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الخميس، 10 مايو، 2012

صور باثولوجى -- Patholgy Slides : Tumors or Neoplasia : Malignant epithelial tumors


Patholgy Slides : Tumors or Neoplasia  
Malignant epithelial tumors

اضغط على الصورة للتكبير - Click on image to enlarge size


Squamous cell carcinoma (skin)
Squamous cell carcinoma is a malignant epithelial tumor which originates in epidermis, squamous mucosa or areas of squamous metaplasia. In skin, tumor cells destroy the basement membrane and form sheets or compact masses which invade the subjacent connective tissue (dermis). In well differentiated carcinomas, tumor cells are pleomorphic/atypical, but resembling normal keratinocytes from prickle layer (large, polygonal, with abundant eosinophilic (pink) cytoplasm and central nucleus). Their disposal tends to be similar to that of normal epidermis: immature/basal cells at the periphery, becoming more mature to the centre of the tumor masses. Tumor cells transform into keratinized squames and form round nodules with concentric, laminated layers, called "cell nests" or "epithelial/keratinous pearls". The surrounding stroma is reduced and contains inflammatory infiltrate (lymphocytes). Poorly differentiated squamous carcinomas contain more pleomorphic cells and no keratinization. (H&E, ob. x10)


Squamous cell carcinoma (skin). Tumor cells transformed into keratinized squames form round nodules with concentric, laminated layers, called "cell nests" or "epithelial/keratinous pearls". (H&E, ob. X40)

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Basal cell carcinoma

Basal cell carcinoma is a malignant epithelial tumor arising only in skin, from the basal layer of the epidermis or of the pilosebaceous adnexa. Tumor is represented by compact areas, well delineated and invading the dermis, apparent with no connection with the epidermis. Tumor cells resemble normal basal cells (small, monomorphous) are disposed in palisade at the periphery of the tumor nests, but are spindle-shaped and irregular in the middle. Tumor clusters are separated by a reduced stroma with inflammatory infiltrate. (H&E, ob. x4)

Basal cell carcinoma (detail
Basal cell carcinoma. (H&E, ob. X40)

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Gastric carcinoma, intestinal type
Gastric adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the gastric mucosa. According to Lauren classification, gastric adenocarcinoma may be: intestinal type, diffuse type and mixed type.

Gastric adenocarcinoma, intestinal type. Tumor cells describe irregular tubular structures, with stratification, multiple lumens surrounded by a reduced stroma ("back to back" aspect). The tumor invades the gastric wall, infiltrating the muscularis mucosae, the submucosa and thence the muscularis propria. Often it associates intestinal metaplasia in adjacent mucosa. Depending on glandular architecture, cellular pleomorphism and mucosecretion, adenocarcinoma may present 3 degrees of differentiation : well (photo), moderate and poorly differentiate. (H&E, ob. x10)

Gastric adenocarcinoma, intestinal type, infiltrating muscularis propria. (H&E, ob. x10)

Gastric adenocarcinoma, intestinal type. (H&E, ob. X40)

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Gastric carcinoma, diffuse type (mucinous)
Gastric adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the gastric mucosa. According to Lauren classification, gastric adenocarcinoma may be: intestinal type, diffuse type and mixed type.

Gastric adenocarcinoma, diffuse (infiltrative) type. Tumor cells are discohesive and secrete mucus which is delivered in the interstitium producing large pools of mucus/colloid (optically "empty" spaces) - mucinous (colloid) adenocarcinoma, poorly differentiated (Lauren classification). If the mucus remains inside the tumor cell, it pushes the nucleus against the cell membrane - "signet-ring cell". (H&E, ob. x10)

Gastric adenocarcinoma, diffuse type. (H&E, ob. X20)

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Moderately differentiated adenocarcinoma (colon)

Adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the colorectal mucosa. It invades the wall, infiltrating the muscularis mucosae, the submucosa (photo) and thence the muscularis propria. (Notice the end-point of muscularis mucosae. At left from this point, muscularis mucosae is continuous. At right from this point, muscularis mucosae is destroyed by tumor cells invasion.) Tumor cells describe irregular tubular structures, harboring stratification, multiple lumens, reduced stroma ("back to back" aspect). Depending on glandular architecture, cellular pleomorphism and mucosecretion of the predominant pattern, adenocarcinoma may present 3 degrees of differentiation: well, moderate and poorly differentiate. (H&E, ob. x10)

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Poorly differentiated adenocarcinoma (mucinous), colon

Adenocarcinoma is a malignant epithelial tumor, originating from glandular epithelium of the colorectal mucosa. It invades the wall, infiltrating the muscularis mucosae, the submucosa and thence the muscularis propria. Tumor cells are discohesive and secrete mucus which invades the interstitium producing large pools of mucus/colloid (optically "empty" spaces) - mucinous (colloid) adenocarcinoma, poorly differentiated. If the mucus remains inside the tumor cell, it pushes the nucleus at the periphery, against the cell membrane - "signet-ring cell". (H&E, ob. x20)

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Poorly differentiated hepatocellular carcinoma

Hepatocellular carcinoma, poorly differentiated (photo - upper right), developed on liver cirrhosis. This malignant epithelial tumor consists in tumor cells, discohesive, pleomorphic, anaplastic, giant. The tumor has a scant stroma and central necrosis because of the poor vascularization. In well differentiated forms, tumor cells resemble hepatocytes, form cords and nests, and may contain bile pigment in cytoplasm. (H&E, ob. x20)

Poorly differentiated hepatocellular carcinoma. (H&E, ob. x20)

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Renal cell carcinoma (Grawitz tumor)

Renal clear cell carcinoma (Grawitz tumor) is a malignant epithelial tumor resulted from proliferation of tubule cells. Tumor cells form cords, papillae, tubules or nests, and are atypical, polygonal and large. Because these cells accumulate glycogen and lipids, their cytoplasm appears "clear", lipid-laden, the nuclei remain in the middle of the cells, and the cellular membrane is evident. Some cells may be smaller, with eosinophilic cytoplasm, resembling normal tubular cells. The stroma is reduced, but well vascularized. The tumor grows in large front, compressing the surrounding parenchyma, producing a pseudocapsule. (H&E, ob. x20)

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Endometrioid carcinoma of endometrium

Endometrioid adenocarcinoma of the endometrium is a malignant epithelial tumor. It appears on a background of endometrial hyperplasia, in hyperestrogenism. Tumor cells are atypical and form irregular glands, with multiple lumens, stratification. The stroma is reduced, producing the "back to back" aspect of the tumor glands. The myometrium is not infiltrated. (H&E, ob. x10)

Endometrioid adenocarcinoma of the endometrium. (H&E, ob. x20)

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Invasive ductal carcinoma of the breast

Invasive (infiltrating) ductal carcinoma of the breast is a malignant epithelial tumor resulted from proliferation of ductal epithelium of breast. It is the most common type of breast cancer (70 - 80 %). Atypical tumor cells form ribbons, tubules or nests, broke the basement membrane of the duct and infiltrate the surrounding tissues (fat tissue - photo, skeletal muscle and/or skin). Tumor cells induce desmoplastic reaction in stroma (abundant fibrosis, collagen). (H&E, ob. x20)

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Carcinoma metastasis (lymph node)

Lymph node with carcinoma metastasis : clusters of tumor cells, atypical, with carcinomatous character. (H&E, ob. x20)

Detail from metastatic lymphadenopathy. (H&E, ob. x40)

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