Review Questions

1. A 72-year old man comes to the physician because of a lesion on the side of his forehead. He has had the lesion for "a long time," but he came to the office today because his youngest son is getting married in a few months, and his son's fiancée asked him to get it removed so she does not have to see the "ugly growth" in her wedding pictures. On physical examination, the lesion is a 1.5-cm brown plaque with an adherent greasy scale. It appears to be "stuck-on." Histologic evaluation shows "horn cysts." Which of the following is the most likely diagnosis?

A.

Acanthosis nigricans

B.

Actinic keratoses

C.

Basal cell carcinoma

D.

Malignant melanoma

E.

Seborrheic keratoses

F.

Squamous cell carcinoma

2. A 58-year-old man comes the physician because of an ulcer on his lower lip. The lesion has been there for about 6 months, but lately it has been very "crusty." It started bleeding last week, and his wife scheduled this appointment. Physical examination shows a 1.3-cm hyperkeratotic and eroded plaque on his lower Up. Microscopic evaluation will most likely show which of the following?

A. Basaloid epidermal hyperplasia and keratin-filled epidermal pseudocysts

B. Epidermal hyperplasia, elongation of rete ridges, and Munro microabscesses

C. Invasive nests of basaloid cells with a palisading growth pattern

D. Nests of atypical keratinocytes, keratin pearls, and intercellular bridges

E. Pautrier microabscesses and superficial dermal infiltrate of T lymphocytes

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