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Pathology > Epithelial Neoplasms > Flashcards

Epithelial Neoplasms Flashcards

1
Q 
Multifactorial disease
– Two distinct pathogenesis models:
• Smoking and alcohol
• Human papilloma virus (HPV 16 & 18)
– Actinic Radiation: Lip cancer
A

H+N SCC

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2
Q

What are the 4 most common etiological factors of oropharyngeal squamous cell carcinoma?

A

Smoking
Alcohol
Actinic radiation
HPV

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3
Q

What age group and category of person is at the highest risk for a H+N SCC?

A

White male 65+ smoker and drinker

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4
Q 
• Areca nut
• Betel leaf
• Lime
•CaOH2
• Nitrosamines
Causes oral submucous fibrosis
A

Betel Quid

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5
Q 
• 44M with 22 year history of use of 
betel nut-containing preparations
• Limited oral opening, fibrous bands 
and leukoplakia with erosions
• Premalignant condition
A

Oral submucous fibrosis

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6
Q

What is the cause of acinitic damage?

A

UV light

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7
Q

• The larger the tumor the ______ the

incidence of metastasis

A

higher

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8
Q

The occurrence of metastasis

______ survival

A

decreases

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9
Q

SCC clinical appearance:

– Mass-forming
– Fungating
– Papillary
– Verruciform

A

• Exophytic

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10
Q

SCC clinical appearance:

– Invasive
– Indurated
– Ulcerated

A

• Endophytic

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11
Q

White plaque

A

• Leukoplakia:

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12
Q

Red plaque

A

• Erythroplakia:

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13
Q

Red & white plaque

A

• Erythroleukoplakia:

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14
Q

• A white patch or plaque that can’t be characterized clinically or
pathologically as any other disease

A

Leukoplakia

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15
Q

Things making lesions white:

Increased opacity

A

Hyperkeratosis:

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16
Q

Things making lesions white:

Increased thickness

A

Acanthosis:

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17
Q

Things making lesions white:
Fibrin membrane or
fungal hyphae

A

Surface coating:

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18
Q

The following are or are not leukoplakia
• Morsicatio buccarum
• Linea alba

A

Not leukoplakia

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19
Q

What percentage of leukoplakias are dysplastic/premalignant?

A

20%

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20
Q

• A red plaque that can’t be characterized clinically or pathologically as any
other disease

A

Erythroplakia

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21
Q

What are the 2 reasons why erthroplakias are red?

A

Thin epithelium

Red blood cells

22
Q

What percentage of erythroplakia are dysplastic or malignant?

A

90%

23
Q

What are the 5 High Risk Areas for Premalignancy and Malignancy?

A
  • Lower Lip
  • Floor of Mouth
  • Ventral Tongue
  • Lateral Border of Tongue
  • Soft Palate
24
Q

____ or _____ is required for definitive diagnosis of oral SCC

A

Excisional and incisional biopsy

25
Q 
• Low-grade variant 
of squamous cell carcinoma
• Locally invasive, no metastasis
• Cytologically bland
• Clinicopathologic correlation
• Associated with smokeless tobacco
A

Verrucous Carcinoma

26
Q
  • High-risk, aggressive type of oral leukoplakia
  • High potential for malignant transformation
  • Not associated with tobacco use
  • Women outnumber men
  • Slow-growing
  • Begins as hyperkeratosis
  • Spreads to become multifocal and verruciform
  • Resistant to therapy and recurs
  • Malignant transformation
  • Diagnosis often retrospective
A

Proliferative Verrucous Leukoplakia

27
Q

What is the most common skin cancer that rarely metastasizes?

A

Basal cell carcinoma

28
Q

What is the least common skin cancer causing the most deaths?

A

Malignant melanoma

29
Q 
• Most common skin cancer
• Sun-exposed skin of adults 
with fair complexions
• Locally invasive
• Metastasis extremely rare
• Arises from basal cell layer and 
skin appendages
A

Basal cell carcinoma

30
Q

• Melanocytes present, no melanin produced in skin,
hair, eyes
• Enzyme defect: Tyrosinase

A

Oculocutaneous albinism

31
Q
  • No melanocytes, no melanin

* Autoimmune

A

Vitiligo

32
Q
  • Focal increase in melanin
  • Normal number of melanocytes
  • Lower lip vermillion most common
A

Oral Melanotic Macule

33
Q 
• Generic term for a 
developmental malformation 
of skin or musosa
• Melanocytic 
• Epithelial 
• Vascular 
• Basal cell 
• White sponge 
• Sebaceous
A

Nevus

34
Q

• A benign proliferation of nevus cells that develops during childhood and evolves
through clinical stages (nevus life cycle)
• Less than 6 mm

A

Acquired Melanocytic Nevi

35
Q

• Larger than acquired nevi and involve
deeper structures
• Large congenital nevi have higher risk
for melanoma

A

Congenital Melanocytic Nevi

36
Q

• Spindled nevus cells in connective tissue

A

Blue Nevus

37
Q 
• Malignant lesion of 
melanocytic origin
• Acute rather than 
chronic sun damage
• Prognosis related to 
depth of invasion
A

Melanoma

38
Q

What are the ABCDs of clinical features of Melanoma?

A

Asymmetry
Border Irregularity
Color Variation
Diameter

39
Q

What is the diameter of a melanoma?

A

Greater than 6 mm

40
Q

What is the diameter of a melanoma?

A

Greater than 6 mm

41
Q

_____ growth phase of melanomas

– Within the epithelium (in situ)

A

• Radial Growth Phase:

42
Q

_____ growth phase of melanomas

– Invasion

A

• Vertical Growth Phase

43
Q
  • White adults over 50 years
  • Hard palate, maxillary alveolus
  • Amelanotic forms
A

Oral Mucosal Melanoma

44
Q

• Over 130 subtypes of double-stranded, circular DNA viruses
– family of viruses that can cause abnormal tissue growth and other
changes to cells
– Can produce epithelial tumors of the skin and mucous membranes
• Infection occurs when basal cells of the epithelium are exposed to infectious
virus through a disruption in the epithelial barrier
• Once the epithelial cell is infected, viral replication is confined to the nucleus
• In oncogenic (high-risk) subtypes, oncoproteins E6 and E7 inactivate
tumor supressor genes p53 and pRB

A

HPV

45
Q 
• Solitary lesion in 
adult
• Pedunculated, 
exophytic papule
• Numerous surface 
projections
• HPV-6, 11
A

Squamous papilloma

46
Q 
• Skin of hands in children
• Multiple, clustered lesions 
common
• White, verrucoid surface
• Autoinoculation of oral mucosa
A

Verruca vulgaris

47
Q 
• HPV types 13 and 32
• Children
• Native Americans and other ethnic 
groups
• No treatment, spontaneous regression
A

Focal Epithelial Hyperplasia (Heck’s Disease)

48
Q 
• Venereal wart:
– Sexually-transmitted disease
• Multiple, clustered lesions 
common
• Sessile, pink exophytic mass, 
larger than squamous papilloma
• Low-risk subtypes HPV 6 and 11
A

Condyloma Acuminatum

49
Q
  • Most commonly found in children
  • Infection during childbirth
  • Not a sexually-transmitted disease
  • HPV-6 and 11
  • May cause airway obstruction
  • Recur frequently
A

Laryngeal Papillomatosis

50
Q

__% of HPV genital infections clear on their own within 2 years

A

90%

51
Q

____% of persistent genital HPV infections will cause
dysplastic changes of the uterine cervix
will result in squamous cell carcinoma over a span of 7-10 years

A

5%

Pathology (26 decks)

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