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Old 10-31-2012
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Arrow Billy Step 1 Questions # 65

A 67-year-old male presents with a slowly growing lesion that involves the lower portion of his left lower eyelid. You examine the lesion and find it to be a pearly papule with raised margins and a central ulcer (rodent ulcer). Histologic sections from this lesion would most likely reveal?

a. Reactive epidermal cells surrounding a central superficial ulcer
b. Infiltrating groups of basaloid cells with peritumoral clefting
c. Infiltrating groups of eosinophilic cells with keratin formation
d. Dermal aggregates of small cells histologically similar to oat cell carcinoma
e. An in situ lesion with full-thickness epidermal atypia
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Old 10-31-2012
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my ans is b. Infiltrating groups of basaloid cells with peritumoral clefting
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Old 10-31-2012
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Basal Cell Carcinoma
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ya B ) BCC

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Old 10-31-2012
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I too think of b...bcc ..pearly papule, raised edges, rodent ulcer!
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Old 10-31-2012
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Quote:
Originally Posted by billy View Post
A 67-year-old male presents with a slowly growing lesion that involves the lower portion of his left lower eyelid. You examine the lesion and find it to be a pearly papule with raised margins and a central ulcer (rodent ulcer). Histologic sections from this lesion would most likely reveal?

a. Reactive epidermal cells surrounding a central superficial ulcer
b. Infiltrating groups of basaloid cells with peritumoral clefting
c. Infiltrating groups of eosinophilic cells with keratin formation
d. Dermal aggregates of small cells histologically similar to oat cell carcinoma
e. An in situ lesion with full-thickness epidermal atypia
typical location and description about BCC
b. Infiltrating groups of basaloid cells with peritumoral clefting
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Correct Answer B is correct

Basal cell carcinoma, arising from the pluripotential cells in the basal layer
of the epidermis, is the most common tumor in patients with pale skin.
This carcinoma is locally invasive and may be quite destructive. Metastasis,
however, is quite rare. The classic clinical appearance is a pearly papule
with raised margins and a central ulcer. Variants, which are not infrequent,
include the superficial type (which may be multifocal), the morphea-like
type (which has marked fibrosis and is difficult to eradicate locally), and
the pigmented type (which may be mistaken clinically for malignant
melanoma). Histologically the cells are deeply basophilic with palisading at
the periphery of groups of tumor cells and peritumoral clefting. Abundant
eosinophilic cytoplasm may be seen in squamous cell carcinomas, not
basal cell carcinomas.
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