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HealthCert Education > Pink tumours > Flashcards

Pink tumours Flashcards

1
Q

How does tumour volume influence vascular morphology?

A

Flat tumour - mainly see dotted vessels
Elevated tumour - see curved vessels - parts of loops of vessels
Nodular tumour - see linear vessels - long parts of vessels

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2
Q

How does melanoma size influence vascular morphology?

A

< 1 mm : dotted - coiled
< 2 mm : coiled - linear irregular
> 2 mm : linear irregular

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3
Q

a polymorphous (crazy) vascular pattern is suggestive of ….

A

Malignant tumour

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4
Q

polymorphous vessel definition

A

> 1 type vessel arrange in chaotic distribution

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5
Q

most common vessel combination in melanoma

A

dotted + linear vessels

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6
Q

Approach to pink tumours : use the …

A

3 Step Algorithm

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7
Q

3 Step algorithm

A

1st step morphology of vessels - type of vascular pattern
2nd step architectural arrangement of vessels - distribution within lesion
3rd step Dermoscopic clues

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8
Q

6 main types of vessels

A

Comma, curved vessels. May vary in size.
Dotted
Linear irregular
Hairpin
Glomerular - coiled
Arborizing - branched, usually sharp in focus, large stem then finer

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9
Q

Hairpin vessel with surrounding white area is clue for …

A

keratinizing tumours

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10
Q

Glomerular vessels usually seen in ..

A

Bowen’s disease

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11
Q

Vascular arrangement - 6 types

A 
Regular
String - like
Clustered
Radial
Branching
Irregular
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12
Q

Dotted vessels in regular distribution usually seen in -

A

melanocytic skin tumours

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13
Q

Dotted vessels in string distribution usually seen in -

A

Clear cell acanthoma

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14
Q

Glomerular vessels in Bowen’s disease are usually arrange in ….

A

Clusters or groups

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15
Q

Hairpin vessels arrange in radial distribution associated with keratin found in ..

A

Squamous cell Ca

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16
Q

Red-purple aggregated globules seen in …

A

Cherry angioma

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17
Q

Bright red structureless areas with whitish intersections seen in …

A

Pyogenic granuloma

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18
Q

Milky red globules (strawberry milkshake) + central linear vascular pattern seen in ….

A

Thick amelanotic nodular melanoma

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19
Q

Crown vessels surrounding yellow area seen in …

A

sebaceous hyperplasia

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20
Q

Strawberry pattern - erythematous background intermingled with white to yellow hair follicles seen in …

A

actinic keratosis on face

21
Q

Structureless pink areas and multiple erosions

A

Superficial BCC

22
Q

Vascular patterns of melanocytic tumours

A
  1. Comma (curved) - Intradermal nevus
  2. Dotted (dots) - Spitzoid neoplasms
  3. Linear irregular (lines) - melanoma
23
Q

Intraderal nevus Dermoscopy features

A
  1. Comma vessels
  2. Regular (Within papilla)
  3. Brown globules, comedo openings, milia
24
Q

Dermoscopic features spitzoid neoplasms incl. Spitz nevus and melanoma in situ

A
  1. Dotted vessels.
  2. Regular pattern.
  3. Clues: Pink color, white network, residual brown-grey pigment.,
25
Q

Features that favour Spitz nevus as opposed to early melanoma

A
  1. Early age

2. White network.

26
Q

Features that favour invasive melanoma

A
  1. Lear/ irregular +/- dotted vessels
  2. Central
  3. Clues: Residual pigment. Pink color. White short stream. (Polarizing specific white lines.)
27
Q

Linear irregular vessels. Distinguishing features from barbarizing vessels in BCC:

A
  1. Thinner
  2. Shorter
  3. Not as well defined - less sharply in focus.
28
Q

% of true melanotic melanoma

A

< 2%

29
Q

Amelanotic melanoma important clue

A

Residual pigment

30
Q

Vascular patterns of non melanocytic tumours n

A

Hairpin vessels: Seb keratosis, may also be seen in SCC
Glomerular : Bowens disease.
Arborizing: BCC

31
Q

Derm features seb keratosis

A

Hairpin vessels - usually at border. In centre mainly curved vessels.
Arrangement, regular
Clues: White halo around vessels, milia, comedo openings

32
Q

Clear cell acanthoma

A

Morphology: Dotted.
Arrangement: String like
Clues: White halos around vessels.

33
Q

Bowen’s disease

A

Morphology: glomerular
Arrangement: Clustered
Clues: White halo around vessels. yellow white scales.

34
Q

Nodular cystic basal cell Ca

A

Morphology : arborizing.
Arrangement: Focussed.
Clues: Blue/grey globules

35
Q

Superficial basal cell Ca

A

Morphology: Often lack vessels. Mainly seen at periphery as short linear vessels.
Clues: Structureless white to red areas
Multiple erosions.
White short lines (polarizing)

36
Q

Importance of erosions in flat pink lesions

A

erosions occur late in melanoma and are not seen in flat melanoma.
multiple small erosions are important clue to basal cell carcinoma

37
Q

How many grades of actinic keratosis?

A

3

38
Q

AK, grade 1

A

Better felt than seen

39
Q

AK, grade 2

A

Moderately thick. Easily felt and seen. Classic reddish plaques.

40
Q

AK, grade 3.

A

Very thick. Hyperkeratotic.

41
Q

AK Dermoscopy grade 1

A

red pseudo-network and fine scales.

lines around follicular openings which are similar in size and very fine

42
Q

AK Dermoscopy grade 2

A

background erythema and white hair follicles (strawberry pattern)
hair follicles are enlarged, consist of central yellowish clod surrounded by white halo
background erythema
“strawberry pattern”

43
Q

AK Dermoscopy grade 3

A

Structureless white/yellow keratotic areas.

Keratotic clods within hair follicles

44
Q

Dermoscopy squamous cell carcinoma

A

Morphology: Hairpin, glomerular
Arrangement: Radial
Clues, white structureless areas, white circles
Central masses of keratin

45
Q

Pinkish colour in suspect benign tumour - management

A

Biopsy - should not see pinkish colour in benign tumour

46
Q

Suspected pyogenic granuloma - biopsy

A

May mimic melanoma

47
Q

Benign pink lesions to know

A
  1. Intradermal nevus
  2. Seborrheic keratosis including clear cell acanthoma
  3. Sebaceous hyperplasia.
48
Q

Any pink lesions that is not clearly identified as benign lesion - management

A

Biopsy

HealthCert Education (24 decks)

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