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15 Cards in this Set
- Front
- Back
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Describe the features and layers of normal skin
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1. epidermis
2. dermis 3. adnexae - connections within the skin (hair, sweat glands) reside in the dermis as you age, the epidermis sheds and renews. melanocytes are pigments that create teh skin color. -will also see macrophages, dendritic cells. -must especially pay attention to basement membrane when tumors reach basement membrane. |
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Define the following based on shape and size
1. macule 2. papule 3. nodule 4. vesicle 5. bulla |
1. macule: flat
2. papule: elevated (<5mm) 3. nodule: elevated (>5mm) 4. vesicle: fluid filled (< 5mm) 5. bulla: fluid filled (>5mm) |
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Eczematous dermatitis
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Red papulovesicular oozing and crusted lesions
Later develop into scaly plaques Classification Allergic Contact Photo Atopic Drug Irritant |
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Describe the pathogenesis of eczematous dermatitis
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Spongiosis = Accumulation of edema in epidermis
Progress to scaly and acanthotic Mediated by sensitized T lymphocytes Initially processed by Langerhans cells Migrate to draining node to present the antigen to naïve T cells Upon re exposure memory T cells release cytokines |
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Verruca vulgaris
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irregular viral warts. can be very benign but some variants of human papilloma virus can cause cancer, especially if it appears in cervix. HPV 16 and 18.
-appearance in oropharyngeal cavity. Human Papilloma virus Generally self limiting Gray white to tan papules with a rough surface Transmission due to direct contact In anogenital region can be preneoplastic |
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Seborrheic keratosis
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Common in middle aged and older patients
Usually Trunk Round flat coin like plaques Tan to dark brown velvety surface Exophytic (raised lesion) proliferation of basal cells with horn cysts - nodular clusters; this makes it benign, no breach of basement membrane Excision |
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Squamous cell carcinoma
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Most common tumor
sun exposed sites older patients Highly atypical cells Invade through basement membrane (this is the factor that makes it malignant or mestatize) Early diagnosis is critical in prognosis |
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Basal cell carcinoma
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Slow growing
Sun exposed Older patients Rarely metastasize Pearly papules with telangiectasia (increased vasculature, increase blood cells proliferating) Palisading tumor cells Separation artifact |
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Tumors of melanocytes
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Nevus
Small pigmented papules Transformed melanocytes Dermoepidermal junction (junctional) Cords and nests in dermis (compound) Dermis (dermal) Dysplastic Architectural and cytologic atypia Risk of melanoma |
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What happens in a dysplastic nevus?
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wherever the dermis meets the epidermis, you see basement membrane. the nests of melancytes starts to fuse, and hear you start to see morphological enlargements.
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Malignant melanoma
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Sunlight
Dysplastic nevus Familial CDKN2A gene PTEN gene Change in color or size Vertical and horizontal growth phase Vertical growth determines biologic behavior may see a pigment around the primary lesion. cross section of the lesion will show a brown lesion, but there are cases in which you have amelanoma and don't see a dark lesion. -may also see this in retina. some pts have glass eye that had this removed. may also manifest in liver. |
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Osteoarthritis
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-intrinsic defect of articular cartilage
Older >65 years Wear and tear Genetic factors Fibrillation of articular surface Eburnation of surface: burning away of the cartilage. you get marbeling of the surface. Cysts and osteophytes |
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Soft tissue tumors
1. Fibromatosis 2. Fibrosarcoma |
1. Fibromatosis: Fibroblastic proliferation
Tendency to recur Do not metastasize 2. Fibrosarcoma: stromal cells involved Malignant Adults Solitary Herringbone pattern of spindle cells -better to diagnose them by molecular methods since its hard to distinguish fibroscarcomas from one another. |
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Rhabdomyosarcoma
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Skeletal muscle differentiation
Infancy childhood and adolescence Peak in first decade of life Several variants Alveolar rhabdomyosarcoma t(2:13)(q35;q14) dysregulation of skeletal muscle differentiation by PAX3-FKHR fusion gene |
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Synovial sarcoma
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Arises from mesenchymal cells around joint cavities
Unique chromosomal translocation t(X;18) Epithelial and stromal components Behavior linked to genetic characteristics of tumor |
