Malignant Epithelial Tumors

1. Malignant Epithelial Tumors

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

3. Differentiation=morphological and functional similarity of neoplastic cells with cells of originFrom: Stevens A. J Lowe J. Pathology. Mosby 1995 Normal Fig.9.2. Differentiation and anaplasia: WD

4. normal WD ND MD 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.

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

6. CIS – carcinoma in situ-skin Fig.9.5. CIS-cell and nuclear pleomorphysm; intact BM.

7. Cancer cell morphology From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi Fig.9.6.

8. Fig.9.7. 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.

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

10. Fig.9.9. Ulcerative carcinoma

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

12. Fig.9.11. 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).

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

14. Fig.9.13. Ulcus rodens

15. Basocellular carcinomaFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi Fig.9.14.

16. Fig.9.15. 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.

17. Well differentiated adenocarcinoma of colonFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi Fig.9.16.

18. 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.

19. Local invasionFrom: Stevens A. J Lowe J. Pathology. Mosby 1995 Fig.9.18. Fig.9.18.Invasion: infiltrative feature in adjacent tissues

20. 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

21. Metastastatic ways of the tumor cellsFrom: Stevens A. J Lowe J. Pathology. Mosby 1995 • Local spread • Lymphatic dissemination • Vascular dissemination • Transcelomic dissemination Fig.9.20.

22. Fig.9.21. 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-->Undifferentiated Staging depends on: 1. the size of the primary tumour; 2. the extent of local spread; 3. the extent of distant spread

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

24. Fig.9.23. 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

25. Fig.9.24. Blood dissemination Visceral metastases

26. Fig.9.25.