Skin - tumours Flashcards

1
Q

HG spindled lesions

A

AFX (no necrosis, LVI or deep invasion)

spindled SCC

melanoma

leiomyosarcoma

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2
Q

low grade spindled lesions

A

dermatofibroma

DFSP

nerve sheath (neurofibroma, schwannoma, perineurioma)

cellular blue nevus

Kaposi sarcoma

desmoplastic melanoma

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3
Q

DF vs DFSP

A

DF: epidermal hyperplasia, collagen trapping, birefringent collagen, F13a+, CD34-

DFSP: invades subcutis, F13a-, CD34+

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4
Q

solitary lesion with lichenoid inflammation

A

lichen planus-like keratosis

irritated seborrhoeic keratosis

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5
Q

solitary lesion with acantholysis

A

acantholytic acanthoma

warty dyskeratoma

acantholytic actinic keratosis

acantholytic SCC

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6
Q

clear cell epidermal neoplasms

A

clear cell acanthoma

tricholemmoma

SCC in-situ

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7
Q

infiltrative skin lesions

A

infiltrative BCC: clefts, myxoid stroma, pallisading

desmoplastic trichoepithelioma: single lesion, cheek of young women, small keratin cysts

syringoma: multiple, around eyes older women, tadpole shaped ducts

MAC: superficial microkeratocysts, ducts and strands, deep infiltration, PNI

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8
Q

junctional lesions

A

poroma

tricholemmoma (Cowden’s if multiple)

BCC

naevus

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9
Q

myxoid skin lesions

A

digital mucous cyst

digital fibromyxoma

dermal nerve sheath myxoma (s100+)

superficial angiomyxoma (Carney complex if multiple, epithelial component common eg cyst)

myxoid DF

myxoid DFSP (CD34+, PDGFRB mut)

myxoid NF (s100+)

LG fibromyxoid sarcoma (MUC4+, FUS rearranged)

myxofibrosarcoma

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10
Q

histiocytoid infiltrate

A

LCH: CD1a, s100+

JXG: Touton giant cells

lymphoma: atypical lymphoid cells, LCA/T cell markers
mastocytoma: CD117, mast cell tryptase

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11
Q

Spitz nevus and pigmented spindle cell nevus (Reed) vs melanoma

A

Spitz/Reed: symmetrical, Kamino bodies, no Pagetoid disease, HMB45 decrease with depth

Spitz only: crescent clefts, p16+, FISH panel

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12
Q

special site nevus - features and melanoma differential

A

acral nevus: lentiginous component, Pagetoid spread

genital nevus: rete nests, discohesion

both sites (vs melanoma): symmetry, dermal maturation, no deep mitoses

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13
Q

Painful skin lesions

A

ANGEL

angiolipoma (peripheral capillaries with microthrombi)

traumatic neuroma

glomus tumour (SMA+, also glomangioma/glomangiomyoma)

eccrine spiradenoma (cannonballs in deep dermis, 2 cell types)

vascular leiomyoma

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