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Dermatopathology > Epidermal Neoplasms > Flashcards

Epidermal Neoplasms Flashcards

1
Q

Types of BCC

A

Superficial

Nodular

Micronodular

Keratotic

Basosquamous

Sclerosing/morpheaform

Infiltrative

Fibroepithelioma of Pinkus

Adenoid cystic

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2
Q

BCC Features and DDX

A

Palisading

Mucinous stroma

Clefting

Mitoses and apoptotic figures (distinguishes from trichepithelioma and other benign adnexal tumors)

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3
Q
A

Fibroepithelioma of pinkus

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4
Q
A

AK

(adnexal sparing)

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5
Q
A

Bowen’s disease

Spares basal layer (“eyeliner sign”)

Involves follicles (unlike AK)

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6
Q
A

Acantholytic AK

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7
Q

SCC variants

A
  1. Verrucous carcinoma (HPV)
  2. Acantholytic or adenoid SCC
  3. Spindle cell and sarcomatoid SCC (HMWCK: CK5/6 or 34ßE12 and p63 to distinguish from AFX, spindle cell melanoma, and LMS)
  4. Clear cell and signet ring cell SCC (glycogen or degenerative changes)
  5. Keratoacanthoma (putative SCC) - does have infiltrative borders
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8
Q
A

Spindle cell SCC

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9
Q
A

Basaloid SCC

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10
Q
A

Clear cell SCC

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11
Q
A

Adenosquamous SCC

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12
Q
A

Acantholytic SCC

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13
Q

SK variants

A
  1. Verrucoid
  2. Clonal
  3. Irritated/inverted (inverted follicular keratosis)
  4. Pigmented
  5. Inflammed
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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
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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
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16
Q
A

Epidermal nevus

Usually children

head and neck, UE

Hyperkeratosis, acanthosis, papillomatosis (may look like SK or acanthosis nigricans)

17
Q
A

Clear cell acanthoma

  • Acanthosis
  • psorisiform epidermal hyperplasia
  • Pale-staining keratinocytes (PAS+ due to glycogen) with mild spong
  • occasional neut abscesses
18
Q

Epidermoid cyst aka

A

EIC, epidermoid cyst

has granular layer

19
Q

Pilar cyst AKA

Histo

Location

A

Isthmus-catagen cyst, ticholemmal cyst, “sebaceous” cyst

Lacks granular layer or minimal layer

Can have calcs

Scalp usually

20
Q
A

Steatocystoma multiplex

undulating squamoid epithelium with corrugated eosinophilic lining

Often has underlying sebaceous glands or follicles

lack keratin debris

21
Q
A

Hydrocystoma

  • Head and neck (eyelid)
  • mostly apopcrine (few are eccrine)
  • Flattened to columnar 1-2 cell lining
  • Snouting, decapitation

Dermatopathology (18 decks)

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