Thyroid: Adenoma

1. Thyroid: Adenoma Lab 7, Case 1

2. Thyroid Nodule Note that the mass is well circumscribed and there is a sharp line of demarcation between the mass and the adjacent thyroid tissue (arrows).

3. High-power view of the border between the tumor mass and adjacent thyroid tissue Note that the mass has compressed the adjacent normal thyroid tissue (arrow). Also note the different morphology between the adenoma (very cellular, dense follicles, little or no colloid) and the adjacent normal thyroid (larger follicles, colloid).

4. Adenoma Thyroid Note the compression of the adjacent normal thyroid and the difference in morphology between the adenoma and the thryoid.

5. Densely packed follicular pattern in the adenoma (left) and the larger colloid-filled follicles of the normal thyroid on the right An area of compressed thyroid is present adjacent to the adenoma (arrow).

6. Note that the follicular architecture is well developed and more or less uniform throughout this section of the adenoma.

7. Relatively normal cellular architecture of this follicular adenoma

8. Breast: Fibroadenoma Lab 7, Case 2

9. Three ovoid, well-circumscribed nodules surrounded by fibroadipose tissue

10. Higher magnification of one of the three nodules At this power, the nodule seems to be composed of a solid parenchyma with small glandular spaces. The adjacent breast parenchyma consists mostly of fat.

11. Fibroadenoma Dense stroma of the tumor surrounding the irregularly shaped ducts The adjacent fibrofatty tissue containing breast ducts and lobules has been compressed by the tumor.

12. Compressed connective tissue (arrow) between two nodules of dense fibrous tissue and ducts

13. Fibroadenoma Ducts embedded in connective tissue

14. Fibroadenoma Dense stroma of the tumor surrounding the irregularly shaped duct The ducts are lined by two cell layers, one of cuboidal, two columnar cells (inner layer), and an outer layer of flattened cells with hyperchromatic nuclei (myoepithelial cells)

15. Fibroadenoma Irregularly shaped ducts lined by two cell layers of cells, as previously described

16. Lips: Squamous Cell Carcinoma Lab 7, Case 3

17. Pre-op photo of patient with an ulcerated lesion on his lip (arrow) The area for surgical excision is outlined in black. Also note that the lip is somewhat thickened.

18. Squamous Cell Carcinoma of the Lip 1: Focal Ulceration 2: Tumor infiltration at the vermilion border

19. Large area of ulceration (arrow) with underlying congestion and hemorrhage The area of ulceration is adjacent to an area of tumor infiltration.

20. Well-differentiated Squamous Cell Carcinoma and the inflammatory cell infiltration

21. Squamous Cell Carcinoma and inflammatory cells

22. Well-differentiated Squamous Cell Carcinoma Note the intracytoplamic keratinization which gives the cells a glassy appearance. The focal accumulations of keratinized cells are called keratin pearls (arrows).

23. Poorly differentiated area of tumor Note the spindle-shaped cells and the irregular pattern of growth.

24. Section of muscle from the lip biopsy Note that the squamous cell carcinoma has infiltrated into the muscle tissue. There are also inflammatory cells within this area of tumor infiltration.

25. Esophagus:Squamous Cell Carcinoma Lab 7, Case 4

26. Luminal surface of esophagus 1: Area of constriction (protrudes into lumen) 2: Central area of ulceration

27. Cross-section through esophagus at area of constriction Shows extensive infiltration of the esophageal wall with squamous cell carcinoma (arrows)

28. Normal epithelium undergoing transition to carcinoma (arrows)

29. Invasive squamous cell carcinoma Tongues and islands of tumor cells exhibit areas of central necrosis (arrow).

30. Bands of tumor cells invading into the adjacent tissues (arrows)

31. Bands of tumor cells (arrows) extending between the muscle bundles

32. Tumor cells that have invaded the adjacent muscle tissue

33. Colon: Adenocarcinoma Lab 7, Case 5

34. Adenoma from the surgical specimen Note the large, ulcerated, fungating annular (encircling) carcinoma (1) with areas of hemorrhage (2). Also note the adenomatous polyps (3).

35. Closer view of previous image demonstrating the raised, annular carcinoma (arrows)

36. Transition between normal mucosa on the left and carcinoma which is invading the wall of the bowel (arrow)

37. Transition between the normal (1) and the neoplastic (2) epithelium

38. Tumor cells invading the underlying muscularis

39. Tumor cells forming glands

40. Tumor cells forming glands

41. Ulcerated adenocarcinoma (arrows) at the rectosigmoid junction

42. Distal colon Note the annular tumor that severely compromises the lumen of the colon. There is dilation of the colon proximal to the tumor.

43. Lung and Liver: Metastatic Adenocarcinoma Lab 7, Case 6

44. Multiple, variably-sized pale/white-tan nodules scattered throughout the liver

45. Multiple, variably-sized pale/white-tan nodules scattered throughout the lung

46. Section of liver (left) and lung (right) containing tumor nodules (arrows)

47. Interface between the tumor (top) and normal liver parenchyma (bottom)

48. Tumor cells (arrows) have infiltrated into the liver parenchyma

49. Tumor cells forming glands (arrows)

50. Tumor nodule in the lung The tumor cells are infiltrating into the lung parenchyma (1). There is a large area of necrosis in the center of the tumor (2).