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MSI > Skin Cancer > Flashcards

Skin Cancer Flashcards

0
Q

Leser-trelat sign

A
  • Explosive development of brown papules

- Paraneoplastic syndrome

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1
Q
  • Brown “stuck on” papule that well circumscribed

- immature bland basaliloid keratinocytes with hyperkeratotosis acanthosis, keratin filled horn cysts

A
  • seborrheic keratosis

- activating mutation in FGF-3

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2
Q
  • Soft, flesh colored, bag-like polyp

- fibrovascular covered by normal tissue

A
  • acrochondron (skin tag, fibroepithelial)
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3
Q

Well demarcated papule with central punctum

- recapitulate hair follicle

A
  • epidermoid cysts ( aka sebaceous cyst)

- cyst will recur if entire lining is not excised

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4
Q

Cyst with a stratified squamous cell layer that includes granular layer

A

Epidermoid cyst

- many call them sebaceous cysts

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5
Q

Cyst with a stratified squamous cell layer that doesn’t include granular layer

A

Pilar cyst

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6
Q
  • Lesion of disorganized keratinocytes in the lower layers of epidermis
  • does not involve full thickness of epidermis
A
  • actinic keratosis

- premalignant: can turn into squamous cell carcinoma

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7
Q
  • Full thickness dysplasia

- irregular hyper chromatic nuclei

A

Squamous Carcinoma in situ

  • excision is curative
  • sun exposure is number 1 risk factor
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8
Q
  • Cup shaped lesion with central crater

- dome shaped nodule with central crater and keratin plug

A

Keratoacanthoma

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9
Q

Most common skin carcinoma
Ulcer with rolled boarder or pink pearly papule with talengectasia
Slow growing, circumscribed

A

Basal cell carcinoma

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10
Q

Gorlin syndrome

A
  • nevoid basal cell carcinoma syndrome
  • PTCH mutation (9:22)
  • two hit pathology
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11
Q

Lentigo vs. freckle

A
  • lentigo: darker, doesn’t darken in sun, larger, includes mucous membrane
  • freckle: smaller, darkens in sun, lighter, not on mucous membranes
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12
Q

Nevi

A
  • p16/INK4a, CDNK2 mutation
  • benign
  • moles
  • melanocytes Nevis: nests of melanocytes in basal epidermis
  • compound Nevis: junctional and intra dermal nests of melanocytes
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13
Q

Fused nests of atypical melanocytes between rete pegs

Linear lamellar fibrosis of papillary dermis

A

Dysplastic Nevus

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14
Q

Risk factors for malignant melanoma (genetic and environmental)

A
  • CDNK2a gene mutation
  • RAS/BRAF and PI3K
  • sun exposure, lightly pigmented, giant congenital nevi
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15
Q

Atypical melanocytes within epidermis, esp migrating in stratum spinosum, confluent single melanocytes at basal layer

A

Melanoma-in-situ

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16
Q

Dysplastic melanocytes involve epidermis and invade the dermis

A

Malignant Melanoma

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17
Q

Vertical growth down into dermis

A
  • primary prognostic factor
  • increases the risk in localized melanoma
  • Breslow thickness (measured from granular layer)
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18
Q

Tan-brown-red firm papule commonly on extremities

Fibroblasts and foamy histeocytes trap individual collagen bundles at periphery

A

Benign fibrous histyocytoma

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19
Q

Condition involving optic gliomas and pigmented Hartomas in iris, cafe-au-lait spots on skin

A

Neurofibroma (NF-1: loss of RAS)

AD

20
Q

Cafe-au-lait spots without but no lisch nodules in the iris

A

NF-2

21
Q

Plexiform rubbery mass

A

NF tumor

22
Q

Firm solid nodule/plaque on trunk, uniform spindle cells/storiform fascicles invading subcubitus

A

Dermatofibrosarcoma protuberans

- unlikely to metastasize -> Fibrosarcoma may metastasize

23
Q

Chronic non-healing lesions on trunk

  • atypical T cell infiltration with cerebriform nuclei
  • beads on a string lining up on DE junction
A

Mycoses fungoides

  • prognosis depends on % body coverage
  • moves into blood -> sezary syndrome
24
Q

Dome shaped papules on nodules and forehead

- jigsaw like puzzle islands of basaloid cells with small ductal lumen and surrounding hyaline sheath

A

Cyclindroma, turban tumors

25
Q

Slow-growing flesh colored papule on head and neck of older adults
- well circumscribed dermal nodule of sebocytes and outer layer if basaloid germanitive cells

A

Sebaceous Adenoma

- may be associated with HNPCC

26
Q

Solitary asymptomatic skin colored papules on face

- associoated with PTEN mutation

A
  • trichilemmomas
27
Q

Tumor suppressor genes associated with skin cancer (2)

A
  • p53

- PTCH

28
Q

Solar elastosis

A
  • elastic fibers get damaged and become disorganized

- not full thickness

29
Q

Insitu Squamous vs actinic keratosis

A
  • generally size

- squamous cell is also full thickness with basal layer is intact (in situ)

30
Q

Sunlight damage

A
  • UV -> pyrimidine dimers -> p53 activation (most common mutation in people who develop SCC) -> arrest cell division and corrupt cell dies
  • chronic immunosuppression increases risk factors
  • long term chronic lesion also increases risks
31
Q

Large light pink keratinocytes in well circumscribed cup

A
  • keratoacanthoma
32
Q

BCC transformation

A
  • main issue is damage to local tissue

- BCC rarely metastasize (.5%)

33
Q

BCC pathenogenesis (3 options)

A
  • most are sporadic p53 mutation
  • 30% are PTCH
  • gorlin syndrome: Nevoid BCC, one hit mutation in all cells
34
Q

Long thin rete pegs, non-nested single large myelocytes

A
  • lentigo
35
Q

BRAF-RAS path mutation

A
  • Nevus

- often accumulates p16 (melanoma have decreased)

36
Q

Nests of melanocytes

A

Nevus

- junctional-> compound -> intradermal

37
Q

Decreased p16/ increase in RAS -> increase in BRAF

A
  • associated with malignant melanoma
38
Q

17q11

  • NF1
  • eyes
A

RAS mutation

- plexiform

39
Q

22q11

- acoustic fibromas

A
  • NF2

- no lisch nodules

40
Q

Mycoses fungoides prognosis

A
  • % body coverage

- stage (patch, plaque, nodule)

41
Q

Pautrier abcess

A
  • mycoses fungoides

- lymphocytes infiltrating

42
Q

Association with lynch syndrome

A
  • sebaceous Adenoma
43
Q

Oncogenes tumor suppressor genes

A
  • oncogenes: Dominant expression, gain of function (kinases, GFs et al)
  • tumor suppressors: (p53, PTCH) resistive expression, loss of function
44
Q

Bowen’s syndrome

A
  • squamous cell carcinoma in situ

- unlike Actinic keratosis (which rarely transforms), Bowens transforms in 26 % of cases

45
Q

Trt of AK

A

5-FU: lights up areas affected

46
Q

Eminems CD is Not Killer

A

Malignant melanoma

- CDNK2a

47
Q

Gore PiTCHed his Nevil scheme in Philadelphia

A

Nevoid basal cell carcinoma: gorlin syndrome: PTCH: t9;22

MSI (9 decks)

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