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Dermatology > Lumps and bumps > Flashcards

Lumps and bumps Flashcards

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Dermatology Board Prep flashcards
1
Q

What do nodular lesions often represent?

A
  • cutaneous neoplasia
  • inflammatory process
  • trauma (haematoma)
  • depositional disease (rare, amyloidosis - horses)
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2
Q

T/F: nodules with an inflammatory basis are often granulomatous

A

TRUE (with a diffuse or nodular dermal inflammatory pattern of associated with panniculitis)

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3
Q

Define panniculitis

A

inflammation of subcutaneous adipose tissue

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4
Q

Why might granulomatous inflammation occur?

A
  • sterile
  • FB
  • bacterial infection
  • also mycobacteria, actinomyces, fungi, viruses and parasites)
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5
Q

How can infectious agents be detected in nodular lesions?

A
  • histology and cytology (routine or special stains)
  • macerated tissue culture (especially deep layers of skin and fat)
  • therefore FNA and skin biopsy important
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6
Q

When shouldn’t you do FNA or skin biopsy with a skin nodule?

A

equine sarcoid - invasive procedures may activate a more invasive behaviour

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7
Q

Where might neoplasia in the skin arise from? 4

A

HISTOLOGICAL CLASSIFICATION

  • epithelial cells
  • mesenchymal cells
  • round cells (e.g. histiocytes, mast cells, lymphocytes)
  • metastases from different sites
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8
Q

What is cutaneous amyloidosis?

A

horses especially, overproduction of APPs (liver) –> deposited in skin

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9
Q

What is botryomycosis?

A

= bacterial granuloma

  • Staph pseudomycetoma is causative agent
  • NOT FUNGAL!
  • nodules/ non-healing wound
  • may be grains/ granules in exudate
  • site of trauma in some cases
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10
Q

Name 2 neoplasias arising from epithelial cells

A

SCC and papilloma

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11
Q

Outline the basic facts of hair follicle neoplasias

A

usually benign, single and cured by lumpectomy

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12
Q

What is the likely cause of lumps that appear on the eyelids?

A

Meibomian gland neoplasia

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13
Q

What is the approach to cutaneous neoplasia?

A

most important goal is diagnosis tumour type and where applicable histological grade. behaviour prediction usually depends on pre-treatment histology. then the antaomical location and extend of the lesion (staging) should be established. evaluate other complications where appropriate (haematological and metabolic).

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14
Q

What does the prognosis of a cutaneous neoplasm depend on?

A
  • type and grade of lesion
  • stage
  • whether complications exist (haematological and metabolic)
  • treatments available
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15
Q

What are the most appropriate treatments for the different cutaneous neoplasms? (solid tumours, haemolymphatic tumours and some solid tumours, solid tumours where surgical excision is not appropriate).

A
  • solid tumours = surgery
  • haemolymphatic neoplasms and some solid tumours = chemotherapy
  • solid tumours where surgical excision is not appropriate = radiation therapy
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16
Q

What is the most common cutaneous neoplasm in the dog?

A

hepatoid gland adenoma (27% cases)

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17
Q

What are the 2 most common cutaneous neoplasms in the cat?

A
  1. ) basal cell tumour (34%)

2. ) squamous cell carcinoma (23%)

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18
Q

List the possible types of cutaneous neoplasm in dogs

A
  1. ) hepatoid gland adenoma (27%)
  2. ) sebaceuous adenoma (12%)
  3. ) trichoepithelioma (12%)
  4. ) basal cell tumour (11%)
  5. ) Meibomian gland adenoma (9%)
  6. ) Also intracutaneous cornifying epithelioma (5%), squamous cell carcinoma (5%), apocrine gland adenoma (5%).
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19
Q

What does the diverse array of epithelial neoplasms reflect?

A

the neoplastic transformation of an epithelial cell into:

  • basal keratinocytes and their terminally-differentiated produce the squame
  • cells of the inner and outer root sheaths of the hair follicle
  • adnexal glands and their ducts
  • THEREFORE A PATHOLOGIST WILL TRY TO ESTABLISH WHETHER CELLS ARE ‘TRYING TO MAKE ANYTHING’ such as hair or sebaceous gland etc.
20
Q

T/F: most epithelial tumours are benign and respond to surgical excision

A

True - these include most hair follicle tumours, glandular adenomas and basal cell tumours

21
Q

Name 3 tumours of the epidermis

A
  • papilloma
  • inverted papilloma
  • SCC
22
Q

What are the 3 broad categories of tumours with adnexal differentiation?

A
  • hair follicle tumours
  • tumours of sebaceous glands and modified sebaceous glands
  • tumours of sweat glands and modified sweat glands
23
Q

Name 2 epithelial tumours without squamous OR adnexal differentiation

A
  • basal cell tumour

- basal cell carcinoma

24
Q

List 5 different mesenchymal tumours

A
  • fibrous tumours
  • vascular and perivascular tumours
  • muscle cell tumours
  • neural and perineurial tumours
  • lipocytic tumours
25
Q

What is another name for a basal cell tumour?

A

Trichoblastoma

26
Q

Name 5 different hair follicle tumours

A
  • infundibular keratinising adenoma
  • tricholemmoma
  • trichoblastma
  • trichoepithelioma
  • pilomatricoma
27
Q

Name 3 different tumours of sebaceous glands and modified sebaceous glans

A
  • sebaceous hyperplasia/ adenoma/ epithelioma / adenocarcinoma
  • hepatoid gland adenoma/ adenocarcinoma
  • meibomian gland adenoma / epithelioma/ adenocarcinoma
28
Q

Name 4 tumours of sweat glands and modified sweat glands

A
  • apocrine gland adenoma / ductal adenoma / adenocarcinoma
  • eccrine (atrichial) adenoma / adenocarcinoma
  • anal sac adenoma/ adenocarcinoma
29
Q

T/F: MCT can arise anywhere on the body and the subcutis and dermis may be invovled

A

True

30
Q

Where is there an increased tendency for MCTs to form in dogs?

A

back half of body including perineum, distal limbs and prepuce

31
Q

What age of dogs tend to get MCTs?

A

young and old dogs

32
Q

Breed predisposition - MCT

A
  • Boxers, Pugs and Weimeraners

- Hindlimb tumours: Boxers, pugs, pit bulls, boston terrier and english setters

33
Q

Outline the clinical appearance of canine MCTs

A
  • varies markedly
  • single or multiple
  • small or large
  • well-demarcated or infiltrative
  • firm or soft
  • ulcerated or epithelialised
  • oedematous or inflammatory
  • may or may not be pigmented
  • fluctuating swelling and erythema should increase the index of suspicion of a MCT.
34
Q

What are possible concurrent CS of a MCT?

A

bleeding disorders
- immune-mediated thrombocytopaenia
- GIT ulceration
(since a proportion of MCTs are physiologically active, releasing histamine, heparin and other vasoactive amines)

35
Q

How can MCTs be diagnosed?

A

cytology (can’t be graded this way)

36
Q

How can MCTs be graded?

A

Histopathologically based on mittotic rate, degree of differentiation and tissue invasion.

37
Q

What grade are most canine MCTs?

A

intermediate grade

38
Q

Should MCT be considered as potentially malignant?

A

Yes

39
Q

How should MCT staging be done?

A
  • clinical and cytological exam of the regional LNs
  • consider imaging the liver and spleen
  • buffy coats and bone marrow aspirates are traditionally advised but it may be difficult to interpret.
40
Q

Where do MCTs tend to metastasise?

A
  • regional LNs
  • liver
  • spleen
  • BM
41
Q

T/F: some slow growing MCTs may transform into a more aggressive form

A

True

42
Q

Tx - MCTs

A
  • surgical excision (best in cases without LN involvement. Most low and intermediate grade tumours can be cured by good surgery. Intermediate grade tumours should be excised with a minimum of 2cm lateral margins and one deep facial plane. Examine histologically for completeness of excision)
  • chemotherapy (give adjunctively if tumour is high grade)
  • radiotherapy
43
Q

Describe a papillomata

A

quite clinically striking

44
Q

Describe sebaeceous adenomas

A
  • spaniels
  • older dogs
  • look like warts but they are not
  • biopsy –> straightforward histological diagnosis
45
Q

T/F: cats are generally more likely to have malignant skin neoplasias than dogs

A

True

Dermatology (27 decks)

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