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MSK Week 1 > Lab Dermatopathology video > Flashcards

Lab Dermatopathology video Flashcards

1
Q

What is a nevus

A

mole

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2
Q

Types of Nevi

A

Junctional Compound Intradermal

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3
Q

Junctional Nevi

A

Tend to be flat with nests at the junction of the epidermis and dermis

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4
Q

Compound Nevi

A

Typically a central raised area surrounded by flat with nests at the junction of the epidermis and dermis as well as in the dermis

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5
Q

Intradermal Nevi

A

Nests in the dermis only that often protrude

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6
Q

Clinical Dysplastic Nevi signs

A

Typically larger, flat and pebbly or target-like with irregular pigmentation and border

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7
Q

Under histology, what might we see a dysplastic nevi doing?

A

Cytologically it grows radially (sideways) getting larger with darker nuclei

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8
Q

Vertical growth?

A

Sign of dysplasia in Nevi growth,it is a growth into the dermis, usually presenting as a nodule

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9
Q

ABCs of tumor

A

A - Assymetry B - Border C - Color D - Diameter (larger typically) E - Evolving or changing

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10
Q

Causes of dysplastic Nevi

A
  1. Many sunburns in life 2. 10-15% had familial connections with it 3. Mutations that inhibit the RB tumor supressor gene are common in familial and sporadic melanomas. 40% have CDKN2A abnormalities
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11
Q

Age, location, description for Seborrheic Melanoma

A

Middle aged or older, typically presents on the trunk head and neck and presents as a round, flat, waxy lesion that varies in size with mild inflammation underneath

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12
Q

Fibroepithelial polyp alternative names

A

Also called Acrochordon, skin tag, and squamos papilloma

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13
Q

Age, location, description of fibroepithelial polyp

A

Middle aged folks, usually on neck, trunk, and face, and typically flesh colored, bag-ike with a thin stalk

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14
Q

Basic idea of the epidermal inclusion cyst

A

Keratin buildup

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15
Q

When we see “trich” in the name, what do we know?

A

Involves hair

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16
Q

Basic idea of the dermoid cyst

A

multiple epidermal appendages

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17
Q

Basic idea od Steatocystoma

A

Sebaceous gland

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18
Q

Cylindroma

A

Adnexal tumor making it uncommon. Jigsaw puzzle piece look with basaloid proliferations, common on the forehead

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19
Q

Trichoepithelioma

A

Epithelial proliferation of the hair shaft, this is an uncommon adnexal tumor

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20
Q

Sebaceous adenoma pilomatrixoma

A

Adnexal tumor in the sebaceous gland that is calcified, shows up blue on a stain and the cells lose their nuclei

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21
Q

Actinic Keratosis

A

Prcursor to SCC caused by sun damage to skin. Usually small, less than 1cm with a rough sandpaper consistency, sometimes with a cutaneous horn Hyperkeratosis seen on histology

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22
Q

Squamos Cell Carcinoma

A

Second most common tumor on sun exposed skin 5% metastasize Presents as a red scaling plaque with full thickness dysplasia. They can become invasive, turning nodular and may ulcerate

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23
Q

Keratocanthoma

A

Cup shaped, well differentiated SSC that often regresses spontaneously. Labeled as controversial for whatever reason

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24
Q

Basal Cell carcinoma

A

Most common type of sun exposed skin cancer that is slow growing. Also rarely metastasizes. Presents as pearly papules that may ulcerate or appear melonocytic, making it easily confused with moles. Histologically presents as islands of basophillic cells, hyperchromatic nuclei.

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25
Q

Basal Cell Nevus or “Gorlin Syndrome”

A

Multiple BCC before the age of 20 with possible systemic changes such as intracranial calcification, cleft lip/palate, and vertebral/rib abnormalities. This is an autosomal dominant condition involving the PTCH - 2hit gene

26
Q

Dermatofibroma

A

Also called benign fibrous histocytoma. Presents in adults, particularly on the legs Firm brown papules, thought to be related to trauma and altered collagen. Presents on histology as non-encapsulated, presence of spindle cells with overlying epidermal hyperplasia with collagen “traps.”

27
Q

Dermatofibrosarcoma Protuberans

A

Flesh colored nodule that is firm and goes down into the fat with a radial spoke look on histology

28
Q

Mycosis Fungoides

A

Cutaneous T cell lymphoma that usually presents in patients over 40 on the trunk as scaly patches, plaques, or nodules that can become ulcerated

29
Q

Sezary Syndrome

A

Posible result of Mycosis Fungoides where malignant T cells in the blood cause diffuse erythroderma

30
Q

Mastocytosis

A

Rare dermal tumor involved with increased mast cells. In children, it only affects the skin, causing urticaria and lesions that appear shortly after birth. In adults however, we see a systemic disease with a poor prognosis. Morphology of this is variable, but presents typically with ovoid uniform balls and fried egg on histology. Use Giemsa to locate mast cells.

31
Q

Acute inflammatory dermatoses

A

Acute inflammation process that causes urticaria via mast cell degranulation and microvascular hyperpermeability. We see this as wheals that can be puritic with superficial perivascular infiltrate

32
Q

“To boil over”

A

Eczema

33
Q

Eczema

A

Red, papulovesicular with crusted oozing lesions, puritic that can develop in to raised scaling plaques with hyperkeratosis.

34
Q

Acute contact dermatitis

A

Puritic, edematous, oozing plaques that can blister. Tis is an impetiginization hat presents with acanthosis and increased keratin layers with spongiosis. Noted clinically with intraepidermal collection of vesicles

35
Q

Erythema multiforme

A

Uncommon hypersensitivity to drug or infection. Clinically it varies, but we see macules, papules, vesicles, targetoid and eroded centers

36
Q

Conditions associated with erythema multiforme

A

Herpes simples Typhoid Leprosy Coccidiomycosis

37
Q

Drugs that can cause erythema multiforme

A

Sulfonamides PCN barbiturates antimalarials

38
Q

Psoriasis

A

A chronic inflammatory dermatosis that is well demarcated, salmon colored plaque with silver color from scaling

39
Q

Histology of psoriasis

A

Extensive parakeratosis, thinned stratum granulosum, Auspitz sign munro microabcesses epidermal hyperplasia

40
Q

Auspitz sign

A

Associated with psoriasis, appearence of multiple bleeding points when scale is lifted

41
Q

Munro microabscesses

A

Associated with psoriasis, neutrophils appear beneath the stratum corneum

42
Q

Pemphigus Vulgaris

A

Blistering disease where autoantibodies cause breaking of intercellular attachments of epidermis. Basal layer acatholysis with ulcerated mucosal blister and eroded plaques. Typically presents on the scalp, face, axilla, and groin

43
Q

Staining for Pemphigus Vulgaris

A

We’d see immunoglubuilin deposition along plasma membrane with a reticular or fish net pattern

44
Q

Bullous Pemphigoid

A

Typically in older patiens, presents as dense bullae , large up to 2cm or more that do not rupture easily. Typically on inner thighs, flexor forearms, and 10-15% of people have oral lesions. The DEJ hemidesmosomes are attacked in this condition. No acantholysis, important in distinguishing against Vulgaris.

45
Q

Histology of Bullous pemphigoid

A

Subepidermal nonacontholytic-linear deposits of immunoglobulin and complement along the epidermal-dermal junction

46
Q

Panniculitis

A

AKA Erythema Nodosum. This is an inflammatory reaction that affects the connective tissue between fat lobules. These are very painful erythematous plaques and you need a deep biopsy to learn more.

47
Q
A

Actinic Keratosis

48
Q
A

Acute contact dermatitis

Note the intraepidermal collections of vesicles

49
Q
A

Acute inflammatory Dermatosis

Note the whealing puritis and perivascular involvement

50
Q
A

Basal Cell Carcinoma

51
Q
A

Bullae Pemphigoid

Note in the histology how the upper epidermis is pulled off

52
Q
A

Dermatofibroma

Note the collagen nests

53
Q
A

Dermatofibrosarcoma Protuberans

Note the radial appearence on histology

54
Q
A

Erythema Multiforme

55
Q
A

Mastocytosis

Note the ovoid, uniform appearence and the Mast cell stainong on the right side Giemsa stain

56
Q
A

Mycosis Fungoides

Note the erythematous and ulcerated plaques

57
Q
A

Panniculitis

58
Q
A

Pemphigus Vulgaris

Note the eroded plaques

59
Q
A

Psoriasis

Note the silver scaling with pustules and erythema and thinned stratum granulosum

60
Q
A

Seborrheic Keratosis

Note how closely it resembles a melanoma

MSK Week 1 (14 decks)

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