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CNS and Skin Pathology > Malignant Tumours of the Skin > Flashcards

Malignant Tumours of the Skin Flashcards

1
Q

What is the largest organ in the body?

A

The skin.

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2
Q

What functions does the skin serve?

A

Defense against infections, physical agents, and synthesis of vitamin D.

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3
Q

What do keratinocytes secrete and what is their role?

A

Cytokines and defensins; regulate cutaneous immune responses.

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4
Q

What is the function of melanocytes in the skin?

A

Production of melanin to protect against UV radiation.

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5
Q

What cells are one of the first lines of defense against microorganisms in the skin?

A

Dendritic cells.

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6
Q

What is the role of Merkel cells in the skin?

A

Light touch sensation and neuroendocrine functions.

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7
Q

What are the major histological components of the skin?

A

Epidermis, dermis, and skin adnexal structures.

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8
Q

How are malignant skin tumors classified?

A

Tumors of keratinocytes, melanocytes, Merkel cells, Langerhans cells, skin appendages, connective tissue cells, hematopoietic and lymphoid cells, inherited tumor syndromes, and metastasis to the skin.

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9
Q

What types of tumors arise from keratinocytes?

A

Squamous cell carcinoma and basal cell carcinoma.

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10
Q

What types of tumors arise from melanocytes?

A

Malignant melanoma.

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11
Q

What types of tumors arise from Merkel cells?

A

Merkel cell carcinoma.

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12
Q

What types of tumors arise from Langerhans cells?

A

Langerhans cell histiocytosis.

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13
Q

What types of tumors arise from skin appendages?

A

Sebaceous gland adenocarcinoma.

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14
Q

What types of tumors arise from connective tissue cells in the skin?

A

Angiosarcoma, dermatofibrosarcoma protuberans (DFSP).

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15
Q

What types of tumors arise from hematopoietic and lymphoid cells in the skin?

A

Lymphoma of the skin.

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16
Q

What is the most common type of cancer in white populations?

A

Melanoma and nonmelanoma skin cancer.

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17
Q

How has the incidence of melanoma and nonmelanoma skin cancer changed over time?

A

Increasing incidence rate worldwide but stable or decreasing mortality rate.

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18
Q

What is the most common cancer in white-skinned individuals?

A

Nonmelanoma skin cancer.

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19
Q

Which skin cancer accounts for the most common skin cancer in Nigeria?

A

Melanoma.

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20
Q

What is the lifetime risk of melanoma for whites, Hispanics, and Blacks?

A

2.6% for whites, 0.6% for Hispanics, 0.1% for Blacks.

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21
Q

Which gender has a higher distribution of melanoma?

A

Males.

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22
Q

What is the deadliest form of skin cancer?

A

Melanoma.

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23
Q

Where are melanomas mainly found?

A

Sun-exposed areas.

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24
Q

What are other possible sites of origin for melanoma?

A

Oral and anogenital mucosal surfaces, esophagus, meninges, uvea of the eye.

25
Q

What is the most significant environmental risk factor for melanoma?

A

Ultraviolet Radiation (UVR) damage from sun exposure.

26
Q

What percentage of melanomas are inherited?

A

10-15%.

27
Q

What is the most frequent genetic mutation found in melanoma?

A

BRAF mutation in 50% of cases.

28
Q

What are the RAS genes, and how often are they mutated in melanoma?

A

NRAS, HRAS, KRAS; mutated in about 30% of cases.

29
Q

What gene encodes p15/INK4b, p16/INK4, and p14/ARF, and what is its significance in melanoma?

A

CDKN2A; loss of p16 is clearly implicated in melanoma.

30
Q

What is the role of p16 in melanoma?

A

Inhibits CDK4 and CDK6.

31
Q

How does p14 contribute to melanoma pathogenesis?

A

Enhances p53 function by inhibiting MDM2.

32
Q

What is the net effect of mutations in p16, p14, CDK4, CDK6, and p53 in melanoma?

A

Increased melanocytic proliferation due to loss of cell cycle control.

33
Q

What is the role of RAS and PI3K/AKT signaling in melanoma?

A

Promotes cell growth and survival; mutations in NRAS and BRAF.

34
Q

How does telomerase activation contribute to melanoma?

A

Preserves telomeres and protects cells from senescence.

35
Q

What gene encodes the catalytic unit of telomerase?

A

TERT gene.

36
Q

What does ABCDE stand for in melanoma detection?

A

Asymmetry, Borders, Color, Diameter, Evolution.

37
Q

What are the characteristics of asymmetry in melanoma?

A

One half does not match the other.

38
Q

What do irregular borders indicate in melanoma?

A

The edges are ragged, notched, or blurred.

39
Q

How is variegated color significant in melanoma diagnosis?

A

Shades of tan, brown, or black.

40
Q

Why is increasing diameter a concern in melanoma?

A

Diameter greater than 6mm.

41
Q

What is the importance of evolution or change over time in melanoma diagnosis?

A

Rapid or continuing change in size.

42
Q

Describe the morphology of melanoma.

A

Oval to spindle-shaped nuclei, may be pigmented or non-pigmented, great mimicker.

43
Q

What are the key prognostic factors for melanoma?

A

Tumor depth (Breslow’s thickness), number of mitoses, evidence of tumor regression, ulceration, presence of tumor-infiltrating lymphocytes, gender, microscopic involvement of sentinel lymph node, high stage (TNM).

44
Q

What is the second most common cancer of the skin?

A

Squamous cell carcinoma.

45
Q

What is the incidence of squamous cell carcinoma in the U.S.?

A

1 per 1000 individuals (250,000 new cases per year).

46
Q

What are the common risk factors for squamous cell carcinoma?

A

UV light, immunosuppression, HPV 5 and 8, industrial carcinogens, chronic ulcers, xeroderma pigmentosum, draining osteomyelitis, old burn scars, arsenic ingestion, ionizing radiation, tobacco, betel nut chewing, actinic keratosis, albinism.

47
Q

What is the role of TP53 mutations in squamous cell carcinoma?

A

An early event in sun-induced tumor development.

48
Q

How does UV light contribute to squamous cell carcinoma pathogenesis?

A

UV light causes DNA damage sensed by ATM and ATR, upregulating p53. P53 arrests cells at the G1 phase for DNA repair or apoptosis.

49
Q

What are the common sites for squamous cell carcinoma?

A

Face, ears, scalp, dorsal hands, glans penis/vulva (Erythroplasia of Queyrat), Bowen’s disease.

50
Q

What is the significance of Erythroplasia of Queyrat in squamous cell carcinoma?

A

In-situ carcinoma of the glans penis or vulva.

51
Q

How does squamous cell carcinoma typically present clinically?

A

Thin plaque or erythematous scaly papule, erythematous plaque, nodule, ulcer.

52
Q

What are the morphological patterns of squamous cell carcinoma?

A

Conventional, acantholytic, clear cell, desmoplastic, lymphoepitheliomatous, spindle cell, verrucous, warty.

53
Q

How is squamous cell carcinoma treated?

A

Surgical excision, curettage, electrodessication, cryotherapy, radiation therapy.

54
Q

What is the most common malignancy of the skin?

A

Basal cell carcinoma.

55
Q

What conditions are associated with an increased risk of basal cell carcinoma?

A

Xeroderma pigmentosum.

56
Q

How does basal cell carcinoma typically present?

A

Erythematous patch, papule, nodule, or plaque, often eroded, ulcerated, or indurated, pigmented BCC may mimic a melanocytic neoplasm.

57
Q

What are the common sites for basal cell carcinoma?

A

Sun-exposed skin, any hair-bearing area (e.g., head and neck), sites with limited or no sun exposure.

58
Q

How is basal cell carcinoma treated?

A

Saucerization, standard full-thickness excision, Mohs micrographic surgery, curettage, cryosurgery, topical 5-fluorouracil, imiquimod, radiation.

59
Q

Give examples of malignant skin adnexal tumors.

A

Adenoid cystic carcinoma, sweat gland carcinoma, myoepithelial carcinoma, mucinous carcinoma, microcystic adnexal carcinoma, sebaceous carcinoma, trichilemmal carcinoma, trichoblastic carcinoma, malignant proliferating trichilemmal cyst, pilomatrix carcinoma.

CNS and Skin Pathology (3 decks)

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