB45, Mart1 are markers for this

A

Malignant melanoma

86
Q

Atypical nevus which does not fulfill criteria for malignancy

A

Dysplastic nevus

87
Q

Can Dysplastic nevus evolve into melanoma?

A

It can yes

88
Q

Multiple dysplastic nevi is a marker for what?

A

Increased whole body risk of melanoma

89
Q

Dysplastic nevus syndrome is due to a mutation in this

A

CDKN2A

90
Q

CDKN2A mutation causes this

A

Dysplastic nevus syndrome

91
Q

Patients with Dysplastic nevus syndrome have a high lifetime rate of this

A

Melanoma

Skin & MSK (8 decks)

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