premalignant and malignant Tumors of the skin

Question 1

Rough, sandpaper-like consistency

Answer 1

actinic keratosis

Question 2

what can induce actinic keratosis

Answer 2

sunlight,ionizing radiation,

hydrocarbons, and arsenicals

Question 3

describe the dermis in actinic keratosis

Answer 3

it contains thickened blue gray elastic fibers (elastosis/ basophilic degeneration)

Question 4

the stratum corneum in actinic keratosis

Answer 4

thickened, nuclei of cells are retained

Question 5

what is seen in the lowermost layers of the epidermis in actinic keratosis

Answer 5

cytologic atypia and it may be assctd with hyperplasia of basal cells

Question 6

Slightly elevated red patch of irregular contours is seen

Answer 6

bowen’s disease

Question 7

loss of maturation of epithelium but no invasion is seen in

Answer 7

bowen’s disease

Question 8

Second most common tumor arising on sun-exposed
sites in older people, exceeded only by basal cell
carcinoma.

Answer 8

SCC

Question 9

what is the major predisposing factor in SCC

Answer 9

Exposure to sunlight

Question 10

in SCC, many of the cells demonstrate _____ with abundant ________

Answer 10

keratinization with

abundant pink cytoplasm.

Question 11

(SCC) what is seen near the center

Answer 11

mitosis

Question 12

refers to ulcerating SqCC presenting in an area of
previously traumatized, chronically inflamed or
scarred skin.

Answer 12

MARJOLIN’S ULCER

Question 13

Giant condyloma
• Buschke-Lowenstein tumor
• Uncommon, well-differentiated form of SCC

Answer 13

verrucous carcinoma

Question 14

Present as pearly papules often containing prominent,

dilated subepidermal blood vessels (telangiectasias)

Answer 14

BCC

Question 15

growing downward deeply into the
dermis as cords and islands of variably basophilic
cells with hyperchromatic nuclei, embedded in a
mucinous matrix, and often surrounded by many
fibroblasts and lymphocytes.

Answer 15

Nodular lesions

Question 16

originating from the epidermis and
extending over several square centimeters or more of
skin surface

Answer 16

Multifocal growths

Question 17

Atypical melanocytic hyperplasia histologically “in
between” a clearly benign nevus and a malignant
melanoma.

Answer 17

dysplastic nevus

Question 18

Primary cause of melanoma

Answer 18

ultraviolet light (UV)
exposure in those with low levels of skin pigment

Question 19

in melanoma more superficial cells are

Answer 19

less mature, larger and

produce melanin, and form nests.

Question 20

in melanoma deeper cells are

Answer 20

More mature,

smaller, and acquire fusiform contours

Question 21

The epidermis in a melanoma shows atypical

Answer 21

melanocytic proliferation
consisting of irregular nested and single melanocytes
in all layers of the epidermis.

Question 22

appearance of spindle cells in desmoplastic malignant melanoma

Answer 22

deceptively bland appearance

Question 23

char feature of desmoplastic malignant melanoma

Answer 23

collection of lymphocytes

Question 24

Rare neoplasm derived from the infrequent and

functionally obscure Merkel cell of the epidermis,

Answer 24

Merkel cell epidermis

Question 25

describe a merkel cell

Answer 25

it is a neural crest derived cell and it's important for tactile sensation

Question 26

why does merkel cc resemble bcc or non pigmented malignant melanoma?

Answer 26

its lesions may be ulcerated

Question 27

because the lesions of merkel cc may be ulcerated it resembles

Answer 27

bcc or non pigmented malignant melanoma

Question 28

immunohistochemistry patern of merkel cc

Answer 28

dot like cytokeratin IHC patttern

Question 29

merkel cc is composed of

Answer 29

small, round malignant cells containing | neurosecretory-type cytoplasmic granules

Question 30

Best regarded as a well-differentiated, primary | fibrosarcoma of the skin

Answer 30

DERMATOFIBROSARCOMA PROTUBERANS

Question 31

Often develop as aggregated protuberant tumors within | a firm indurated plaque that may ulcerate

Answer 31

DERMATOFIBROSARCOMA PROTUBERANS

Question 32

describe the fibroblasts appearance on dermatofibrosarcoma protuberans

Answer 32

Fibroblasts arranged like the blades of a pinwheel | storiform

Question 33

can begin as small, sharply demarcated, asymptomatic, often multiple red nodules

Answer 33

Cutaneous angiosarcomas

Question 34

describe the cells on angiosarcoma

Answer 34

cells of which variably recapitulate the morphologic and functional features of normal endothelium.

Question 35

angiosarcoma can also arise in the setting of

Answer 35

lymphedema

Question 36

Arises in hair-bearing, sun-damaged skin typically | involving the face, scalp or ears

Answer 36

TRICHILEMMAL CARCINOMA

Question 37

Nodular plaque typically <3 cm in diameter, which may have a pale or reddish discoloration, or as an exophytic or polypoid nodule.

Answer 37

trichilemmal carcinoma

Question 38

why trichilemmal carcinoma is mistaken clinically for bcc or scc

Answer 38

because of its rapid growth keratoacanthoma

Question 39

Trichilemmal C arises from

Answer 39

outer hair sheath

Question 40

in tirichilemmal C there's an abundant clear cell change in tumor lobules due to

Answer 40

accumulation of intracytoplasmic glycogen as characterizes tumors of follicular outer root sheath derivation.

Question 41

Prototypic malignant lesion that produces matrical | differentiation comprising shadow cells

Answer 41

pilomatrix carcinoma

Question 42

Pilomatrix C arises from

Answer 42

hair matrix

Question 43

Pale or violaceous nodule up to 3 cm in diameter involving the eyelids, face or head and neck of elderly patients.

Answer 43

MUCINOUS ECCRINE CARCINOMA

Question 44

mucinous eccrine carcinoma has a pale or violaceous nodule up to 3 cm in diameter involving the

Answer 44

eyelids, face or head and neck of elderly | patients.

Question 45

describe the cytoplasm of the cells in mucinous eccrine carcinoma

Answer 45

vacuolated and may show signet ring formation with peripheral displacement of the nucleus by a large intracytoplasmic vacuole.

Question 46

in mucinous eccrine carcinoma, pools of mucin dissect the stroma creating

Answer 46

rounded and irregularly shaped aggregates of PAS-positive, diastase-resistant material which decorates with Alcian blue or with Hale's colloidal iron.

Question 47

PRIMARY CUTANEOUS ADENOID CYSTIC | CARCINOMA is usually seen in the

Answer 47

scalp and neck

Question 48

arrangement of tumor cells in primary cutaneou adenoid cystic carcinoma

Answer 48

characteristically arranged in cribriform | pattern in a loose myxoid background

Question 49

sebaceous carcinoma occurs more frequently in males or females?

Answer 49

females

Question 50

in sebaceous carcinoma, what is more common, the occular or extraocular?

Answer 50

ocular sebaceous carcinoma

Question 51

Disorder of middle-aged to elderly individuals with a | mean age of 62–72 years

Answer 51

SEBACEOUS CARCINOMA

Question 52

Definitive test for sebaceous differentiation

Answer 52

oil red O. | • Neutral lipid decorates with a bright red tinctorial quality.

Question 53

Well circumscribed lobules, nests or small aggregates of large, cohesive, epithelioid cells closely associated with a dense, mixed T and B lymphocytic and plasmacytic infiltrate. this is seen in

Answer 53

LYMPHOEPITHELIOMA-LIKE CARCINOMA OF THE | SKIN

Question 54

what can be seen sorrounding and intermingling with epithelial tumor cells in lymphoeptihelioma like carcinoma of the skin

Answer 54

Mandatory dense inflammatory infiltrate (polymorphous | and polytypic)

Question 55

Histiocytosis X | • Eosinophilic granuloma

Answer 55

LANGHERHANS CELL HISTIOCYTOSIS

Question 56

describe the cutaneous form of langherhans cell histiocytosis

Answer 56

solitary or multiple papules or nodules or as scaling erythematous plaques resembling seborrheic dermatitis

Question 57

Variable numbers of eosinophils with diffuse-togranulomatous dermal infiltrates of round-to-ovoid mononuclear cells with indented, bland nuclei this can be seen in

Answer 57

LANGHERHANS CELL HISTIOCYTOSIS

Question 58

Cutaneous T-cell Lymphoma • Arises primarily in the skin and generally remains localized there for may years

Answer 58

MYCOSIS FUNGOIDES

Question 59

seeding of the blood by malignant T | cells, accompanied by diffuse erythema and scaling

Answer 59

Sezary syndrome

Question 60

Rare family of disorders characterized by cutaneous | (and occasionally visceral) mast cell proliferation

Answer 60

MASTOCYTOSIS

Question 61

most common tissue that is | systematically affected in mastocytosis

Answer 61

Bone marrow

Question 62

in mastocytosis there is point mutation of

Answer 62

c-KIT proto-oncogene

Question 63

point mutation of c-KIT proto-oncogene results in

Answer 63

activation of the KIT tyrosine kinase that direct mast | cell growth and differentiation

Question 64

may be used to specifically highlight mast cells | in mastocytosis

Answer 64

CD117

Question 65

Variable dermal fibrosis, edema, eosinophils, and mast | cells is seen in

Answer 65

mastocytosis

Question 66

number of mast cells that is considered pathological in mastocytosis

Answer 66

>15 mast cells/HPF