Malignant Epithelial Pathology

  1. Carcinoma is from ____
    Sarcoma is from_____
    • Epithelium
    • Connective Tissue
  2. accounts for >90% of oral cavity cancers 
    minimal pain
    seen more commonly in males 65+
    presents as an indurated/hard lesion, fixed to underlying structures, will have "rolled" border if ulcerated and may destroy the underlying bone
    Squamous cell carcinoma
  3. What is the most common site for SCC in the ORAL cavity ?
    Other location of SCC
    Tongue (posterior lateral and ventral surfaces)

    Gingiva--may cause bone destruction and present at the site of an extraction site
  4. initial symptoms may be dysphagia and pain
    more difficult to see and diagnose so most cases are in late stages
    majority associated with high risk HPV (16,18,33)
    Oropharyngeal SCC
  5. What is the best predictor of prognosis of oral cancer?
    Staging (based on tumor size and metastatic spread)
  6. SCC mainly metastasizes though ____
    lymph nodes (ipsilateral)
  7. 50% of SCC patients have ____ ___ ___ at the time of diganosis
    Positive cervical nodes
  8. what is a characteristic microscopic feature of SCC?
    keratin curls
  9. the ___ grade usually associated with ___ prognosis
    • Higher
    • Poorer

    • well-diff (low-grade)
    • poorly-diff (high-grade)
  10. Low grade variant of SCC 
    AKA snuff dipper's cancer (more common in smokeless tobacco users but not exclusive)
    Presents as painless and slow growing, papillary or veracious surface, usually white in color
    Verrucous carcinoma
  11. T/F: Verrucous carcinoma has a very low chance of metastasis
  12. a type of carcinoma that is related to salt fish with nitrosamines and EBV as causes 
    More common in males ages 40-60
    First sign of disease for most patients is enlarged cervical lymph nodes
    Symptoms: epistaxis, nasal obstruction, pharyngeal pain
    Nasopharyngeal carcinoma
  13. What are the three types of microscopic features of nasopharyngeal carcinoma
    • SCC
    • Non-Keratinizing SCC
    • Undifferentiated/poorly differentiated (must use special stains to identify cytokeratins, almost all occur inpatients younger than 40)
  14. How is nasopharyngeal carcinoma treated?
    Radiation (due to inaccessibility and presentation with metastasis)
  15. 80% of all skin cancers (85% in the head and neck region)
    Results from chronic exposure to UV light 
    NOT found in the oral cavity
    Basal Cell Carcinoma
  16. Where and who is most affected by basal cell carcinoma
    • Fair-complexioned Caucasians
    • most commonly on the sun-damaged skin of the middle third of the face
  17. Begins as firm, painless papule and enlarges and develops central depression 
    Boarder is smooth, elevated rolled and shiny or pearly
    Telangiectasia is often present
    Basal cell carcinoma--nodular form
  18. Nodular BCC colonized by benign melanocytes 
    usually irregular distribution of pigment (unlike a nevus)
    Basal cell carcinoma--pigmented form
  19. "morpheaform"--like localized scleroderma
    mimics scar tissue 
    firm to palpation, with indistinct boarder
    Basal cell carcinoma--sclerosing form
  20. Well-demarcated, erythematous, scaly patches
    can be mistaken for psoriasis
    have a narrow and raised edge and usually multiple present
    Basal cell carcinoma--superficial
  21. Which basal cell form?

    ___1___ dense connective tissue with infiltrating strands of basal cells

    ___2____multiple lobules of basal cells dropping from the surface
    • 1. Sclerosing
    • 2. Superficial
  22. Most malignant cancer (third most common cancer)
    Arises from melanocytic nevi or de novo 
    Risk factors: sun exposure, light complexion, family history, past Hx
  23. T/F: rates of melanoma are decreasing over the past few decades
  24. Which type of melanoma is rare?
    Oral melanoma 

    occasionally presents as mets from skin to parotid
  25. ABCDs of clinical presentation
    • A: Asymstrical 
    • B: boarders are irregular, notched, indistinct
    • C: color is brown, black, pink, red, blue, white
    • D: diameter is greater than 6 mm
  26. Growth stages

    1. usually early stages
    2. nodular and later stages
    • Radial growth
    • Vertical growth
  27. what is the most common form of melanoma
    Superficial spreading 

    presents as a colored macule or low papule (usually <3 cm)
  28. type of melanoma that immediately begins with vertical growth phase
    elevated and deeply pigments 
    1/3 develop on the head and neck
  29. Precursor of this disease is lentigo maligna and the present of modularity in the lentigo maligna makes it this disease
    this is a radio phase melanoma in situ seen in fair skinned old people
    Lentigo Maligna Melanoma
  30. Most common form of melanoma in blacks 
    Found on soles of feet, under nails, mucosa, palms 
    most common form of oral melanoma

    Presents as a darkly pigmented, irregular marginated macule that later develops nodular, invasive growth phase
    Acral Lentiginous melanoma
  31. Patient usually in 50s to 60s
    2/3 of patients are male
    80% on hard palate or maxillary alveolus
    Looks  like other melanomas
    May show “moth-eaten” bone destruction
    Mucosal Lentiginous Melanoma
  32. What three stains are used for amelanotic melanomas?
    • S-100
    • MART-1
    • HMB-45
  33. what is the most important prognostic indicator of cutaneous melanoma?
    Histologic depth of invasion
Card Set
Malignant Epithelial Pathology
Final Exam Material