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Transcript of Carcinomas Presentation
7/23/2019 Carcinomas Presentation
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Carina Dudas (Petricau) and MariaAnastasapolu
Carcinomas
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Defnition• A carcinoma is a malignant growth that
arises rom the _____________.
•
Two general classes: – Epithelial Membranes co!ering"lining o
organs• ________________
– Glandular Epithelium # epithelial cells growdown into the connecti!e tissue and ormglands• ________________
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Classifed $% epithelium t%pe
• Columnar" Cu$oidal epithelium – &' tract (e: Colorectal carcinoma) – Th%roid (e: th%roid carcinoma) – Trachea (e: Adenoid c%stic carcinoma ) – idne% (e: *enal cell carcinoma+ urothelial carcinoma o
renal pel!is)
• ,-uamous epithelium – ,in (e: /asal cell carcinoma) – 0agina" outer cer!i (e: adenos-uamous carcinoma o
cer!i) – Distal urethra (e: s-uamous cell carcinoma o distal urethra) – 1sophagus (e: s-uamous cell carcinoma o the esophagus) – 2ar%n (e: lar%ngeal carcinoma)
• &landular epithelium – /reast+ cer!i+ allopian tu$es+ o!aries+ prostate+ pancreas3
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4igure 5
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6rothelial (transitional cell)tumors• *epresent a$out 789 o all $ladder tumors• Ma% appear an%where $etween the renal
pel!is to the distal urethra
•
6rothelial tumors !ar% $% orm (papillar%+nodular+ at) and $% depth (nonin!asi!e+in!asi!e)
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Morpholog% o urothelialtumors
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;istological criteria: Transitional cell carcinoma
• ;%perplasia (increased num$er) o epithelial cellla%ers
• 'ncreased papillar% olding o urothelium• A$normalities o nuclear morpholog%
–
;%perchromatic nuclei• 2oss o cellular polarit%• A$normalities o the normal cellular maturation
rom $asal to superfcial la%ers• Presence o giant cells• 'ncreased nuclear to c%toplasm ratio• 4re-uent mitotic fgures• 2oss o cellular cohesi!eness• <idened intracellular spaces
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Papillar% urothelialcarcinomas
Low-grade papillary urothelialcarcinoma with an o!erallorderl% appearance+ a thicerlining than in papilloma+ andscattered h%perchromatic nucleiand mitotic fgures.
High-grade papillaryurothelial carcinoma withmared d%scohesi!e cells+ largeh%perechromatic nuclei+ re-uentmitotic fgures
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Carcinoma in situ ( at)
Normal urothelium with uniorm
nuclei and well#de!eloped um$rellacell la%er
Flat carcinoma in situ withnumerous cells ha!ing enlargedand pleomorphic nuclei+ loss ocellular cohesi!eness+ h%perplasiao urothelium
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'n!asi!e urothelial cancer
6rothelial carcinoma whichin!ades the lamina propria ordeeper
Associated with either high#grade papillar% urothelial canceror with carcinoma in situ
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4igure =
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Colorectal Cancer
7>9 o colorectal cancers are adenocarcinomas
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Colorectal cancer• Distri$ution o the colorectal cancers:
– ==9: cecum"ascending colon – 559: trans!erse colon – ?9: descending colon – @@9: rectosigmoid colon –
?9: other sites• All colorectal carcinomas $egin as in situ lesions+ $ut
e!ol!e into dierent morphologic patterns (grosspatholog%): – *ight#sided colonic adenocarcinomas# etend along one
wall o the cecum and"or ascending colonB usuall% noo$struction is present
– 2et#sided colonic adenocarcinomas# annular+ encirclinglesions that produce constrictions o the $owel (lumen isnarrowed and proimal $owel distended)
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&ross Patholog%
Carcinoma o the cecum
Carcinoma o the descending colo
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,u$t%pes o colorectal cancerMucinous carcinoma,ignet ring carcinoma
/asaloid carcinoma
Anaplastic carcinoma1ndocrine dierentiation,cattered endocrine cells
,mall cell carcinoma
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;istopatholog% o colorectalcancer
• <ell#to#moderatel% dierentiated adenocarcinoma secreting!aria$le amounts o mucin
• Tumor cells are a com$ination o – Columnar cells and go$let cellsB occasional endocrine cells
• Consistent inammator% and desmoplastic reaction: – prominent at edges – Presence o inammator% cells:
• most T l%mphoc%tes• Ma% also fnd:
– / l%mphoc%tes – plasma cells – ;istoc%tes
•
occasionall% numerous eosinophils• 1dge o tumor:
– ma% show oci o residual pol%p – h%perplastic change in glands:
– taller – more tortuous –
more go$let cells – alterations in mucin secretion
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Pathologic staging o colorectalcancer
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4igure
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,in CancerMost common t%pes:/asal cell carcinoma,-uamous cell carcinomaMelanoma
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/asal cell carcinoma
• Common+ slow#growing tumor+ not painul and does not itchB rarel%metastasies $ut destro%s adEacent tissue $% etending downward intothe dermis
• Clinicall%: pearl% papules oten containing telangiectasias (nodularsu$t%pe)
•
Fpen sore# rodent ulceration
4igure G
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Morphological changes o/CC
•
Tumor cells resem$le the normal $asal cells oepidermis+ $ut tumor cells ha!e larger nucleus :c%toplasm ratio and h%perchromic nuclei
• Two maEor patterns are seen:
– Multiocal growths# originating rom epidermis and
etending o!er sin surace – Hodular lesions# growing downward+ deep into dermis
as cords and islands
• The cells orming the peripher% o the tumor cell islands
ha!e a palisading arrangement $ut the central cell areirregular or spindle shaped with intracellular $ridges
• /asal cell nests or islands are separated romsurrounding stroma $% clets
•
Mitotic fgures are !er% rarel% o$ser!ed
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/asal Cell Carcinoma
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,-uamous cell carcinoma
• Common+ deri!ed rom eratinoc%tes o theepidermis+ in!ades the dermis
• Clinicall%: raised+ frm+ pin#to#eshcolored
eratotic papule+ oten ulcerated
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Morphological changes in,CC Tumor cells are large and ha!e
h%perchromatic+ pleomorphic nuclei
D%splasia o cell in the ull depth o epithelium
<hen these cells $rea through $asementmem$raneI in!ade dermis
Most cells are well dierentiated and producelarge amounts o eratin
eratin pearls (onion lie swirls) in the dermis'ntracellular $ridges (space)# loss o
homot%pic cell adhesion
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,-uamous Cell Carcinoma
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*eerences
http:""www.ilpi.com"msds"re"carcinoma.html umar et al.+ JPathologic /asis o DiseasesK Lth edition+ *o$$ins and Cotran.
=88@.
4igure 5: Dangle et al. World Journal of Surgical Oncology =88> 6:58
Da!ison et al.+ Ford tet$oo o cinical nephrolog%+ 0olume 5. =88@.
4igure =:
http:""www.microscop%u.com"staticgaller%"patholog%"adenocarcinomaocolon=88=.html
http:""www.pathconsultdd.com"pathCon"diagnosispiiI,5@@7#>?L@9=>8?9=7L88?8#=
http:""www.ma%oclinic.com"health"sin#cancer"D,88578
4igure : http:""sincancer#act.com"sin#cancer#t%pe#$asal#cell#carcinoma#$cc"
http:""emedicine.medscape.com"article"5585@@#o!er!iew 4igure G: http:""dermnetn.org"lesions"img"$cc#ace"source"5.html