Epidermal Neoplasms Flashcards
1
Q
Types of BCC
A
Superficial
Nodular
Micronodular
Keratotic
Basosquamous
Sclerosing/morpheaform
Infiltrative
Fibroepithelioma of Pinkus
Adenoid cystic
2
Q
BCC Features and DDX
A
Palisading
Mucinous stroma
Clefting
Mitoses and apoptotic figures (distinguishes from trichepithelioma and other benign adnexal tumors)
3
Q
A
Fibroepithelioma of pinkus
4
Q
A
AK
(adnexal sparing)
5
Q
A
Bowen’s disease
Spares basal layer (“eyeliner sign”)
Involves follicles (unlike AK)
6
Q
A
Acantholytic AK
7
Q
SCC variants
A
- Verrucous carcinoma (HPV)
- Acantholytic or adenoid SCC
- Spindle cell and sarcomatoid SCC (HMWCK: CK5/6 or 34ßE12 and p63 to distinguish from AFX, spindle cell melanoma, and LMS)
- Clear cell and signet ring cell SCC (glycogen or degenerative changes)
- Keratoacanthoma (putative SCC) - does have infiltrative borders
8
Q
A
Spindle cell SCC
9
Q
A
Basaloid SCC
10
Q
A
Clear cell SCC
11
Q
A
Adenosquamous SCC
12
Q
A
Acantholytic SCC
13
Q
SK variants
A
- Verrucoid
- Clonal
- Irritated/inverted (inverted follicular keratosis)
- Pigmented
- Inflammed
14
Q
A
Inverted follicular keratosis
- Grows down a hair follicle
- Squamous eddies tend to be particularly prominent
- Otherwise, the features are those typical for irritated seborrheic keratosis, namely:
- Basal and sqamous proliferation with hyperkeratosis, papillomatosis and horn cysts (general features of seborrheic keratosis)
- Exocytosis
- Apoptosis
- Acantholysis
- Scale-crust formation
- Spongiosis
- Trichilemmal keratinization
15
Q
A
Benign lichenoid keratosis (BLK)/lichen planus-like keratosis
- Usually on chest/arms
- dense band-like infiltrate with PK, dyskeratotic cells
- often adjacent to lentigo or SK