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Pathology > Neoplasms Of The Skin - HIPON > Flashcards

Neoplasms Of The Skin - HIPON Flashcards

1
Q

Which cell type is arranged across all five layers of the epidermis?

A

The keratinocytes.

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2
Q

Name the five layers of the epidermis.

A
  1. Stratum basale
  2. Stratum spinosum
  3. Stratum granulosum
  4. Stratum lucidum
  5. Stratum corneum
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3
Q

Describe briefly the stratum basale of the epidermis.

A
  1. Single layer of cuboidal to columnar cells that stand on the basement membrane.
  2. Region of cell division.
  3. Also contains melanocytes + Merkel cells.
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4
Q

Describe briefly the stratum spinosum of the epidermis.

A
  1. Many layers of polyhedral prickle cells bearing intercellular brigdes (keratinocytes).
  2. Mitotic activity is present.
  3. Also contains Langerhans cells and processes of melanocytes.
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5
Q

Describe briefly the stratum granulosum of the epidermis.

A
  1. Somewhat flattened cells containing keratohyalin granules.
  2. Absent as a distinct layer in the thin skin.
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6
Q

Describe briefly the stratum lucidum of the epidermis.

A
  1. Thin, translucent layer with cells containing eleidin.

2. Absent from thin skin.

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7
Q

Describe briefly the stratum corneum of the epidermis.

A
  1. Squames packed with keratin.

2. Superficial squames are desquamated.

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8
Q

Give a brief description of the dermis.

A

Dense, irregular, collagenous connective tissue subdivided into two layer:

  1. Papillary
  2. Reticular
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9
Q

Give a basic description of the papillary layer of the dermis.

A
  1. Dermal ridges (papillae) and secondary dermal ridges interdigitate with the epidermal ridges (+ interpapillary pegs) of the epidermis.
  2. Collagen fibers are slender.
  3. Capillary loops + Meissner’s corpuscles are found between the dermal ridges.
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10
Q

Give a basic description of the reticular layer of the dermis.1

A
  1. Composed of coarsed bundles of collagen fibers.

2. This layer supports a vascular plexus and interdigitates with the underlying hypodermis.

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11
Q

What may be present in the reticular layer of the dermis?

A

Frequently:

  1. Hair follicles
  2. Sebaceous glands
  3. Sweat glands
  4. Krause’s end bulbs
  5. Pacinian corpuscles
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12
Q

What is the most common neoplasm in terms of sheer numbers?

A

Tumors of the skin.

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13
Q

What is the most common warning sign of skin cancer?

A

Change in the appearance of the skin, such as a new growth or a sore that will not heal.

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14
Q

What is the main cause of skin cancer?

A

UV light

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15
Q

Besides UV light, mention some other factors that play a role in the development of skin cancer.

A
  1. Smoking tobacco
  2. HPV
  3. Aging
  4. Light skin color
  5. Artificial UV radiation
  6. Immunosuppressive drugs
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16
Q

What lesion may occur in areas of skin exposed to sunlight over a long period of time?

A

Actinic (solar) keratosis - with aberrant differentiation of the epidermal cells.

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17
Q

What is the origin of basal cell carcinoma of the skin?

A

It originates from the lowest layer of the epidermis - most common + least dangerous skin cancer.

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18
Q

What is the origin of squamous cell carcinoma of the skin?

A

It originates from the middle layer - less common, but more likely to spread and to be fatal.

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19
Q

What are the 2 forms of skin cancer that are collectively known as non-melanoma skin cancer?

A
  1. Basal cell carcinoma

2. Squamous cell carcinoma

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20
Q

What is the origin of melanoma?

A

It originated in the pigment-producing cells (melanocytes) - least common, but most aggressive, most likely to spread. Fatal if untreated.

21
Q

Where does SCC of the skin commonly arise?

A

Chronically sun exposed areas:

  1. Backs
  2. Hands
  3. Lips
  4. Ears
22
Q

What is the precancerous condition of SCC of the skin?

A

Actinic (solar) keratosis

23
Q

What is the morphology of SCC of the skin?

A

Red, scaling, thickened patch on sun-exposed skin.

24
Q

When does SCC of the skin have a low potential for metastasis?

A

When it arises on sun-damaged skin.

25
Q

What is the most common location of basal cell lesions?

A

The face

26
Q

Mention some not sun-exposed areas, in which a basal cell carcinoma can occur?

A
  1. Chest
  2. Back
  3. Arms
  4. Legs
  5. Scalp
27
Q

What is the gross morphology of a basal cell carcinoma?

A
  1. Begins as a small, dome-shaped bump.
  2. Often covered by small, superficial blood vessels –> Telangiectases.
  3. Texture is often shiny and translucent - sometimes referred to as “pearly”.
28
Q

What types of adnexal neoplasms of the skin may occur?

A

Neoplasms that involve:

  1. Hair follicles
  2. Sweat glands/Ducts
  3. Sebaceous glands
29
Q

What is a keratoacanthoma?

A

Neoplastic proliferation of the infundibular portion of the hair follicle.

30
Q

With what can keratoacanthoma be confused both clinically and microscopically?

A

With SCC.

31
Q

What is the characteristic morphology of keratoacanthoma?

A

Dome-shaped lesion in which there is a central crater filled with keratin.

32
Q

What is the classic course of keratoacanthoma?

A

It arises from a previously normal portion of the skin, waxes rapidly over the next 4-6 weeks and then regresses over a further 4-6 weeks, leaving a depressed scar.

33
Q

Mention an aggressive tumor of the skin that derives from neuroendocrine cells.

A

Merkel cell tumor.

34
Q

What is the microscopic morphology of Merkel cell tumor?

A

Uniform proliferation of small, round, dark cells, this being responsible for the not infrequent misdiagnosis of cutaneous lymphoma.

35
Q

How do we classify the benign melanocytic tumors (nevi)?

A

According to the level within the skin where the melanocytic proliferation is predominant.

36
Q

What are the 3 most common variants of benign melanocytic tumors?

A
  1. Junctional
  2. Intradermal
  3. Compound
37
Q

Mention some rare variants of benign melanocytic tumors.

A
  1. Blue nevus
  2. Spitz nevus
  3. Pigmented spindle cell nevus of Reed
38
Q

What is estimated about the incidence of melanoma?

A

Over 1% of children born today will develop malignant melanoma.

39
Q

What is the prognosis of most melanomas and on what does it depend?

A

Excellent prognosis, if lesions are recognized and excised before entering a vertical growth phase.

40
Q

When is a patient with melanoma at risk of dying from metastatic disease?

A

If the tumor exceeds a critical depth in the dermis.

41
Q

Where do men most commonly develop melanoma?

A

On the trunk, particulalry at the back.

42
Q

Where do women most commonly develop melanoma?

A

Legs or arms.

43
Q

What is the usual color of a melanoma?

A

Various colors from shades of brown to black.

44
Q

What are the amelanotic melanomas?

A

A small amount of melanomas are pink, red, or fleshy in color.

45
Q

What is the prognosis of amelanotic melanomas?

A

They tend to be more aggressive.

46
Q

What are the main warning signs of melanoma?

A

A change in:

  1. Size
  2. Shape
  3. Color
  4. Elevation of the mole
47
Q

What are the main connective tissue tumors of the skin?

A
  1. Fibrous histiocytoma
  2. Dermatofibrosarcoma protuberans
  3. Tumors/Tumor-like conditions arising from blood vessels
48
Q

What are the 4 cellular components of the epidermis?

A
  1. Keratinocytes
  2. Melanocytes
  3. Langerhans cells
  4. Merkel cells

Pathology (16 decks)

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