Histopathology Description Information Sheet

01
h
ks AU
1J
L tA
I
MEDIC AL CUM
Pathology Information Sheet
Not all lesions on the skin can be identified as cancerous or benign (ok) just by using
technology such as dermoscopy.
Sometimes a lesion can look normal but behave abnormally.
To make sure we need to biopsy the lesion and have it tested at a microscopic level.
This pamphlet can be read in conjunction with your pathology results
Pathology results you may see are:
Name
Page
Name
Page
Actinic Keratosis
6
lentigo Simplex
3
Acral Melanoma
7
lichen Planus
5
Basal Cell Carcinoma
6
5
Blue Naevi
4
lichen Planus like
Keratosis
Melanoma
7
Bowen's Disease
7
Insitu Melanoma
7
Compound Naevus
3
lentigo Maligna
7
Congenital Naevus
4
Naevus
3
Dermatofibroma I
Histiocytoma
Dysplastic Naevus
4
Porokeratosis
4
5
Solar Keratosis
6
Dysplasia
5
Sebaceous Hyperplasia
5
Ephilis
2
Seborrheic Keratosis
5
Haemangioma
4
Solar lentigo
3
Hyperplasia
4
Spindle Cell Naevus
4
Intradermal Naevus
3
Spitz Naevi/Spindle Cell
4
Junctional Naevus
3
Squamous Cell Carcinoma
6
To help you as you read this, there are smiley faces to show whether the lesion is safe or
dangerous.
If you see this face, this lesion is perfectly safe. It will not become cancer.
eo
If you see this face, this lesion is safe, but must be checked, it has a low risk of becoming cancer
•
If you see this face, although this lesion is cancerous or showing signs of abnormal change, your
life is not currently at risk, because the cancer is not fully formed yet. Time is still on your side These
lesions are slow growing and you may still have multiple options available to you for treatment.
If you see this face, this lesion is cancerous and must be treated immediately. Your life may not
be in danger, and there may be multiple options for treatment.
Benign/Safe Lesions
lentigo
Lentigo - pigmented spots surrounded by normal skin. These spots have a defined edge and may be any
shade of brown, from tan to black. A lentigo can be flat or raised, can grow slowly or suddenly, and may
occur anywhere on the body. The most common are ephildes (freckles), solar lentigines and lentigo
simplex.
Ephilis
An ephilis - freckles. Freckles are flat, brown marks on the skin, which are caused by a response to sun
exposure. Pigment (melanin) is produced by cells called melanocytes in the skin when the skin is exposed
to the sun. Freckles occur when this pigment or melanin spreads to surrounding skin cells, these patches
of pigment fade if there isn't constant exposure to the sun, which is why freckles are darker in summer
and lighter in winter. Usually freckles will fade as people get older. Although they mostly affect people
with fair skin and hair, they can also affect people with dark skin. Freckles are not dangerous and will not
'turn into' cancer.
Solar Lentigo
'-"
Solar lentigines are larger flat, brown marks on the skin. They are often called liver spots, old age spots,
and sun spots. They are caused by exposure to the sun, and people of most skin types can develop these .
They come up when the melanocytes produce extra pigment, but don't fade like freckles do. Sometimes
an early melanoma can look like a solar lentigo, so it is important to monitor these spots and make sure
they are behaving like a normal solar lentigo. They, like freckles, are not dangerous, and will not 'turn into'
cancer.
Lentigo Simplex
Lentigo simplex - dark spots, which usually grow early in childhood . Unlike freckles or these spots are not
caused by the sun, so they do not get darker or lighter depending on sun exposure. They are one colour all
the way through the spot, usually a darker colour than the spots around them . Again, these spots are not
dangerous, and will not 'turn into' cancer.
Naevus
A naevus - a mole. There are many types of naevi. In this publication we will discuss melanocytic naevi,
vascular naevi and epidermal naevi. Naevi are safe, as long as there is no dysplasia.
co
Melanocytic Naevi
Melanocytic naevi are moles that contain melanocytes (cells that make pigment in the skin when exposed
to the sun).
Junctional Naevi
Moles that occur at the junction of the epidermis, the outermost layer of the skin and the dermis, the
layer just below. Usually brown, round and flattish . Provided there is no dysplasia they are safe.
co
Intradermal Naevi
Moles with naevus cells in the dermis. They can be skin coloured or have pigment They are usually a little
bit raised. Provided there is no dysplasia they are safe.
co
Compound Naevi
Moles that contain both junctional and intradermal cells. Provided there is no dysplasia in the compound
naevi they are safe.
Although all these naevi themselves are not considered dangerous, they may develop into melanoma,
so they must be checked.
eo
Blue Naevi
Moles that are formed much deeper in the skin than others. This gives them a blue appearance . They are
not dangerous, and can appear at any age and anywhere on the body. It is important to check these naevi
as melanoma can also be blue.
eo
Congenital Naevi
Congenital naevi - birth marks. A true birth mark or congenital naevus was present at birth; spots that
appear soon after birth are congenital-like naevi. They are caused by extra melanocytes in the skin, and
occasionally also have extra hair-forming cells. Sometimes a congenital naevus becomes melanoma, but
this is very rare (less than 1%) and will usually happen before puberty.
­
eo
Spitz Naevi/Spindle Cell Naevi
Moles that usually appears on children . They tend to grow very quickly, and although Spitz naevi are not
dangerous, it is often impossible to tell the difference between a Spitz and a melanoma. It is always safer
to remove Spitz naevi because of this .
.
Haernangloma
"
......"
Purply red spots that are made up of blood vessels. They often look like a red mole, and are very common
across the chest, back and upper arms. These spots are not dangerous, and if they are accidently
scratched or knocked they can bleed more than normal skin would. Sometimes, they can change colour to
black very quickly if a clot forms in them . This is ok and normal.
-Q
Porokeratosis
Porokeratoses are a kind of sunspot that are not dangerous, and is a condition that causes the skin to
produce pigmented spots when exposed to the sun.
Histiocytoma/Dermatofibroma '-'
These are often white in the middle and pink or brown around the edge. One popular theory as to why
they occur is that some trauma or injury has occurred, such as an insect bite, and the immune system has
responding by forming scar tissue to 'wall off' the foreign invader. Although they can look dramatic, they
are not dangerous .
Hyperplasia
Hyperplasia literally means extra growth (hyper - extra, plasia - growth). Hyperplasia can occur through
stress, such as a callous forming where we get extra rubbing, or it can occur for other reasons. Hyperplasia
in the skin does not lead to cancer.
It
Q
......"
Sebaceous Hyperplasia
Sebaceous hyperplasia occurs most commonly on the face. An oil gland (sebaceous gland) becomes
blocked and a build up of oil occurs. It often looks like a pinky-white bump, and up-close the pattern that
forms looks like a coil or flower. We are able to treat some of them very effectively at this clinic.
Lichen Planus
Shiny, pinky purple lesions that affect the skin anywhere on the body. They are very common on the They
can be itchy, scaly or painful, and occasionally even blister.
Q
Seborrheic Keratosis ......"
Seborrheic keratosis are patches of thick, waxy skin, caused by a combination of genetic predisposition
and sun exposure. They are sometimes wrongly called old age warts or senile warts, they are not warts,
nor are they caused by old age. They are not dangerous, but at their worst can be unattractive, itchy and
irritating. They usually begin as small, skin coloured lesions, but can grow and get darker very quickly.
They are less annoying if kept well moisturised or scraped off. They may grow back or leave a grey patch
on the skin.
Lichen Planus Like Keratosis
Lichen planus like keratoses can appear as a pinky or greyish patch on the skin. They usually appear on the
areas exposed to the sun. They are made up of extra keratin on top layer of the skin. They can sometimes
be confused with a mole (naevus) or a cancerous lesions but are actually safe.
Dysplasia
•
Skin does not just go from 'normal' to 'cancer'. In between 'normal' skin and 'cancer' is a huge area called
dysplasia. Dysplasia means abnormal growth, and these abnormal changes can be mild, moderate,
moderately severe, and severe. Dysplasia does not automatically mean that cancer will form, but once
tissue reaches moderately severe or severe dysplasia there is a good chance that the growth is almost
cancerous. For skin, dysplasia can occur in moles or in the basal or squamous cells of the skin.
Dysplastic Naevus
•
Dysplastic naevi are moles that are changing in an abnormal way. They may not appear to be getting
bigger on the surface, but instead changing the structure of the mole. If dysplastic naevi continue to
cancer, they form melanoma. Part of what we do at Bedford Medical Clinic and Molechecks Australia is to
remove these moles before they get to melanoma.
Cancer
There are two kinds of skin cancer : melanoma and non-melanoma . There are two kinds of non-melanoma
skin cancer: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
Some cancerous lesions are described as "in situ". If a lesion is "in situ" it means that the cancerous cells
are reproducing within their contained, natural area. In other words, although the cancer is growing, it
has not begun to spread.
Non-Melanoma Skin Cancer Lesions
These occur mainly in the sun exposed areas. They typically appear as a pink lesion that won't heal. They
can be itchy, scaly, painful or bleed for no reason, or may not show any symptoms other than a sore that
won't go away. Fairer skin is more susceptible to these kinds of cancer.
They are slow generally growing and easily treated if detected early .
Basal Cell Carcinoma
BCC is the most common cancer in the world. There are many different kinds of BCC, and the most
common of these are superficial BCC or nodular BCe. They occur mainly in the sun exposed areas. They
grow in a slow but relentless manner, but rarely make secondary tumours. In rare cases, if basal cell
tumours are left untreated on the head they can still cause death, but they have to be left for a long time
for this to occur. They have not been known to cause death in other areas of the body.
Solar KeratosislActinic Keratosis
•
Solar keratosis/ actinic keratosis are lesions that have extra keratin because of exposure to light. They are
also called "squamous cell insitu" and are the most common precancerous or early cancer lesion in
Australia. They occur in the sun exposed areas of the skin and often appear in groups together. They
usually appear as pink or brown, rough or scaly lesions. Some AKs will disappear by themselves, but some
AKs are cancerous, and develop into squamous cell cancer (SCC).
Squamous Cell Carcinoma
SCC is the second most common skin cancer. Unlike BCC, they can grow and spread if not treated early,
and can be life threatening.
6
Bowen's
---
Bowen's Disease is another form of see in situ. They usually appear as a pinky area on the leg, but can be
found anywhere on the skin. About 3% of Bowen's lesions transform into see, and about a third of these
lesions make secondary tumours.
Melanoma Cancer Lesions
Melanoma cancers are the most dangerous form of skin cancer due to their ability to grow and spread
very quickly, often making secondary tumours before they are even noticed. Melanoma can occur
anywhere on the body, even where there has not been any sun exposure . They can also be any colour
(not just black or brown) and be any size (they can be smaller than 1.5mm). Melanoma have a strong
genetic link and often occur in families.
If melanoma is caught early, then there is no change to your life expectancy .
In-Situ Melanoma
In-situ melanoma are melanoma that have not begun to spread through the skin yet. If melanoma is
caught at this stage, there is 100% survival rate . It is important to be aware that if a person has a
predisposition to make one melanoma, then they have predisposition to make more .
Lentigo Maligna
Lentigo maligna are a kind of melanoma that commonly occur on the face and neck. They are often much
more slow growing than melanoma on other parts of the body, and are related to sun exposure. If they
are caught while they are still "in situ", then there is 100% survival rate. Once they begin to spread down,
however, they behave just as aggressively as other forms of melanoma.
Acral Melanoma
Acral melanomas are melanomas that form on the soles of the feet, the palms of the hands, or under the
nails. They are the most common melanoma for people with dark skin. They can grow as a new lesion or
from an already existing lesion.