Quizwise related to the ImageWise 80- Conjunctival naevus: Clinical insights
1. What is the most common type of tumor among conjunctival neoplasms?
A) Invasive melanoma
B) Basal cell carcinoma
C) Melanocytic nevus
D) Squamous cell carcinoma
2. Which of the following terms is used to describe a circumscribed, flat to slightly raised pigmented lesion on the bulbar conjunctiva that is most common in young white individuals?
A) Primary Acquired Melanosis (PAM)
B) Conjunctival melanoma
C) Complexion-associated melanosis
D) Melanocytic nevus
3. Which term is used for a group of lesions showing intraepithelial melanocytic proliferation with cytologic atypia, which is associated with a risk of progression to melanoma?
A) Conjunctival melanoma
B) Melanocytic nevus
C) Primary Acquired Melanosis (PAM) with atypia
D) Complexion-associated melanosis
4. What is the most common location for conjunctival melanoma?
A) Cornea
B) Caruncle
C) Palpebral conjunctiva
D) Bulbar conjunctiva
5. Which architectural pattern is a clue to the diagnosis of conjunctival melanoma?
A) Intraepithelial nests
B) Cyst formation
C) Maturation with depth
D) Pagetoid growth
QuizWise answers
Answer 1 : C) Melanocytic nevus
Explanation: melanocytic naevi are the most common tumors of the conjunctiva, accounting for up to 28% of all conjunctival neoplasms.
Answer 2: D) Melanocytic nevus
Explanation: Melanocytic naevi are circumscribed, flat to slightly raised pigmented lesions on the bulbar conjunctiva that are most common in young white individuals.
Answer 3: C) Primary Acquired Melanosis (PAM) with atypia
Explanation: Primary acquired melanosis (PAM) with atypia refers to a group of lesions showing intraepithelial melanocytic proliferation and/or increased cellularity and is associated with a risk of 36% -75% progression to melanoma.
Reference: Zembowicz A, Mandal RV, Choopong P. Melanocytic lesions of the conjunctiva. Arch Pathol Lab Med. 2010 Dec;134(12):1785-92. doi: 10.5858/2009-0522-RAR.1. PMID: 21128776.
Answer 4: D) Bulbar conjunctiva
Explanation: The most common location for conjunctival melanoma is the bulbar conjunctiva close to the limbus.
Reference: Wong JR, Nanji AA, Galor A, Karp CL. Management of conjunctival malignant melanoma: a review and update. Expert Rev Ophthalmol. 2014 Jun;9(3):185-204. doi: 10.1586/17469899.2014.921119. PMID: 25580155; PMCID: PMC4285629.
Answer 5: D) Pagetoid growth
Explanation: Presence of intraepithelial nests, cyst formation, and maturation with depth are not specific architectural clues for conjunctival melanoma, while the presence of pagetoid growth is a pattern suggestive of conjunctival melanoma. The most useful architectural patterns suggestive of conjunctival melanoma include (1) intraepithelial component showing pagetoid growth (2) radial extension of the intraepithelial component beyond the lateral edge of subepithelial component, (3) patchy or bandlike inflammation at the base of the lesion, (4) mitotic activity, (5) lack of maturation toward the base of the lesion, (6) invasion of the sclera or cornea.
Reference: Zembowicz A, Mandal RV, Choopong P. Melanocytic lesions of the conjunctiva. Arch Pathol Lab Med. 2010 Dec;134(12):1785-92. doi: 10.5858/2009-0522-RAR.1. PMID: 21128776.