Pathology of pigmented lesions Flashcards

1
Q

Where do melanocytes originally come from?

A

neural crest

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2
Q

In early embryogenesis, where do melanoblasts migrate to?

A

Skin
Uveal tract of the eye
Leptomeninges of the spinal column

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3
Q

What does the MC1R gene do?

A

Determines balance of pigment by turning phaemelanin into eumelanin.

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4
Q

What does 2 defective copies of this gene cause?

A

Red hair and freckles!

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5
Q

What are ephilides?

A

freckles

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6
Q

What causes ephilides?

A

One defective copy of the MCR1 gene

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7
Q

What are liver spots known as?

A

Actinic lentigines

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8
Q

Where are liver spots most common at?

A

Face, forearms and dorsal hands.

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9
Q

What causes melanocytic naevi?

A

The melanocyte: keratinocyte ratio breaks down so more melanocytes.

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10
Q

What is a sporadic dysplastic naevi?

A

> 6mm diameter with variegated pigment and has no familial link

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11
Q

True or False

Familial dysplastic naevi have a strong link with developing melanomas

A

True

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12
Q

True or False

Malignant melanomas are more common in females.

A

True

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13
Q

What type of melanoma affects the trunk and limbs ?

A

Superficial spreading

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14
Q

What type of melanoma affects sun-damaged face/head/scalp?

A

Lentigo maligna

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15
Q

What type of melanoma affects the mucosa?

A

Acral/mucosal lentiginous

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16
Q

What does RGP stand for?

A

Radial growth phase.

E.g. macules in-situ

17
Q

Why do VGP melanomas metastasise?

A

Blood and lymphatic access.

RGP melanomas are restricted to the epidermis.

18
Q

How does nodular melanoma differ from other melanomas?

A

Begin as a nodule as opposed to a macule/patch.

Much more aggressive.

19
Q

What is prognosis related to?

A

Breslow thickness of tumour

20
Q

what does in-situ mean?

A

100% survival since cancer cells are present but no melanoma is yet present.

21
Q

How thick is a stage 2 tumour?

A

1-2mm. v

it has an 80% survival rate.

22
Q

How thick is a stage 4 tumour?

A

> 4mm thick.

20% survival

23
Q

What does the suffix -b mean in staging?

A

Presence of ulceration

24
Q

Describe the spread of malignant melanomas

A
  1. dermal lymphatics.
  2. regional lymph node metastases
  3. blood spread to heart, lungs, GI tract, brain.
25
What are satellite deposits?
First stage of metastasis.
26
What is the primary treatment for melanoma?
Excision and send to pathology.
27
What is a sentinel node biopsy?
Radioactive tracer and blue dye inserted to see which node the lymphatics drain into. If this node is positive then all nodes are removed.
28
What is a BRAF mutation?
Mutation of an oncogene.
29
What colours of naevi are red flag signs?
Red, white, blue and black
30
True or False | Melanoma can regress.
True. | Metastases can appear after the melanoma has disappeared