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Neoplastic Derm Flashcards

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Dermatology Board Prep flashcards
1
Q

Primary cutaneous b cell neoplasm are usually staining positive for

A

CD20 and 79a (1979- china instituted 1 boy policy)

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2
Q

priamry cutaneous diffuse large b cell lymphoma, leg type stain

A

BCL6 and BCL2 positive, MUM1 positive (elderly mum)

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3
Q

ppl with intravascular b cell lymphoma can also have what clincal features

A

thrombosis in CNS, causing neuro deficits

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4
Q

dermatofibroma staining (4 postives and 1 negative)

A

CD34 negative. Positive for (factor 13, CD10, stromelysin, D2-40)

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5
Q

DFSP associated w what fusion gene

A

DFSP affects people 17 to22yo Called Pat t(7,22) COL1A1-PDGFB fusion

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6
Q

Metastatic DFSP tx?

A

imatinib (46% response rate)

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7
Q

what pediatric disease has the same translocation as DFSP?

A

Giant cell fibroblastoma

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8
Q

Spindled SCC stains for

A

CK5/6, p63 (mucinous carcinoma primary cutaneous, poor prognosis for merkel), p40

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9
Q

Desmin positive in

A

leiomyosarcoma, angioleiomyosarcoma

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10
Q

Angiofibromas have 2 other names

A

fibrous papule, peraly penile papule

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11
Q

Facial and periungal angiofibromas a/w what 3 sundromes

A

TS, MEN1, and Birt Hogg Dube

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12
Q

Sclerotic fibromas associated with

A

Cowden

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13
Q

Acral fibrokeratoma vs supernumeray digit: histology

A

supernumery digit has nerve fascicles

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14
Q

Inclusion body fibromatosis, prognosis?

A

50% recurrence

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15
Q

Inclusion body fibromatosis, inclusions are?

A

Actin, stain red with trichrome

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16
Q

Deep desmoid tumor a/w what tumor?

A

Gardner’s syndrome

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17
Q

Nodular fasciitis histology:

A

Well-circumscribed deep noudde with myoid stroma, frequent mitoses and extravasated RBCs

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18
Q

Fibrous hamartoma of infancy histology:

A

mature fat, immagure mesenchymal cell, spindle cells in fascicles

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19
Q

Infantile myofibromatosis is the most common fibromatosis in kids. Histology:

A

biphasic population with staghorn vessels

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20
Q

Neoplasm with numerou osteoclastic giant cell?

A

Giant cell tumor of the tendon sheath

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21
Q

Pyogenic granuloma of prengnacy appears where?

A

gingiva

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22
Q

Angiosarcoma stains?

A

CD31, CD34, ERG, FLI-1

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23
Q

The spindle cells in Spindle cell lipoma stain for?

A

CD34 positive

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24
Q

Spindle cell lipoma vs pleomorphic lipoma on histology?

A

pleomorphic lipom as floret giant cells

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25
Q

Most common location for a spindle cell lipoma?

A

shoulder/posterior neck of men

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26
Q

Syringofibroadenoma looks like what on pathology?

A

Looks like a finger comb (fingers of the comb have ductal differentiation)

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27
Q

What is syringofibroadenoma associated with?

A

Chronic staiss dermatitis, Schopf-Schulz Passarge, Clouston syndrome

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28
Q

Mucinous carcinomas on the face are almost always primary. Ones on the trunk d/t

A

metastasis of visceral malignancy (breast, lung, ovaria, GI)

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29
Q

Adenoid cystic carcinoma can be primary or a cutaneous metastasis from ? Prognosis?

A

salivary gland. If metastatic, then highly aggressive and high mortality

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30
Q

Adenoid cystic carcinoma of primary cutaneous occur on? Prognosis

A

Occur on scalp, indolent tumor, no mets but high local recurrence rate

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31
Q

SPAP has abundant what type of cells?

A

plasma cells

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32
Q

Primary cutaneous mucinous carcinoma stains for what? Positive for?

A

AE1/AE3, CAM5/2, EMA, CEA, CK7, ER, PR, Neuroendocrine markers

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33
Q

How do you confirm the cutaneous origin for mucinous carcinoma?

A

by finding a myoepithelial layer (stain for p63, SMA, calponin)

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34
Q

Primary cutaneous mucinous carcinoma stains for what? NEgative for?

A

CK20

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35
Q

GI metastasis of Mucinous carcinoma would stain positive for?

A

CK20, sulfomucin NOT sialomucin (in primary cutaneous mucinous carcinoma)

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36
Q

Schimmelpenning syndrome

A

extensive nevus sebaceous, seizeures, mental retardation

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37
Q

Birt Hogg Dube a/w what cancers?

A

RCC and medullary carcinoma of the thyroid and pneumothroax, pulonary cysts

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38
Q

Trichoepithelioma found where?

A

On the central face like the nose, NLF, lip

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39
Q

Trichoepithelioma stains with what?

A

Scattered CK20 merkel cells within tumor, PHLDA1, peripheral Bcl2

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40
Q

Trichoep vs BCC staining: Bcl2

A

Bcl2 is diffusely positive in BCC, but only stains the periphery on trichoep

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41
Q

Trichoep stroma stains for

A

CD34+ and CD10+

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42
Q

Trichoep vs BCC staining: Androgen Receptor

A

Androgen Receptor is posivie in most BCC negative in trichoep

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43
Q

Trichoep vs BCC staining: CD10

A

BCC stroma is negative for CD 10

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44
Q

Syndromes with multiple trichoepitheliomas?

A

Brooke Spiegler and Rombo syndrome (atrophoderma, acrofacial vasodilation and cyanosis)

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45
Q

Trichoep vs BCC staining: PHLDA1

A

positive in Tricho ep (stains benign follicular tumor) and negative in BCC

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46
Q

BCC stains positive for ? Negative for?

A

Positive for BCL2, negative for CK20, Phlda1, CD10 (stroma)

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47
Q

Desmoplastic trichoep stains positive for

A

CK20 and PHLDA (which would be negative in morpheaform BCC)

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48
Q

Trichilemmomma clear cells derived from glycogen that resembles the ? Stains for

A

outer root sheath. Stains for CD34

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49
Q

desmoplastic trichoemmoma vs invasive SCC, how do you differentiate on pathology?

A

Look at the peripherla to identify conventional trichilemmoma features

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50
Q

juxtaclavicular beaded lines is what?

A

sebaceous hyperplasia

51
Q

Most common sebaceous neoplasm associated with muir torre?

A

sebacenous adenoma

52
Q

How is a sebaceous adenoma different from a sebaceoma on location?

A

sebaceous adenoma opens broadly to the skin surface while a sebaceoma is purely intradermal

53
Q

Sebaceoma has what percent basaloid cells compared to sebaceous adenoma

A

Sebaceoma has greater than 50% basaloid cells

54
Q

mucosal neuromas in MEN2B similar to what neural neoplasm

A

palisaded encapsulated neuroma

55
Q

Schwannomas stain with what? Negative for?

A

Schwann cells (S100) and Perineurial Capsul (EMA) with NO AXONS (negative for neurofilaments).

56
Q

How does schwannoma staining differ from NF/PEN/Traumatic neuroma

A

NO AXONS (negative for neurofilaments). Vs NF, PEN, traumatic neuromas, which have axons

57
Q

neurothekeoma found where on the body

A

found on the fingers

58
Q

how is neurothekeoma staining different from cellular neurothekeoma staining?

A

cellular neurothekeoma is always S100 negative, but positive for S100A6+, NKI/C3+, PGP9.5+

59
Q

Cellular neurothekeoma looks like?

A

fascicles of epitheliod cells recembling spitz nevus cells

60
Q

Granular cell inclusion callsed

A

pustulo-ovoid bodies of milian which are aggregated lysosomes

61
Q

Merkel cell associated with what virus?

A

merkel cell polyomavirus

62
Q

Merkel cell vs small cell lung cancer

A

Small cell lung cancer is TTF 1 positive and CK7 positive

63
Q

what portends a worse prognosis in merkel cell?

A

p63 expression and diameter greater than 2cm

64
Q

Angioleiomyoma vs myopericytoma staining?

A

Angioleiomyoma is desmin positive

65
Q

Do leiomyosarcomas have a high risk of metastasis?

A

Dermal LMS has a 10% metastatic rate. Subcutaneous LMS is more aggressive

66
Q

Hypopigmented MF markers

A

CD8 pos CD4 neg

67
Q

Ppl with granulomatous slack skin at risk of

A

NHL 30%

68
Q

Adult T cell leukemia looks like what on pathology? Stains for

A

Looks like a clover leaf. CD 25+

69
Q

LyP mnemonic

A

Read more than 30 and you’ll be great. Reed, MF, 30+ ALCL, CD8

70
Q

Tx for LyP

A

MTX

71
Q

LyP patient at at risk for

A

20% have MF, ALCL, Hodgkin’s lymphoma

72
Q

Primary cutaneous ALCL vs systemic ALCL

A

primary cutaneoue ALCL lack ALK translocation.

73
Q

Subcutanoue panniculitis like Tcell lymphoma stain for

A

Positive for (CD8, TIA, Granzyme B) Negative for (CD4, CD56)

74
Q

CD56 stains

A

Mommy born in 1956 and is Natural Killer

75
Q

Primary cutaneous gamma-delta T cell lymphoma stains for

A

Positive for (CD56, Granzyme, TIA) Negative for (CD4,CD8, BF1)

76
Q

Seborrheic keratosis associated with

A

sun exposure and FGFR3 and PIK3CA mutations

77
Q

Porokeratosis of Mibielli onset? Presnetation?

A

Onset in infancy or childhood with 3cm large circinate plaque on extremities

78
Q

Linear Porokeratosis presents as?

A

Onet in newborns. Follow lines of blashko

79
Q

Histology for porokeratotic eccrine ostial and dermal duct nevus?

A

Abundant cornoid lamellae arising from acrosyringium

80
Q

Risk of tranformation to SCC in porokeratosis?

A

Highest in linear porokeratosis, lowest in punctate, DSAP is second lowest

81
Q

Stucco keratosis associated with which HPV?

A

HPV 23b

82
Q

Inverted follicular keratosis most commonly found on

A

cheek and upper lip

83
Q

Histology for IFK?

A

Endophytic SK with prominent squamous eddied

84
Q

Nevus comedonicus see on what part of the body? Worsens during?

A

See as a linear array on face. Worsens during puberty

85
Q

Flegel disease presents as ? Histology

A

discs on distal extremities. Absent/altered lamellar granules (odland bodies) on EM

86
Q

What does UV cause AK? Which UV A or B

A

UVB causes thymidine dimers (C T or CT)

87
Q

Increasing risk of metastases in Invasive SCC at how much of a breslow depth?

A

greater than 2mm

88
Q

Increased risk of SCC in pt taking what medications?

A

voriconazole, vemurafenib, RA pts on MTX and etanercept

89
Q

Verrucous carcinoma HPV

A

HPV 6 and HPV 11

90
Q

What type of Kas do not involute?

A

subungal KAs

91
Q

Ferugson Smith onset of KA? Natural history?

A

Onset in 30’s on sunexposed areas. Resolves spontaneously

92
Q

Grzybowski onset of KA? Natural history?

A

Oneset later in adulthood and can involave airway.

93
Q

most common mutations in BCC?

A

Patch and p53

94
Q

BCC syndrome mnmonic

A

Green Berets Rarely Buy Xtra Shoes, but the get a lot of BCCs from being in the sun

95
Q

BCC syndromes

A

Gorlins, Bazex Dupre, Rombo, Brooke Spiegler, XP, Schopf Schulz Passarge

96
Q

Pilar cyst inherited?

A

AD inheritance

97
Q

Steatocystoma muliplex are inherited how?

A

Inherited AD

98
Q

Hidrocytomas can be associated with what syndrome?

A

Schopf Scheulz Passarge, also no teeth, hair, PPK (AR inheritance)

99
Q

bronchogenic cyst: where? Histology?

A

suprasternal notch, see cartilage, smooth muscle and GOBLET cells

100
Q

acral mucosal melanoma mutation?

A

ckit, CDK4

101
Q

BAP1 mutation can be associated with what cancers?

A

Uveal melanoma, mesothelioma, RCC, malignant cellular blue, epithelioid spitzoid nevi

102
Q

What is the natural history of a porocarcinoma?

A

frequent metastasis (20 percent to LN) and 10 percent mortality

103
Q

clear cell syringoma associated wit?

A

diabetes mellitus

104
Q

Mixed tumor most commonly see on what part of body?

A

nose, cheek, upper lip

105
Q

Spiradenoma is apocrine or eccrine?

A

apocrine

106
Q

Spiradnoma hyaline droplets are made of what? Stains with?

A

BMZ type 4 collagen. PAS positive

107
Q

Papillary eccrine adenoma seen in who?

A

black women on the legs. Looks like many dilated ducts in a fibrotic stroma

108
Q

tubular apocrin adenoma (TAA) is often indistinguishable from?

A

From papillary eccrine adenoma.

109
Q

tubular apocrin adenoma (TAA) found where, asscoiated with?

A

Forund on the scalp. Associated with nevus sebaceus

110
Q

brachial cleft cyst: where? Histology?

A

Lateral neck, dense lymphoid follicles

111
Q

Cafeau lait are also associated with what 3 syndromes? Mnemonic ?

A

Black no milk. Bloom, Noonan, MEN1

112
Q

ppl with nevus of Ota are at increased risk for?

A

10 percent develop glaucoma, and rarely also uveal melanoma

113
Q

Blue nevus mutatoin?

A

Blue jeans. GNAQ GNA11

114
Q

Malignant blue neuvs arrises from what type of blue nevus, where? mutation?

A

cellular blue on scalp. In addition to GNAQ, also have BAP1 loss

115
Q

Drug induced halo neuvs?

A

infliximab

116
Q

Atypical eithelioid spitz have what mutatoins?

A

HRAS mutation, BRAF mutation, BAP 1 mutation

117
Q

Spitz nevus immunostains?

A

Positive for S100A6, S100, p16

118
Q

What stain is lost in spitzoid melanoma?

A

p16 positive

119
Q

What gene locus is helpfu in risk stratification of spitz?

A

Homoyzgous loss of 9p21 (p16, CDKN2a) have increased risk of metastasis

120
Q

Congenital melanocytic nevus mutation?

A

NRAS

121
Q

Acquired melanocytic nevus mutation?

A

BRAF

122
Q

What does CDKN2A gene encode?

A

p14 and p16

123
Q

Non-sun damaged skin mutation?

A

BRAF

124
Q

Sun damaged skin mutation?

A

NRAS

Clinical Dermatology (11 decks)

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