Fitz9. Ch2: Pathology of Skin Lesion

Question 1

most common type of biopsy for BCC and SCC

Answer 1

shave

Question 2

primary loss of cohesion of epidermal cells due to widening of interdesmosomal regions

Answer 2

acantholysis

Question 3

secondary loss of cohesion of epidermal cells

Answer 3

spongiosis

Question 4

primary dissolution of cells

Answer 4

cytolysis

Question 5

diseases found in the granular layer (4)

Answer 5

pemphigus foliaceous,
subcorneal pustular dermatosis,
SSSS,
bullous impetigo

Question 6

diseases found in the spinous layer (4)

Answer 6

spongiotic dermatitis,
herpes virus infection,
friction blister,
familial benign pemphigus (Hailey-Hailey disease)

Question 7

diseases found in suprabasal blister (2)

Answer 7

Pemphigus vulgaris,

Darier disease

Question 8

Diseases found in spinous versus suprabasal layer

Answer 8

spinous: Hailey-Hailey disease
suprabasal: Darier disease

Question 9

diseases found in the subepidermal layer (5)

Answer 9

epidermolysis bullosa
EBA
bullous pemphigoid
dermatitis herpetiformis
porphyria cutanea tarda

Question 10

diseases found in
granular
suprabasal
subepidermal

Answer 10

granular: pemphigus foliaceous
suprabasal: pemphigus vulgaris
subepidermal: bullous pemphigoid and Dermatitis herpetiformis

Question 11

VERRUCA VULGARIS versus

verruca plana

Answer 11

VERRUCA VULGARIS: hyperkeratosis, acanthosis, papillomatosus; koilocytes (spinosum and granulosum)

[verruca plana: no papillomatosis; koilocytes (granulosum)

Question 12

characteristic finding of keratoacanthoma

Answer 12

neutrophilic microabscesses within the atypical epithelium

Question 13

multiple keratoacanthomas may be due to this syndrome and these 3 meds

Answer 13

Muir-Torre syndrome

BRAF inhibitors: so-, vemu-, dab-rafenib

Question 14

full thickness atypia of the epidermis with keratinocytes that have enlarged nuclei and increased mitotic activity

Answer 14

SCC in situ

Question 15

lobules of basaloid cells with peripheral palisading of columnar cells; with mitotic figures within lobules

Answer 15

basal cell carcinoma

Question 16

lobules of basaloid cells with cribriform or lace-like; horn cysts within lobules

Answer 16

Trichoepithelioma

Question 17

characteristic feature of trichoepithelioma

Answer 17

papillary mesenchymal bodies

Question 18

smaller basaloid islands with surrounding stroma

Answer 18

trichoblastic fibroma

Question 19

tadpole like epithelial islands

Answer 19

syringoma

Question 20

bridging of melanocytic nests

Answer 20

dysplastic nevi

Question 21

characteristic feature of spitz nevi

Spitz nevi: melanocytic nevi with spindled melanocytes

Answer 21

kamino bodies

Question 22

type of growth phase in
melanoma in situ:
nodular melanoma

Answer 22

melanoma in situ: radial growth phase

nodular melanoma: vertical growth phase

Question 23

elongated spindled nuclei set within a fibrotic stroma rich in thickened collagen bundles with nodular lymphocytic aggregates in the dermis
What is this disease?
What are the stains?

Answer 23

desmoplastic melanoma
S100+
SOX10+
(MART negative)

Question 24

hyperplastic epidermis and hyperpigmented flattened rete described as DIRTY FEET. follicular induction at epidermis with collagen wrapping.
Disease?
Stain?

Answer 24

Dermatofibroma
Factor XIIIa+
(CD34 negative)

Question 25

bland appearing spindle cells in the reticular dermis and subcutaneous fat with cells intercalating between adipocytes resulting in HONEYCOMB appearance with little cytologic atypia
Disease?
Stain?

Answer 25

Dermatofibrosarcoma protruberans
CD34+
(Factor XIII negative)

Question 26

marked cytologic ATYPIA of spindled and epithelioid cells in dermis
Disease?
Srain?

Answer 26

atypical fibroxanthoma

CD10

Question 27

irregular VASCULAR channels
Disease?
Stain?

Answer 27

Angiosarcoma

CD31, CD34

Question 28

small bland NEURAL cells with wavy S-shaped nuclei set within a light pink stroma (myxoid)
Disease?
Cells commonly observed?

Answer 28

neurofibroma

mast cells

Question 29

differentiate ANTONI A versus antoni B for schwannoma/ neurilemomma

Answer 29

ANTONI A: more cellular with palisading nuclei around an acellular ECM (verocay bodies)

[antoni B: spindled cells within a looser and often myxoid ECM]

Question 30

LEIOMYOMA versus leiomyosarcoma

Answer 30

both derived from pilar or vascular smooth muscle

leiomyoma: cell are pink and elongated with CIGAR-SHAPED nuclei having tapered ends; LOW mitotic rate
[leiomyosarcoma: high mitosis

Question 31

stain for elastic fibers

Answer 31

verhoeff-van gieson stain

Question 32

stain for mucin

Answer 32

toluidine blue, alcian blue

Question 33

stain for collagen

Answer 33

masson’s trichome

Question 34

stain for mast cell
mast cell granules (metachromatic)
mast cell cytoplasm (red)
mast cell (blue)

Answer 34

mast cell granules: toluidine blue, giemsa
mast cell cytoplasm red: leder
mast cell blue: giemsa

Question 35

stain for fungi (red)

stain for fungi (gray-black)

Answer 35

fungi red: periodic acid-schiff stain (also collagen)

fungi black: gomori methenamine silver

Question 36

stain for iron

Answer 36

prussian blue

Question 37

stain for melanin

Answer 37

fontana-masson

Question 38

stain for calcium orange red

calcium black

Answer 38

calcium orange red: alizarin red

calcium black: von kossa

Question 39

stain for lipids red

lipids black

Answer 39

lipids red: oil red O

lipids black: sudan black

Question 40

stain for myobacteria
red
red yellow

Answer 40

red mycobacteria: ziehl-neelsen, fite acid-fast stain

red yellow mycobacteria: auramine-rhodamine