malignant epithelial tumors
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Malignant Epithelial Tumors. Differentiation and anaplasia; The rate of growth ; Local invasion ; Metastasis. Differentiation=morphological and functional similarity of neoplastic cells with cells of origin From: Stevens A. J Lowe J. Pathology. Mosby 1995. Normal. - PowerPoint PPT PresentationTRANSCRIPT
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Malignant Epithelial Tumors
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Fig.9.1.Histological features of differentiation of the neoplasms
Behavior Benigntumor
Malignanttumor
Rate of growth Progressive, slow growthLocal and expansive growth
Rapid growth; Expansive and invasive growth;
Local invasion Expansive and cohesive masses, well demarcated, no invading adjacent normal tissues
Local invasive masses, infiltrating adjacent normal tissues
Metastasis Absent Present
Differentiation cytological features
Well differentiated-are resembling with cell of origin
cell differentiation failure
Few mitosis Many mitosis, some abnormal
normal N/C Ratio=(1/4) increased N/C Ratio=(1/1)
Homogenous cell shape and size
Cell and nuclear pleomorphism; anizocytosis.
Differentiation and anaplasia; The rate of growth; Local invasion; Metastasis
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Differentiation=morphological and functional similarity of neoplastic cells with cells of origin
From: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.2. Differentiation and anaplasia: WD
Normal
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Fig.9.3. TM are more or less differentiated, showing various degrees of differentiation ranging from well-differentiated forms (BD) to non-differentiated (ND) or anaplastic forms.
WD
MD ND
normal
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Precancerous lesion-progression to neoplasiaFrom: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.4. I-Normal epithelium; II-Dysplastic epithelium (DP mild, moderate and severe); CIS – carcinoma in situ; III-Microinvasive carcinoma; Invasive carcinoma.
I II III
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CIS – carcinoma in situ-skin
Fig.9.5. CIS-cell and nuclear pleomorphysm; intact BM.
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Cancer cell morphologyFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.6.
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Fig.9.6-7. Cellular and nuclear abnormalities: Cellular and nuclear pleomorphism and size; Increase of nucleo/cytoplasmic ratio; Nuclear hypercromasia; Single or multiple nucleoli; Atypical mitoses.
Fig.9.7.
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Scuamocellular carcinoma From: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.8. Vegetative carcinoma
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Fig.9.9. Ulcerative carcinoma
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Scuamocellular carcinomaFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.10.Ulcerative and invasive SCC into dermis
Fig.9.10.
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Fig.9.10-11. Islands of polygonal atypical cells separated by a reduced connective stroma. By differentiation the tumoral cells fill with keratin disposed as concentric lamellae (keratin pearls).
Fig.9.11.
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Basal cell carcinoma (ulcus rodens) From: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.12. Ulcus rodens
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Fig.9.13. Ulcus rodens
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Basocellular carcinomaFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.14.
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Fig.9. 14-15. The tumour cells resemble with basal layer cells. They penetrate basement membrane and form dermal tumoral islands separated by a reduced stroma.
Fig.9.15.
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Well differentiated adenocarcinoma of colon From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.16.
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Fig.9.17.
Fig.9. 14-15. The tumor wirh origin in the glandular epitheliumpenetrates muscularis mucosae and infiltrates the submucosa and muscular layer. The tumor is composed from tumoral glands separated by a reduced stroma.
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Local invasionFrom: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.18.Invasion: infiltrative feature in adjacent tissues
Fig.9.18.
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Invasive colonic adenocarcinomaFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.19.
Fig.9.19.Invasion: infiltrative feature in adjacent tissues
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Metastastatic ways of the tumor cellsFrom: Stevens A. J Lowe J. Pathology. Mosby 1995
1. Local spread2. Lymphatic
dissemination3. Vascular dissemination4. Transcelomic
dissemination
Fig.9.20.
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Grading is based on the degree of differentiation and the rate of growth (number of mitosis) of tumour.Histological spectrum of cancer: Well differentiated --> Poor differentiated-->UndifferentiatedStaging depends on: 1. the size of the primary tumour; 2. the extent of local spread; 3. the extent of distant spread
Fig.9.21.
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Lymphatic dissemination: lymph node metastasesFrom: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.22.
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Fig.9.23. Lymph node metastasis of adenocarcinoma: The tumoral cells invade lymph node and form tumoral glands limited by an atypical epithelium.
From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.23.
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Visceral metastases
Blood dissemination
Fig.9.24.
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Fig.9.25.