Uncontrolled Uncontrolled uncoordinated cell uncoordinated cell division division non responsive non responsive to growth controls.to growth controls.

NEOPLASIANEOPLASIA

Malignant Malignant BenignBenign::

Well circumscribed,Well circumscribed, Usually small in Usually small in

size,size, Slow growing,Slow growing, capsulated, capsulated, Non-invasive Non-invasive No hge. and No hge. and

necrosisnecrosis do not metastasize, do not metastasize, well differentiated, well differentiated, suffix “oma” eg. suffix “oma” eg.

Fibroma.Fibroma.

Not well Not well cirumscribed,cirumscribed,

Usually larger in size,Usually larger in size, Fast growing, Fast growing, non capsulated, non capsulated, Invasive & Infiltrate Invasive & Infiltrate He and necrosis.He and necrosis. Metastasize. Metastasize. poorly differentiated, poorly differentiated, Suffix “Carcinoma” Suffix “Carcinoma”

or “Sarcoma”or “Sarcoma”

Signs of malignancySigns of malignancy

CellularCellular Dysplasia Dysplasia (different from (different from

tissue of origin)tissue of origin)

DisorganizationDisorganization Loss of polarity.Loss of polarity. Pleomorphism Pleomorphism

(variable in size and (variable in size and shape)shape)

Loss of cohesion.Loss of cohesion. Presence of giant cellsPresence of giant cells

NuclearNuclear Large nucleiLarge nuclei Hyperchromasia.Hyperchromasia. N/C ratio high.N/C ratio high. Pleomorphic nuclei.Pleomorphic nuclei. Prominent nucleoli.Prominent nucleoli. Frequent mitoses.Frequent mitoses. Abnormal mitotic Abnormal mitotic

figuresfigures..

Tumor DiagnosisTumor Diagnosis HistoryHistory and Clinical examinationand Clinical examination ImagingImaging - X-Ray, US, CT, MRI - X-Ray, US, CT, MRI BiopsyBiopsy – –

– Conventional histopathologyConventional histopathology:: Paraffin sections stained with ordinary Paraffin sections stained with ordinary stainsstains

– Frozen sectionsFrozen sections:: Intra-operativeexamination of frozen tissue Intra-operativeexamination of frozen tissue sections.sections.

– Immunohistochemistry:Immunohistochemistry: Paraffin or frozen sections stained for Paraffin or frozen sections stained for markers.markers.

CytologyCytology – –– Exfoliative cytologyExfoliative cytology : study of cells shedded in body fluids.: study of cells shedded in body fluids.– FNABFNAB:: Aspiration of cells from tumor masses. Aspiration of cells from tumor masses.

Tumor markers: Tumor markers: Blood laboratory analysis Blood laboratory analysis MolecularMolecular TechTech (DNA studies) (DNA studies)

– Gene re-arrangement studies ( in lymphoma)Gene re-arrangement studies ( in lymphoma)– DNA quantitation by image analaysis or flow cytometry.DNA quantitation by image analaysis or flow cytometry.

BenignBenign MalignantMalignant

Slides of the weekSlides of the week

Benign Epithelial Benign Epithelial TumoursTumours

Squamous cell papilloma.Squamous cell papilloma. Adenoma intestine.Adenoma intestine. Pericanalicular fibroadenoma.Pericanalicular fibroadenoma. Intracanalicular fibroadenomaIntracanalicular fibroadenoma..

))11((Squamous cell papilloma Squamous cell papilloma skinskin..

))22((Columnar cell papillomaColumnar cell papilloma as : as : Duct papilloma of breastDuct papilloma of breast

PapillomaPapilloma

Squamous cell PapillomaSquamous cell PapillomaBenign tumors of surface epitheliumBenign tumors of surface epithelium..

GrosslyGrossly:: Non capsulated, projecting Non capsulated, projecting villousvillous-like -like from the surface, sessile or from the surface, sessile or pedunculatedpedunculated..

MicrosciopicallyMicrosciopically::Vascularized connective tissue Vascularized connective tissue core core coveredcovered with proliferating epithelium with proliferating epithelium..

.. ]-]-

Squamous cell papillomaSquamous cell papilloma

Squamous cell papillomaSquamous cell papilloma

Squamous cell papillomaSquamous cell papilloma

Squamous cell papillomaSquamous cell papilloma

Squamous cell papillomaSquamous cell papilloma

Duct Papilloma, BreastDuct Papilloma, Breast

AdenomaAdenomaBenign tumor arising from columnar epitheliumBenign tumor arising from columnar epithelium..

Grossly:Grossly: CCapsulated, round or oval mass with a apsulated, round or oval mass with a solid or cystic cut sectionsolid or cystic cut section..

Histological typesHistological types::

))11((Simple adenomaSimple adenoma:: proliferating aciniproliferating acini with with stromastroma..

))22((FibroadenomaFibroadenoma:: proliferating proliferating acini acini ++ proliferating proliferating stromastroma (Breast) (Breast)..

))33((CystadenomaCystadenoma:: proliferating acini with dilated proliferating acini with dilated acini forming acini forming cysts cysts (Ovary)(Ovary)..

))44((Papillary cystadenomaPapillary cystadenoma:: cystadenoma cystadenoma with the epithelial lining forming with the epithelial lining forming papillaepapillae..

Adenoma of intestineAdenoma of intestine

Benign tumour formed ofBenign tumour formed of 1-proliferating intestinal mucosal 1-proliferating intestinal mucosal

glandsglands lined with columnar lined with columnar epithelial cells and slightly epithelial cells and slightly variable in size variable in size

2- Glands separated by 2- Glands separated by vascularized connective tissue vascularized connective tissue

stroma.stroma.

Adenomatous polyp - ColonAdenomatous polyp - Colon

Familial Adenomatous Familial Adenomatous PolyposisPolyposis

Intestinal adenoma,Villous Intestinal adenoma,Villous typetype

Adenoma

Adenoma

FibroadenomaFibroadenoma of the breast of the breast* Mixed Tumour formed of epithelial and stromal elements

•Most common breast tumor in adolescent and young adult women (peak age = third decade).

• Higher incidence in black patients

• Well-circumscribed, freely movable (Breast mouse), non painful mass

• Regress with age if left untreated (hormonal-dependent T).

•2 Types :

1- intracanalicular pattern. Compressed ducts

2-pericanalicular growth . Opened ducts .

Breast FibroadenomaBreast Fibroadenoma

Pericanalicular Pericanalicular fibroadenomafibroadenoma

Tumor is capsulatedTumor is capsulated

Tumor consists of:Tumor consists of:

1- 1- OOpenedpened proliferating breast proliferating breast ductsducts lined with an inner columnar lined with an inner columnar and outer myoepithelial cells. and outer myoepithelial cells.

2- Ducts are separated by 2- Ducts are separated by loose loose myxoid connective tissue myxoid connective tissue stroma. stroma.

Pericanalicular fibroadenoma

Intracanalicular Intracanalicular fibroadenomafibroadenoma

* * Tumor is capsulatedTumor is capsulated• Tumor consists of Tumor consists of • 1- 1- CompressedCompressed proliferating proliferating

breast breast ductsducts that are lined with that are lined with an inner columnar and outer an inner columnar and outer myoepithelial cells.myoepithelial cells.

• 2- Ducts are separated by 2- Ducts are separated by loose myxoid connective tissue loose myxoid connective tissue stromastroma..

Intracanalicular Fibroadenoma