Malignant Epithelial Tumors

Differentiation and anaplasia; The rate of growth; Local invasion; Metastasis

Fig.9.1.Histological features of differentiation of the neoplasmsBehaviorBenigntumorMalignanttumorRate of growthProgressive, slow growthLocal and expansive growthRapid growth; Expansive and invasive growth;Local invasionExpansive and cohesive masses, well demarcated, no invading adjacent normal tissuesLocal invasive masses, infiltrating adjacent normal tissues MetastasisAbsentPresent Differentiation cytological featuresWell differentiated-are resembling with cell of origincell differentiation failure Few mitosisMany mitosis, some abnormalnormal N/C Ratio=(1/4)increased N/C Ratio=(1/1)Homogenous cell shape and sizeCell and nuclear pleomorphism; anizocytosis.

Differentiation=morphological and functional similarity of neoplastic cells with cells of originFrom: Stevens A. J Lowe J. Pathology. Mosby 1995

Fig.9.2. Differentiation and anaplasia: WD

Normal

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.

WDMDNDnormal

Precancerous lesion-progression to neoplasiaFrom: Stevens A. J Lowe J. Pathology. Mosby 1995Fig.9.4. I-Normal epithelium; II-Dysplastic epithelium (DP mild, moderate and severe); CIS carcinoma in situ; III-Microinvasive carcinoma; Invasive carcinoma.IIIIII

CIS carcinoma in situ-skinFig.9.5. CIS-cell and nuclear pleomorphysm; intact BM.

Cancer cell morphologyFrom cases of the Pathology Department - U.M.F. Gr. T. Popa IasiFig.9.6.

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.

Scuamocellular carcinoma From: Stevens A. J Lowe J. Pathology. Mosby 1995Fig.9.8. Vegetative carcinoma

Fig.9.9. Ulcerative carcinoma

Scuamocellular carcinomaFrom cases of the Pathology Department - U.M.F. Gr. T. Popa Iasi Fig.9.10.Ulcerative and invasive SCC into dermisFig.9.10.

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.

Basal cell carcinoma (ulcus rodens) From: Stevens A. J Lowe J. Pathology. Mosby 1995 Fig.9.12. Ulcus rodens

Fig.9.13. Ulcus rodens

Basocellular carcinomaFrom cases of the Pathology Department - U.M.F. Gr. T. Popa IasiFig.9.14.

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.

Well differentiated adenocarcinoma of colon From cases of the Pathology Department - U.M.F. Gr. T. Popa IasiFig.9.16.

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.

Local invasionFrom: Stevens A. J Lowe J. Pathology. Mosby 1995

Fig.9.18.Invasion: infiltrative feature in adjacent tissues Fig.9.18.

Invasive colonic adenocarcinomaFrom cases of the Pathology Department - U.M.F. Gr. T. Popa IasiFig.9.19.

Fig.9.19.Invasion: infiltrative feature in adjacent tissues

Metastastatic ways of the tumor cellsFrom: Stevens A. J Lowe J. Pathology. Mosby 1995

Local spreadLymphatic disseminationVascular disseminationTranscelomic dissemination

Fig.9.20.

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.

Lymphatic dissemination: lymph node metastasesFrom: Stevens A. J Lowe J. Pathology. Mosby 1995Fig.9.22.

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 IasiFig.9.23.

Visceral metastases Blood disseminationFig.9.24.

Fig.9.25.

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