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Neoplasia Block > MOD 2 more lectures (dermatopathology and cancer genetics) > Flashcards

MOD 2 more lectures (dermatopathology and cancer genetics) Flashcards

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1
Q

Risk factors for skin cancer

A

solar dmg (melanoma, basal, squam, and merkel cell carcinoma, angiosarcoma)
viral infection (squam cell)
chemical (squam cell)
genetic (melanoma, basal cell nevus)

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2
Q

Melanocytic nevi and types

morphology?

A

(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

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3
Q

Lentigo maligna?

Invasive melanoma?

A

Lentigo: melanoma in situ on sun dmgd skin
Invasive: breslows thickness , clarks level, ulceration and invasion in dermis or beyond

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4
Q
  • seborrheic keratosis
  • actinic keratosis
  • basal cell carcinoma
  • squmaous cell carcinoma
  • keratoacanthoma
  • merkel cell carcinoma
A

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)

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5
Q

Fibriohistiocytic neoplasia

A

benign factor XIIIa expressing dermal dendrocytic neoplasm

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6
Q

Mycosis fungoides

A

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
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7
Q

Adnexal neoplasia

A

ben/mal

pilomatricoma: diff of hair follics, sebaceous hyperplasia and tumors etc
- eccrine (hidrademona aka sweat gland tumor) etc

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8
Q

Vascular neoplasia

  • hemangioma
  • angiosarcoma
  • kaposi’s sarcoma
A
  • 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)
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9
Q

Skin layers

A

Epidermis (5 layers CLGSB)
Dermis
Subcutaneous tissue (mostly fat)

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10
Q

4 main keratinocytic neoplasms?

A

SK
AK
BCC
SCC

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11
Q

congenital vs acquired nevus

A

congenital usu benign

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12
Q

How to estimate melanoma vol? rank

A

Breslows thickness for vol

Clarks levels

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13
Q

What does merkel cell carcinoma look like on slides and what is it assoc with

A

dense core neuroendocrine granules on EM

assoc with sun dmged skin and polyomavirus

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14
Q

Adenxal neoplasms (3)

A

tumors of skin appendages
Cylindroma
Pilomatricoma
Sebaceous adenoma

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15
Q

Hematopoeitic neoplasms (2)

A
  • 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
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16
Q

Dermatofibroma

A

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)

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17
Q

3 vascular neoplasms

A

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

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18
Q

TABLE:

Actinic keratosis

A
  • from UV, epidermis basal layer, keratinocytes partially transformed
  • scaly lesion, may be red, common on forearms and scalp
  • histo: dysplasia of lower epidermis
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19
Q

Basal cell carcinoma

A
  • 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
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20
Q

Squamous cell carcinoma

A

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
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21
Q

Keratoacanthoma

A
  • skin tumor, unlikely to metas, caused by uv
  • dome shaped symm, surr by inflamed skin, keratin scales
  • fast growing, necrosis and healing w scarring
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22
Q

Seborrheic keratosis

A
  • benign epid neoplasm >30, may be pigmented, inflam, thickening of epid, senile warts
  • slides: porlif of keratinocytes with cystic formation
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23
Q 
Melanoma types (3)
And clinical course/px?
Study These Flashcards
A

melanoma in situ
invasive
nodular
-biopsy the lesion, use melan-a stain to det if cause of lesion is melanoma, deeper ulcer means worse px, measure depth from gran layer ot base ot det invasion and px

24
Q

melanoma in situ

Study These Flashcards
A

confined to epid, no metas, no lymph

25
invasive melanoma appearance
dermis or beyond, melanocytes with prom mitoses, necrosis, shotgun pattern, cells have diff shapes
26
nodular melanoma appearance
cells create nodule in dermis, usus invasive, rec when it becomes a bump, varies in color
27
Merkel cell carcinoma
- cut neuroendo carcionma, dnese granules, older ppl head and neck, sun dmg, blue cell tumor, hard to treat - slides: stem cell prolif, primitive blue cells with high N;C ratio
28
Acanthosis nigricans
- velvety hyperppigmentation in skin in body folds, ben or mal, assoc with obesity or endocrine issues - slides: hyperkeratosis church spire appearance
29
Fibrous histiocytoma
dermatofibroma, benign factor XIIIa expressing dermal dendrocytic neoplasm, legs of females due to razor, dense fibrous tissues
30
epidermal cysts
benign cyst on skin, result of implantation of epid into dermis -slides: thin layer of squamous epith
31
Junctional nevus Compound nevus Intradermal nevus
- jxnl: melanocyte agg at dermo-epid jxn, flat w smooth border, nest, no mitoses/necroses - cpd: melan agg mix of jxnl and intraderm porlif, raised, brown/black beauty mark - intraderm: mel agg in dermis, raised, flesh colored
32
Pilomatricoma (follicular) Sebaceous adenoma Cylindroma (eccrine)
Pilo: benign neo with pilomatrix diff in hair follic, firm irreg nodules, scalp or anywhere - seb ad: benign with seb diff, large nodules in dermis, smooth borders, non aggro, monotonous cells, not many mitoses, yellow-orange, slides have vacuoles with sebum - cyclindroma: benign wtih islands of cuboidal cells with thick BM material, histo: nest like cylinders with thick fibrous band around nodules
33
Cancer genetics
ALL are genetic, but only small portion are inherited
34
Characteristics of hereditary cancer
early onset, relatives with the same cancer, bilateral tumors, multiple primary tumors of same cancer type, AD inheritance
35
Retinoblastoma (Rb)
most common eye tumor in children herit and non herit Rb is a TSG, RB1 gene on chrom 13
36
Knudson's two hit model, and tumor's involved
can have predisposition, but need second mutation to develop cancer (dominant inheritance, but need recessive gentoype) Rb, wilm's, p53, APC
37
Why cant you give ionized radiation therapy to patient with de novo heritable form of Rb?
bc mutation is de novo so patient may be prone to other types of cancers and radiation could cause their onset (eg sarcomas)
38
genes involved in BC/ovarian cancer
usu sporadic, but can inv BRCA1 mostly (also BRCA2, and a lil bit p53/ PTEN)
39
BRCA1 assoc cancers
BC, some ovarian, a lil bit of others (pancreatic, prostate)
40
BRCA2 assoc cancers
BC, OC, others (prev, and melanoma, laryng), and male breast cancer
41
Sx that may indicate BRCA mutation
multiple early onset cases, ovarian cancer with fam history of either, BC and OC in same person, bilateral, ashkenazi jew, male BC
42
TABLE: Cancer, inheritance, clinical findings, genes, tx BC
``` BCRA 1 (and 2??) tx: mamo, mastectomy, prostate screening in men with mutation ```
43
Wilm's tumor
WAGR, 11p13 deletion | tx: serum tumor marker for AFP and ultrasounds of abd as kid
44
Hereditary melanoma
relatives affected, seen w pancreatic cancer, CDKN2A, CDK4, screen by age 10
45
Ataxia Telengiectasia
AR, clumsy gait, weird eye vessels, genes ATM 7:24 transloc, screen both carrier women and partners, preven BC/pancr cancer
46
Li Fraumeni syndrome
Diff cancers, TP53, same prevention methods as prevs
47
Cowden syndrome
Thyroid tumors, mucocutaneous stimata, cobblestone appearance around lips and nose, PTEN, same methods (with endometr biopsies)
48
Multiple endocrine neoplasia type 2
Tall, medullary thyroid carcinoma, neuromas of tongue and eyelids, RET, tx by removing thyroid gland
49
Von Hippel-Lindau syndrome
AD, hemangioblastomas, pancreatic cysts, neuroendocirne tumors, renal carcinoma, bilateral VHL gene
50
Peutz-Jeghers
AD, intestinal polyps and hyperpigmented macules, STK11 mutation
51
Basal cell nevus syndrome
AD, jaw cysts, basal cell carcinomas thru skin, kids, calcification of falx cerebri (PTCH, SUFU)
52
Which involves thryoid tumors?
cowden syndrome
53
Which involves intestinal polyps and hyperpig macules
Peutz-jeghers sydnrome
54
Which involves calicfication of falx cerebri?
Basal cell nevus syndrome
55
Tx or preventative methods for ovarian cancer
salpingo-oophorectomy to elim (can still cause peritoneal) PARP (poly ALD ribose polymerase) last resort if chemo isnt working lifestyle prophylatic surgery (remove all breast tissue eg mastectomy), mammo/MRI
56
FAP what cancer risk genes tx
Familial Adenomatous Polyposis risk for colorectal cancers, colonic polyps in teens (min 100), prophylatic colectomy (found on APC gene chrom 5, de novo, AD)
57
Lynch syndrome or HNPCC
hereditary non-polyposis colorectal cancer AD -microsatellite instability: HNPCC related genes are in DNA mismatch repair, instability, -IHC: look for MMR genes to see which gene is mtuated (use tests together) -colorectal cancer (do colonoscopy), endometrial cancer (do transvag ultrasound)

Neoplasia Block (16 decks)

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