MOD 2 more lectures (dermatopathology and cancer genetics) Flashcards
Risk factors for skin cancer
solar dmg (melanoma, basal, squam, and merkel cell carcinoma, angiosarcoma)
viral infection (squam cell)
chemical (squam cell)
genetic (melanoma, basal cell nevus)
Melanocytic nevi and types
morphology?
(mole)
junctional: dermo-epidermal junction
compound nevus: dermo-epiderm jxn and dermis
intradermal: melanocyte aggregates in dermis
-morph: spitz (spindle/epith melanocytes), and halo nevi (w chronic inflam)
-blue nevi: dnedritic melanocytic nevi assoc with pigmentation and dermal fibrosis
Lentigo maligna?
Invasive melanoma?
Lentigo: melanoma in situ on sun dmgd skin
Invasive: breslows thickness , clarks level, ulceration and invasion in dermis or beyond
- seborrheic keratosis
- actinic keratosis
- basal cell carcinoma
- squmaous cell carcinoma
- keratoacanthoma
- merkel cell carcinoma
SK: benign, looks like moles. epid
AK: dysplasia of lower epid above solar, forearms/scalp, precancerous, plaques (UV causes basal layer to disorg), can excise it easily
MALIG:
BCC: malig immature basal cell keratinocytic neoplasm (most common human cancer), flesh or red papules, bluish cells on biopsy bc large nucl, can lose eyes/nose but wont metas, basal cell prolif caused by UV (low grade cancer that rarely metast)
SCC: malig mature keratinocytic neoplasm (scaly ulcerated plaque on head/neck/genitals, irreg dermis nodules (pink keratin pearls), UV light or HPV (genitals)
KA: well diff SCC with crater formation
MCC: primary cutaneous neuroendocrine carcinoma (older person, head and neck, sun dmg)
Fibriohistiocytic neoplasia
benign factor XIIIa expressing dermal dendrocytic neoplasm
Mycosis fungoides
chronic cutaneous CD4 T-cell lymphoma
- patch, laque, lympo infiltrate of epid and dermis
- pautrier mciroabcess, abnormal CD markers, clonal prolif
- Sezarys syndrome: cut T-cell lymphoma with tumor cell sin blod with erythema and other sys issues
Adnexal neoplasia
ben/mal
pilomatricoma: diff of hair follics, sebaceous hyperplasia and tumors etc
- eccrine (hidrademona aka sweat gland tumor) etc
Vascular neoplasia
- hemangioma
- angiosarcoma
- kaposi’s sarcoma
- hemang: benign
- angiosarc: malig, high grade neoplasms with diff in sun dmg skin, head and neck, older ppl
- kaposi: low grade malig vasc spindle cell neoplasm (herpes virus 8 transformation aka HHV8)
Skin layers
Epidermis (5 layers CLGSB)
Dermis
Subcutaneous tissue (mostly fat)
4 main keratinocytic neoplasms?
SK
AK
BCC
SCC
congenital vs acquired nevus
congenital usu benign
How to estimate melanoma vol? rank
Breslows thickness for vol
Clarks levels
What does merkel cell carcinoma look like on slides and what is it assoc with
dense core neuroendocrine granules on EM
assoc with sun dmged skin and polyomavirus
Adenxal neoplasms (3)
tumors of skin appendages
Cylindroma
Pilomatricoma
Sebaceous adenoma
Hematopoeitic neoplasms (2)
- Mycosis fungoides: hemo neoplasm, older patients, clocnal prolif, of lymphocytes in upper epidermis, forms patch then plaque then tumor
- Sezary’s syndrome: cut t cell lympoma, erythrema can evolve into leukemia
Dermatofibroma
A type of stromal neoplasm, fibrous histiocytoma–benign dermal dnedrocyte neoplasm (firm solitary nodules, squeezing forms dimple, firbroblast prolif, common in legs of females eg induced by razor)
3 vascular neoplasms
Hemangioma (benign, bv’s dilate)
Angiosarcoma (UV dmg, blood vessel prolif in head and neck of elderly)
Kaposi sarcoma (vasc spindle neoplasm from HHSV-8) dont know if ben/mal (common if low CD4 count), small red purple lesions
TABLE:
Actinic keratosis
- from UV, epidermis basal layer, keratinocytes partially transformed
- scaly lesion, may be red, common on forearms and scalp
- histo: dysplasia of lower epidermis
Basal cell carcinoma
- mal immature basla keratin neoplasm, most common, cuased by UV
- red papule, pearl like, may be pigmented, assoc with upper lip, stem cell like prolif nests
- rarely metast, destruction to surr tissue
- slides: blueish, bc high nucl:cyto ratio
Squamous cell carcinoma
malig mature keratin neo, tumor modules in derms, lower lip, invasive, irreg cells, prom nuclei, irreg mitosis
- aggro, lethal, not just in skin
- slides: cells look like upper layers of epidermis
Keratoacanthoma
- skin tumor, unlikely to metas, caused by uv
- dome shaped symm, surr by inflamed skin, keratin scales
- fast growing, necrosis and healing w scarring
Seborrheic keratosis
- benign epid neoplasm >30, may be pigmented, inflam, thickening of epid, senile warts
- slides: porlif of keratinocytes with cystic formation