Malignant Epithelial Tumors

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

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

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

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

CIS – carcinoma in situ-skin

Fig.9.5. CIS-cell and nuclear pleomorphysm; intact BM.

Cancer cell morphologyFrom cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi

Fig.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 1995

Fig.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 dermis

Fig.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” Iasi

Fig.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” Iasi

Fig.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” Iasi

Fig.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

1. Local spread2. Lymphatic

dissemination3. Vascular dissemination4. Transcelomic

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 1995

Fig.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” Iasi

Fig.9.23.

Visceral metastases

Blood dissemination

Fig.9.24.

Fig.9.25.