Norton Part 4

Question 1

what are the subtypes of squamous cell carcinoma

Answer 1

oral and verrucous (resemble large warts)

Question 2

diagnosis of non melanoma skin cancer requires what

Answer 2

biopsy (shave, punch, incisional, or excisional)

Question 3

to determine the presence or absence of invasive disease one must go how deep in a biopsy

Answer 3

mid dermis

Question 4

if lymphadenopathy is present w/ squamous cell carcinoma what should be done

Answer 4

lymph node biopsy or FNA (fine needle aspiration)

Question 5

a squamous eddy is seen in what?

Answer 5

squamous cell carcinoma

looks like a swirl

Question 6

keratoacanthoma is what

Answer 6

a benign epithelial tumor that mat progress to squamous cell carcinoma

Question 7

what appears suddenly on actinically-damaged skin, grow rapidly and spontaneously regress after a few months

Answer 7

keratoacanthoma

Question 8

what does keratoacanthoma look like

Answer 8

red to flesh colored dome-shaped papule with a central crater filled with keratinous plug

Question 9

what histological features are seen in keratoacanthoma

Answer 9

large, red, glassy squamoid cells
neutrophil micro abscesses common
eosinophils and lymphocytes are common in surrounding infiltrate
cellular atypia and mitoses uncommon

Question 10

keratoacanthoma may BE what

Answer 10

well-diffentiated SCC

Question 11

what is the most common malignancy

Answer 11

basal cell carcinoma

Question 12

basal cell carcinoma is of what cells

Answer 12

pluripotent cells in the basal layer of the epidermis or follicular structures

Question 13

basal cell carcinoma grows at what speed and how often does it metastasize

Answer 13

slow growing

rarely metastasizes

Question 14

if neglected or inadequately treated what can basal cell carcinoma cause

Answer 14

local destruction and disfigurement

Question 15

with proper therapy what is the prognosis of basal cell carcinoma

Answer 15

excellent

Question 16

what are risk factors for basal cell carcinoma

Answer 16

UV radiation
X-ray
arsenic
immunosuppression
prior history of NMSC

Question 17

basal cell carcinoma often presents with what

Answer 17

a non-healing lesion that bleeds

Question 18

basal cell carcinoma is commonly found where

Answer 18

face, ears, scalp, neck, or upper trunk

Question 19

what are the subtypes of basal cell carcinoma

Answer 19

nodular (most common)
superficial (second most common)
morphaeaform
other rare ones

Question 20

what is the most common subtype of basal cell carcinoma

Answer 20

nodular

Question 21

nodular basal cell carcinoma is most commonly found where

Answer 21

face (most common site)

Question 22

superficial basal cell carcinoma is most commonly found where

Answer 22

trunk

Question 23

nodular basal cell carcinoma presents how

Answer 23

waxy papule with central depression
pearly appearance
erosion, ulceration, or crusting
bleeding with minor trauma
rolled (raised) border
translucency
telangiectasia over the surface

Question 24

superficial basal cell carcinoma presents how

Answer 24

slightly scaly papule or plaque
light red color
atrophic center with fine translucent micropapules on rim

Question 25

the stroma separating from tumor nodules (separation artifact) is seen in what

Answer 25

basal cell carcinoma

Question 26

nests of “basaloid cells” which “palisade” at the border of the nest is commonly seen in what

Answer 26

basal cell carcinoma

Question 27

basal cell carcinoma is diagnosed how

Answer 27

biopsy (punch or shave usually preferred)

if small the entire lesion may be removed but not exceeding clinical margins

Question 28

nests of fibromyxoid stroma are seen in what

Answer 28

basal cell carcinoma

Question 29

what is seen histologically in basal cell carcinoma

Answer 29

nests of fibromyxoid stroma
nests of “basaloid cells” which “palisade” at the border
most tumor nests/nodules attach to the undersurface of the epidermis
stroma separates from tumor nodules

Question 30

when taking HPI of suspected skin cancer what should you ask

Answer 30

duration of lesion
changes in size and color
associated symptoms
lymphadenopathy
treatment
past and present sun exposure