Skin and Soft Tissue Neoplasms
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| Disorders of Pigmentation and Melanocytes = ? | * Freckles -- Lentigo -- Melanocytic Nevus -- Dysplastic Nevi -- Melanoma
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| Most common pigmented lesions of childhood = ? | * Freckle (Ephelis) - from increased melanin in basal keratinocytes..... * Due to HYPERTROPHY
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| Lentigo basics = ? | * Linear HYPERPLASIA of melanocytes.... * Does NOT darken when exposed to sunlight (is dark to begin with though)
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| Melanocytic Nevus (Mole) basics and what it is commonly confused with = ? | * Benign, and can come out during pregnancy... * Confused with Melanoma a good bit
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| Melanocytic Nevus Patho = ? | * Mutations in BRAF or NRAS
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| How the Melanocytic Nevus tumor stops growing ? | * Oncogene-induced senescence = get cellular arrest by p16 when BRAF/NRAS are out of whack
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| Maturation Sequence of Nondysplastic Melanocytic Nevi = ? | * Flat = when it forms at the EPI/DERMis Junction --> Junctional Nevus.... * Compound Nevus = at Junction AND in the DERMIS... * DERML NEVUS = all of it grows in the DERMIS
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| Histo of Junctional Type = ? | * small, flat, uniform, nests at the dermal-epidermal junction
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| Compound Type = ? | * raised, and more domed shape... * see intraepidermal and dermal nevus cells
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| Melanocytic Nevus Variants = ? | * Congenital nevus -- Blue nevus -- Spitz nevus -- Halo nevus -- Dysplastic nevus
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| Congenital Nevus = ? | * nevus cells are surrounded such structures such as hair follicles, dense nevus cells in the dermis,
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| Blue Nevus = ? | * Is a Dermal Lesion = is benign, but can reoccur
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| Spitz Nevus = ? | * DDx = Hemangioma... * Common in children.... * Histologically mimics MELANOMA... * See streaming down nests and hypergranulosis
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| Halo Nevus = ? | * Looks like a white patch, with a red dot in the middle of it... * Is from Lymphocytic infiltrate around nevus cells
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| Dysplastic Nevus = ? | * usu numerous and found on the back... * found at the epi/dermal junction... * See architectural changes and bridging... * PRECURSOR to MELANOMA
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| Dyplastic Nevus genes usu involved = ? | * CDK = cyclin dependent kinase
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| Melanoma basics = ? | * DEADLY if not caught early.... * Can arise not only from skin, but from mucosal surfaces
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| Melanoma Cx Features = ? | * Usu asymptomatic or may start with pain/itching.... * Most are >10mm at Dx.... * ABC's = Asymmetric, Irreg Borders, and Color Changes
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| Melanoma Histo = ? | * Has either a Radial Phase = Flat, wide growth OR Vertical Phase = Raised, that is due to increased mitosis (VERTICAL = Worst Prog.)... *
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| Signaling Pathways important in Melanoma = ? | * Cell Survival = mTOR Pathway (usu in non-sun exposed ppl)... * Cell Prolif = RAS/RAF Pathways (BRAF/NRAS) (sun exposed ppl)
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| Some Melanoma Prognostic Factors = ? | * Depth, Number of Mitoses, Growth Patterns, Tumor Regression/Progression
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| Merkel Cell Carcinoma = ? | * Neuroendocrine CA of the skin.... * rare, aggressive, common mets... * BIGGEST ISSUE = it may be rarer than Melanoma, but is TWICE as deadly
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| Morphology of Merkel cell Carcinoma = ? | * Raised/Indurated Ulcer looking lesion, with rolled edges.... * Histo: See lots of large blue cells
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| AEIOU of Merkel Call CA = ? | * Asymmetry, E ?, immunocomp?, older than 55, and UV exposure
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| Benign Epithelial Tumors = ? | * Seborrheic keratosis -- Acanthosis nigricans -- Fibroepithelial polyp (skin tag)
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| Seborrheic Keratosis mutations and is from ? | * Due to mutations in FGFR3 and is from tumor growth factor alpha.... *
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| Leser-Trelat sign = ? | * Large numbers of seborrheic keratosis appear as part of paraneoplastic syndrome (lots of them)
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| Seborrheic keratosis histo = ? | * well demarcated, coin like lesion, filled with dark keratin, and is composed of benign BASALOID cells thar produce the keratin layer and can get keratin horns
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| Actinic Keratosis = ? | * PRE-Malig epi lesion, from sun expose and exhibits hyperkeratosis and parakeratosis... * HIGH incidence in light skinned people... * Can get a CUTANEOUS HORN
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| Malignant Epidermal Tumors = ? | * Basal Cell Carcinoma -- Squamous Cell Carcinoma
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| Basal cell Carcinoma basics = ? | * Most common, slow growing, tends to be in sun exposed ppl and light skinned ppl... * Incidence rises in immunocomp ppl
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| BCC Morphology and Histo = ? | * Raised, Shiny, telangiectatic nodules .... * Histo = see nests of Basaloid cells and Artifactual retraction (BCC separates from the rest of the layers)
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| Gorlin syndrome = ? | * A nevoid BCC syndrome when we have basal cell nevi arising before the age of 20... * We see medulloblastoma, ovarian fibroma, palmar pits, and other things in these pts.
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| Patho of Gorlin Syn = ? | * Mutation in PTCH, and doesn't have SMO joined to it to keep it inhibited
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| Squamous cell carcinoma = ? | * 2nd most common skin CA.... * Higher in MEN.. * Usu detected when small and usu resectable
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| SqCC Morpho/Histo = ? | * can look like a scab... * see the typical squamous keratin pearls and intracellular bridges
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| Patho of SqCC = ? | * From UV Exposure (280-320nm) = formation of pyrimidine dimers (C-T bind instead of the normal A-T and C-G)
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| Tumors of the Dermis = ? | * Dermatofibroma (benign fibrous histiocytoma) -- DFSP (dermatofibrosarcoma protruberans)
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| Dermatofibroma = ? | * BENIGHN... * usu a Hx of Trauma, and arises on the legs of middle aged women... * looks like BCC without the vasc... * Histo = see well circumscribed prolif of collagen bundles and see the overlying hyperplasia of the epidermis
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| Soft Tissue Tumors = ? | * Fatty Tumors -- Fibrous tumors and Tumor like lesions -- Fibrohistiocytic Tumors -- Synovial sarcoma
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| Lipomas and Liposarcomas = ? | * Liposarcomas = see in DEEP tissues and in the retroperitoneum (pleomorphic is worst kind)
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| Fibrous Tumors and Tumor Like-Lesions = ? | * Reactive pseudosarcomatous proliferations -- Fibromatosis -- Fibrosarcoma
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| Reactive Pseudosarcomatous Proliferations types and basics = ? | * Nodular Fasciitis = painless, solid, benign, fast growing mass that has spindle fibers and RBCs in it..... * Myositis Ossificans = see bone growing the muscle after a trauma (young athletic ppl usu)
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| Fibromatoses = ? | * Superficial Fibromatosis = nodular or poorly defined broad fascicles of fibroblasts & myofibroblasts surrounded by abundant dense collagen (ex. Peyronies - penis curve).... * Deep-Seated Fibromatosis (Desmoid Tumors) = lg, reoccur if incomplete excision
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| Deep-Seated Fibromatosis genes = ? | * Mutations in APC or B, in those with or without underlying Gardner syndrome
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| Fibrosarcoma = ? | * Histology = Buzzword is Herringbone Pattern (spindle cells and TONS of mitosis)
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| Fibrohistiocytic Tumors = ? | * contain both fibroblast elements and macrophages.... * Benign Fibrous Histiocytoma and Malignant Fibrous Histiocytoma
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| Synovial Sarcoma = ? | * Cell of origin is unclear and ppl usu 20-40... * usu in soft DEEP tissue,slow grower, and around the hip/knee (can be in neck too).... * Can be Monophasic = epi OR spindle cells only, OR Biphasic = BOTH epi and spindle cell
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| Synovial Sarcoma genes and important trait = ? | * from translocation in T(X,18) (p11;q11)... * Has a high chance to Mets to LUNG, LNs, and BONE
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