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Flashcards in Chapter 2 Pathology of Skin Lesions Deck (39)
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1
Q

_______ biopsies are best for cases where most of the pathology is in the epidermis or superficial dermis

A

Shave

2
Q

For most inflammatory dermatoses, a _____ biopsy produces the best results.

_______ biopsies are used for complete removal of a cutaneous neoplasm as well as in cases of panniculitis or fasciitis where substantial deep tissue is needed

A

punch

Excisional

3
Q

For patients with unusual or persistent dermatoses, or if ________________ is suspected, more than one biopsy can be beneficial.

When a biopsy is performed for _______, two 4-mm punch biopsies are optimal: one for horizontal sections and one for vertical sections

A

cutaneous T-cell lymphoma

alopecia

4
Q

Enhanced cell proliferation accompanied by an enlargement of the germinative cell pool and increased mitotic rates lead to an increase of the epidermal cell population and thus to a thickening of the epidermis –> ___________

A

acanthosis

5
Q

___________ –> in which faulty and accelerated cornification leads to retention of pyknotic nuclei of epidermal cells at the epidermal surface

A

parakeratosis

6
Q

In some diseases, dyskeratosis is the expression of a genetically programed disturbance of keratinization as is the case in _________. Dyskeratosis may occur in _________ and ________.

A

Darier disease

actinic keratosis and squamous cell carcinoma

7
Q

The most common result of disturbed epidermal cohesion is the __________,

A

intraepidermal vesicle

8
Q

____________ is a primary loss of cohesion of epidermal cells

A

Acantholysis

9
Q

Dermal–epidermal attachment is enforced by ________________ that anchor basal cells onto the basal lamina

A

hemidesmosomes

10
Q

In bullous pemphigoid, cleft formation runs through the _________________ of the ______ membrane and is caused by autoantibodies directed against specific antigens on the cytomembrane of basal cells (junctional blistering)

A

lamina lucida of the basal

11
Q

In both interface and lichenoid processes, lymphocytes are present along the _________________ associated with vacuolar alteration of basal layer keratinocytes.
Examples of diseases?

A

dermal–epidermal junction
lichen planus
lupus erythematosus

12
Q

Angiocentric pattern:
infiltrate composed mostly of neutrophils associated with fibrin and hemorrhage is typical of _________________________ that presents clinically as palpable purpura.

In contrast, perivascular lymphocytes with hemorrhage is typical of __________________

A

small vessel or leukocytoclastic vasculitis

Schamberg’s pigmented purpuric dermatosis

13
Q

Periadnexal pattern:
Perieccrine inflammation is not specific, but it is often a clue that leads to a diagnosis of__________, ________, perniosis, or syringotropic mycosis fungoides

A

lupus erythematosus, neutrophilic eccrine hidradenitis

14
Q

Nodular or diffuse pattern:
Nodular collections of lymphocytes raise a differential diagnosis of _________, cutaneous lymphoid hyperplasia (pseudolymphoma), and angiolymphoid hyperplasia
If neutrophils predominate in a nodular infiltrate, one considers ___________, ________, follicular rupture, or abscess formation

A

cutaneous B-cell lymphoma

Sweet syndrome, pyoderma gangrenosum

15
Q

Palisading granulomas surround hypocellular areas of the connective tissue with histiocytes in radial alignment. _____________, _____________, and rheumatoid nodules belong to this group

A

Granuloma annulare, necrobiosis lipoidica

16
Q

The hallmark of scleroderma and morphea is the homogenization, thickening, and dense packing of the ___________, and a narrowing of the ___________ within the reticular dermis

A

collagen bundles

interfascicular clefts

17
Q

The fragmentation and curled and clumped appearance of elastic fibers are diagnostic in __________________

A

pseudoxanthoma elasticum

18
Q

______________ staining is often used to highlight presence, absence, or alteration of elastic fibers in the dermis

A

Verhoeff-van Gieson

19
Q

Verruca vulgaris:
___________ are identified by small round nuclei, perinuclear halos, and clumping of keratohyaline granules. They tend to be localized in the upper ___________ and ___________ in newer warts, and may be absent in more mature verrucae

A

Koilocytes

stratum spinosum and stratum granulosum

20
Q

Condyloma acuminatum:
While papillomatosis is a common feature, the surface of condyloma acuminata show rounded crests (so-called _________) as compared to verrucae vulgaris, which demonstrate elongated, pointed spires

A

knuckling

21
Q

____________ is reserved for SCC in situ of sun-protected anatomic sites such as the anogenital region

A

“Bowen disease”

22
Q

Multiple keratoacanthomas may arise spontaneously, in the context of genetic syndromes such as in _____________, or as a side effect of taking certain medications, notably the BRAF (v-raf murine sarcoma viral oncogene homolog B) inhibitors ________, _________, _________

A

Muir-Torre syndrome

sorafenib, vemurafenib, and dabrafenib

23
Q

BCC:
The lobules display palisading of columnar cells at the periphery. Within the lobules, mitotic figures and apoptotic cells (often referred to as ______________) are observed

A

single-cell necrosis

24
Q

____________ demonstrate lobules of basaloid cells in embedded in the dermis, which have a cribriform or lace-like appearance. ______ are often present within the basaloid lobules.

A

Trichoepitheliomas

Horn cysts

25
Q

A variant of a trichoepithelioma is the desmoplastic trichoepithelioma, which classically occurs on the _____ of young adult women.
desmoplastic trichoepitheliomas show elongated thin islands of basaloid cells set within a _____________ stroma

A

face

fibrotic (desmoplastic)

26
Q

Trichoblastoma:
Unlike BCC, however, ____________ are NOT commonly observed in trichoblastomas. Another distinguishing feature compared to BCC is the stroma surrounding the basaloid islands, which is richer in ______ and ______, lacking mucinous ground substance

A

epidermal connections

fibroblasts and compacted

27
Q

Dysplastic nevi:
The “shoulder” refers to the junctional component of a nevus that extends at least _____________ beyond a central area of dermal nevus cells
______________ is a phenomenon in which nests of nevic cells from adjacent rete appear to grow toward each other and fuse.
_______________ is commonly observed in dysplastic nevi, and indicates fibrosis in the papillary dermis that runs in parallel to areas of bridging in the epidermis

A

at least 3 rete pegs
Melanocytic bridging
Lamellar fibroplasia

28
Q

Spitz nevi:
__________ are a characteristic feature of Spitz nevi. These are acellular, globular eosinophilic inclusions in the epidermis, which are thought to be derived from _________ material.

A

Kamino bodies

basement membrane

29
Q

melanoma:
Solar elastosis is also frequently present, particularly in the ________ and ________ types
The epidermis is ______ in superficial spreading melanoma and often ______ in lentigo maligna melanoma

A

superficial spreading and lentigo maligna
thickened
atrophic

30
Q

melonoma:
Acral lentiginous and mucosal lentiginous melanomas, similar to lentigo maligna melanomas, show a predominance of _________ over nested growth along the dermal–epidermal junction

A

single melanocytes

31
Q

melanoma:
desmoplastic melanomas have a distinct immunohistochemical staining profile com- pared to conventional melanomas; they are typically MART-1 negative and positive for _____ and _____ stains.

A

S-100 and SOX10

32
Q

Dermatofibromas are benign lesions, which tend to have a hyperplastic epidermis and hyperpigmented, flattened rete, which are described as “________.”
“____________” is frequently seen, particularly at the periphery of dermatofibromas, in which spindle cells encircle collagen bundles

A

dirty feet

Collagen wrapping

33
Q

Dermatofibrosarcoma protuberans:
The cells intercalate between adipocytes in the subcutaneous fat, resulting in a “_________” appearance. A ______ or ______ pattern of the cells is commonly observed in the dermal com- partment

A

honeycomb

storiform or whorled

34
Q

In contrast to dermatofibrosarcoma protuberans, atypical fibroxan- thomas (AFXs) demonstrate marked ___________ of spindled and epithelioid cells in the dermis

A

cytologic atypia

35
Q

Pyogenic granuloma:

Typically, there is an _________ around the dermal vascular proliferation

A

epidermal col- larette

36
Q

angiosarcoma:

The lesional cells are high- lighted by endothelial cell markers, including ____ and ____

A

CD31 and CD34

37
Q

____________ ?
They are dermal tumors that consist of small, bland neural cells with wavy, S-shaped nuclei, set within a light pink stroma

A

neurofibroma

38
Q

Schwannoma:
_______ areas are more cellular, with areas of palisading of nuclei in parallel to one another around a relatively an acellular extracellular matrix, also referred to as ________.
_________ areas demonstrate spindled cells within a looser and often myxoid extracellular matrix

A

Antoni A
Verocay bodies
Antoni B

39
Q

The leiomyoma is a benign smooth muscle neoplasm, and in the skin is derived from either _______ (_______) or from _______________ (________)

A
pilar muscle (piloleiomyoma)
vascular smooth muscle (angioleiomyoma)