Skin Cancers Flashcards
Most skin cancers originate in the ___.
Most skin cancers originate in the epidermis
Melanocytes live at the ___.
Melanocytes live at the dermal-epidermal junction.
Types of keratinocyte carcinoma
Basal cell carcinoma (arising from basal layer keratinocyte)
Squamous cell carcinoma (arising from any other layer)
Acanthosis
Hyperplasia-induced thickening of skin
Equivalent to saying “hyperplasia” when talking about skin cancer
Hyperkeratosis
Hyperplasia of keratinocytes in the stratum corneum
Intraepithelial neoplasm
Squamous cell carcinoma in-situ
Keratin pearls
Clumbs of keratin in the dermis or epidermis in skin cancer which are produced by atypical keratinocytes. Stain brightly with eosin
Histological characteristics of BCC
- Retraction artifact (white highlighting of subepidermal clusters of basiloid cells)
- Prominent nuclei
- Peripheral pallisading (linear layer of cancer cells between tumor and normal tissue)
- No scaling
Histological characteristics of squamous cell carcinoma
- Hyperkeratosis
- Acanthosis
- Nuclear pleiomorphism
- Variable thickness of epidermis
- Keratin pearls
- Keratin staining subepidermally
- Immune cell infiltration
telangiectasia
Dilated blood vessel which may be visible to the naked eye or with low-lower microscope
Sign of angiogenesis
Hallmark feature of many basal cell carcinomas
A nevus is defined by. . .
. . . the presence of melanocytes outside of the dermal-epidermal junction
(This may mean intraepidermally, or intradermally. Note that this has nothing to do with whether there is a malignant process occuring or not)
In a benign nevus. . .
- Clusters are well-demarkated and orderly
- Often symmetrical in distribution
- Uniform morphology of melanocytes
- Low level or absent inflammation
In a melanoma lesion. . .
- Clusters are not well demarkated and disorderly
- Melanocytes appear heterogeneous
- Distribution is often asymmetric
- High degree of inflammation
Early horizontal growth phase
- Early lesion of melanoma. Melanoma cells tend to spread horizontally along the dermal-epidermal junction before they spread veritcally
Melanoma in-situ
Hornziontal growth of melanoma along the basement membrane, but no penetration through the basement membrane. Prognosis is quite good for excision with excess margins,
Breslow tickness
Measurement from epidermis to point of deepest invasion of dermis
Single most important prognostic factor for patients. The deeper the melanoma, the worse the prognosis.
Types of benign nevus
- Junctional (melanocytes at dermal-epidermal junction)
- Dermal (melanocytes in dermis)
- Compound (some of both)
Junctional nevus
Compound nevus
Dermal nevus
Melanoma
ABCDE mnemonic
- Asymmetry
- Border
- Color (red, white, blue)
- Diameter (>6mm)
- Evolution
Why are red, white, blue worrisome on a nevus?
Red indicates inflammation
White indicates “regression,” or loss of melanocytes in a patch due to an adaptive immune response against them
Blue indicates deep dermal melanin (because of light scattering by collagen)
Subtypes of melanoma
- Superficial spreading
- Nodular
- Lentigo maligna
- Acral lentiginous
Superficial spreading melanoma
Nodular melanoma
Lentigo maligna melanoma
Acral lentiginous melanoma
Basal cell carcinoma
What is the correct order of prevalence for the most common skin cancers?
BCC > SCC > Melanoma
While ___ itself is not a risk factor for carcinoma, methods of treating ___ may induce cancer.
While psoriasis itself is not a risk factor for carcinoma, methods of treating psoriasis may induce cancer.
Squamous cell carcinoma
Most non-melanoma skin cancers occur at. . .
. . . sun-exposed surfaces
Non-radiation risk factors for skin cancer
- Arsenic
- Hydrocarbons
- HPV
- Scars
- Chronic inflammatory processes
- Ulcers
- Immunosuppression
Metastatic BCC is. . .
. . . EXTREMELY rare. Less than 0.1% of all BCCs metastasize
Basil cell carcinoma
actinic keratosis
precursor lesion to SCC.
Extremely common in fair-skinned elderly Caucasian individuals who have had significant chronic sun exposure. AKs occur as well-demarcated, scaly, rough patches or plaques on chronic sun-exposed skin surfaces.
Often more easily palpated than seen.
___ is the most common form of skin cancer in immunosuppressed individuals.
SCC is the most common form of skin cancer in immunosuppressed individuals.
SCC with keratin pearl
First step for treating any skin cancer
Biopsy!!! It is important to know which cancer it is FOR SURE.
The most frequent site for melanoma in men is the ___. The most frequent sites for melanoma in women are the ___.
The most frequent site for melanoma in men is the trunk. The most frequent sites for melanoma in women are the legs.
In invasive melanoma, ___ is the most powerful predictor of overall survival.
In invasive melanoma, the status of the regional lymph node basin is the most powerful predictor of overall survival.
