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QUESTION 9-1. A 16-year-old female presents with multiple flesh-colored to yellow papules under the lower eyelids that range from 1 to 2 mm. One of these lesions is biopsied and is illustrated below. Immunohistochemistry reveals the basolateral cell layer of the tubules to stain positive for EMA and the inner ductal lining staining positive for CEA. Which of the following diagnoses is CORRECT?


A) Trichoepithelioma

B) Syringoma

C) Microcystic adnexal carcinoma

D) Desmoplastic basal cell carcinoma

E) Milium cyst

QUESTION 9-2. A 76-year-old patient presents with a painless, firm, slightly pedunculated flesh-colored to slightly pigmented nodule on the sole of the foot measuring 1 cm. The lesion is well demarcated with a peripheral “moat-like” change. A biopsy is performed and the findings are illustrated below. Which of the following diagnoses is CORRECT?



A) Eccrine poroma

B) Invasive squamous cell carcinoma

C) Basal cell carcinoma

D) Tumor of the follicular infundibulum

E) Trichilemmoma

QUESTION 9-3. A patient presents with two eroded hyperkeratotic nodular plaques on the left upper extremity measuring approximately 3 cm in diameter. The patient has thickened palms and soles, sparse hair, multiple eyelid cysts and is missing some teeth. A biopsy is performed and the findings are illustrated below. The thin anastomosing strands of epithelium contain lumina lined by eosinophilic cuticles. Which of the following diagnoses is CORRECT?


A) Fibroepithelioma of Pinkus

B) Eccrine syringofibroadenoma

C) Reticulated seborrheic keratosis

D) Pseudoepitheliomatous hyperplasia

E) None of the above

QUESTION 9-4. A 55-year-old male patient presents with numerous dome-shaped smooth nodules on the scalp of varying sizes. There are also tumors on the face and upper body. His mother as well as two of his children also have similar lesions. Which of the following statements regarding this patient’s tumor is INCORRECT?


A) This is an autosomal dominant syndrome in which patients may also develop multiple trichoepitheliomas and eccrine spiradenomas.

B) The presence of small, detached tumor islands in the subcutis represents malignant transformation.


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