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PATHOANA > Epithelial tumors – classification, typing and grading. > Flashcards

Epithelial tumors – classification, typing and grading. Flashcards

1
Q

covering eipthelia carcinomas

A

squamos cell carcinomas

epidermoid carcinoma

basaloma-semimalignant

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2
Q

covering epithelial-transitional carcinomas

A

transitional cell carcinoma

papillocarcinoma

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3
Q

glandular epithelia: glandualr and ductal epithelia

A

adenocarcinoma

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4
Q

glandular epithelia: hepatocytes

A

hepatocellular adenocarcinoma

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5
Q

glandular epithelia: renal ductal epithelia

A

renal cell carcinoma

carcinoma clarocellulare

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6
Q

where can squamos cell carcinoma develop from and how can tehy look

A

metaplastic resp failure,

The presence of keratin pearls and intercellular bridges

can be keratinizing/non kera: 80% is keratinzing and well differentiated

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7
Q

outcomes/prognosis of squamos cell carcinoma

A
  • Acantholytic(pseudoglandular or adenoid)
  • spindle cell (sarcomatoid)
  • pseudoangiosarcomatous(pseudovascular)
    -small cell or basaloid
  • post traumatoc (marjolins ulcer)
  • adeno-squamos (mixed differentation
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8
Q

other, abit better outcomes of suqmoas cell caricnomas

A
  • verrucous
  • clear cell (elderly, scalp) (renal cell carcinoma)
  • papillary
  • lymphoepithelial (nasopharyngeal localization)
  • keratoacanthoma
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9
Q

verrucous

A
  • sole of foot and anal margin
  • outward-growing (exophytic) lesion featuring “church spire” shaped hyperkeratosis and a deep margin that pushes into surrounding tissue, characterized by a cytologically bland, bubble-like (bullous) process.
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10
Q

keratoacanthoma

A

rapid growth and craterifrom(central depression) with central keratin plug and lipped rim of hyperplastic squamos epithalim

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11
Q

Basal cell carcinoma

A

msot common non-melanocytic cutaneous carcinoma

  • semimalignant
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12
Q

different types/growth patterns of basal cell carcinoma

A

nodular

superficial multifocal

infiltrative and mrphoiex

micronodular

metypical /basosquamos carcinoma

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13
Q

nodular -substyoe of BCC

A

charcateristics
- can vary in size
- can be wiht or without tumor necrosis and cystic spaces: may form cyst like structure

hsitological patterns:
- peripheral palisading-outer layer of cell in tumor forms a fence like pattern
- mitoses and dermal retraction artifact ar common (mellomrom mellom tumor or resten av tissue)

other features:
- can contian tarbecular(cords of cells), keratotic area(area with keratin cyst or squamos differentitation), squamos meyaplasia
- may exhinit fibroepithelial (pinkus tumor like) features and adnexal(like hair follicles or sweat glands) differentitation

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14
Q

superficial multifocal- subtype of BCC

A

-multiple tumor cell nests that are budding off form epidermal basal layer (laterally)
- superficial, flt lesions, welldefined and thin borders

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15
Q

infiltrative and morphoeic

A

small. irregulaar groups of tumor cells that infiltarte into fibrous or hyaline (glassy) scirrhous storme. –<porly circumscribed lesion that can be challenging to identy and remove

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16
Q

micronodular- sub of BCC

A

nest less than 25 cell in dia
- asymmetrical infiltrative growth pattern

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17
Q

metatypical/basosquamos carcinoma

A
  • more nuclar atypia, fibroblastic responsive and may have areas of malignant squmaos differense
  • more aggressive-characteristic of SCC AND BCC
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18
Q

usual types of transitional cell carcinoam

A

papillary and sessile

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19
Q

variant with bening features-TCC

A
  • microcystic tyoe:intra-urothelial microcysts. like cystitis cystica

-nested type: uniform cell in lamina propria like von Brunns neste
- irr margin, muscle invasion, maybe agrresive

-micropapillary type: like ovarian serous papilalry carcinoma
- stromal retraction artifact like
lymphovascular inavasia
- high grade tumor

  • inverted: like inverted papilloma but with WHOO II/III cytology
    • muscle invasion

clear cell, plasmacytoid, lipid cell, psuedosacamatous stroma, trophobalstic cells, lymphoepithelouma

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20
Q

what are adenocarcinomas classified on

A

on the tumor cell-stroma relationship

  • carcinoma solidum/simplex: Storma and Parenenchyme =1:1
  • medulalry carcinoma: S:P=1:2
  • scirrhous: S:P=2:1
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21
Q

ehat is peculiar form of adenocarcinoma

A

singnet cell carcinoma: cell are round and enclose in their cytoplasm a large PAS+, vacoule of mucin that pushes the nucleus to periphery

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22
Q

what are most majority of adenocarcinoma

A

colorectal adenocarcinoma because colon has so many glands in the tissue

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23
Q

how does normal ciolonic glands look liek

A

simole and tubular with a mixture of mucus secreting goblet cells and water absorbing cells(absorb water and feces into blood)

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24
Q

groeth pattern of galndular and ductal adneocarcinoma

A

exophytic: grworing into lumen-best
endophytic: into wall

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25
Q

grading of malignant neoplasm:

A

how well differentiated

  1. well diff, >95%
  2. moderatly, 50-95%
  3. poorly diff, <50%
  4. nearly anaplastic
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26
Q

stagining of malignant neopplasm: T-umor staging

A

Tis: in situ, non invasive, attached to epi
T1: small, minimall invasive within primary organ site, into lamina propria
T2: large, more invasinve within, inti muscularis prorpia/subserosa/lesser or greater omenta
T3: large, more , penetrate serosa(visceral peritoneum)
T4: very large and inavsive, spread to adjacent organs

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27
Q

staginin og malignant neoplasm: N(LN)

A

No: no lymphnode involved
N1: nearby ln involved
N2: regional
N3: Distant

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28
Q

staging of malignant neoplams: M(metastasis)

A

M0: no distant metastasis
M1: distant metastasis involved

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29
Q

how do we differentiate carcinomaform lymphoma or sarcoma

A

by positice cytokeratin

30
Q

signet cell

A

grade 3

31
Q

small cell carcinoma

A

grade 4

32
Q

carcinoembryonic antigen (CEA): immunohistochemical staining to detect systems for carcinomas

A

adenocardinomas

33
Q

cytokeratin:immunohistochemical staining to detect systems for carcinomas

A

carcinomas, but can also be in sarcomas

34
Q

alpha fetoprotein:immunohistochemical staining to detect systems for carcinomas

A

yolk sac tumors and hepatocellular carcinoma

35
Q

CD 117(c-KIT):immunohistochemical staining to detect systems for carcinomas

A

gastrointestinal stromal tumours-GIST

36
Q

CD 10(CALLA):immunohistochemical staining to detect systems for carcinomas

A

renal cell carcinomas and acute lymphoblastic leukemia

37
Q

prostate specific antigen-PSA:immunohistochemical staining to detect systems for carcinomas

A

Prostate cancer

38
Q

Estrogens and progestrone:immunohistochemical staining to detect systems for carcinomas

A

tumor identificaition

39
Q

most common cancer in women

A

skin, breast, lung, colon, uterus

40
Q

most common cancer in men

A

skin, prostate, lung, colon

41
Q

virchow node

A

left supraclavicular lymph node metastaiss from abdominal malignancy

42
Q

trosseaus signq

A

migratory venous thrombosis most often associated with pancreativ and brochogenic carcinomas

43
Q

what the guardian genome and how does mutation affect it

A

P53, tumor suppressor gene, located on chromosome 17

severe to arrest cell cycle and induce apoptosis under condition of DNA damage. when mutated: dna damage will continue to divide and proliferate

44
Q

papilloma

A

-squamos cell
- squamos or transitional epit
- skin, oral cavity, UB, oesophagus, vagina

45
Q

condylomata accuminata

A
  • other papilloma
  • on penios, around female ext genitalia, urethra,
    -HPV virus-16&18
46
Q

adenoma

A

-bening, exophytic neoplasm of galndular pei

47
Q

solid adenoma

A

hepatoma

48
Q

cystic adenoma

A

ovarian mucinous

49
Q

what do we uaslally se in squamos papilloma

A

hyperkeatosis, acanthosis with elogngation of rete ridges ans parakeratosis

50
Q

seborrheic keratosis

A
  • squamos papilloma
  • also called verruca seborrhoica, vercua senilis
  • idiopathic epidermal prolif composed principally of monomorphous basaloid keratinocytes
  • middle ages adults, exophittc
  • trunk, shoulder, face, neck
  • macro: soft/hard, yellow/black/grey, sharply demarked, warty surface
  • histo: basaloid cells (spehircal, pale, large nucleus), sharply demarkated, hyperkeratosis, acanthisis, papillomatosis, HORN CYST/PERALS IN EPIDERMIS
51
Q

renal papillary adenoma

A
  • well circumasisted, yellow-gray -white nodules in renal cortex
  • solitary-but may renal adenomatosis

micro: papirllay/tubulopapillary, around thin fibrous capsule, psammoma bodies, foamy macrophages,

52
Q

renal onocytoma

A

-neoplams of renal cortex
- may be palpalbe mass or with hematuria
- mahagony brown color
-central zones of withish storma and foci of hemorrhae

mciro: cells in diffuse sheets or cellular island in loose edematous CT

53
Q

bening epithelial(urothelial tumors)

A
  • form transinotal epi of bladder in continuity wiht epi of renal pelvis, ureter and urethra

TRansitional cell papilloma
- branchin patters
- cells resebel normal: no size of shape diff
- exo or endophytic growth
-^micro or macro hematouria

54
Q

serous cystadenoma of ovary

A

-bening glandular epit tumor
- unilocular or multilocular, >5cm in dia, spehrical masses
-20-50y
- coelomic epi–>tubal type of epi
- thin walls with clear fluid

micro:
- lined by cilated or non ciliated low columnar cells with bland ovoid nucleo
- epi becomes falttend if cyst under tension
- small foci of mild to moderate nuclear atypia or nuclear stratificaiton

55
Q

mucinous cystadenoma of ovary

A
  • larger, ca 10 cm in dia, unilat/uniocular/multiocular
  • 20-50y
  • coelomic epi–>endocervical type or intestinal type of mucos
    -smooth surfaced
  • non ciliated columnar cells
    -focal low grade atyoua
56
Q

adenoma of GI tract

A
  • not before 40y
  • asymptomatic, larger adenoma–>bleeding, rare villous adenoma may produce abundant mucus–>diarrhea
  • rare in stomach or SI
  • ^colon and rectum

micro: tubular or villous structure lined by dysplastic epi
- ^proportion of immature cells-hyerpchromatic stratified nuceli
- mitotic act-upper crypt and surface eoi

3types:
1. tubular adenoma
2. villous adenoma
3. tubulovillous adenoma

57
Q

tubular adenoma (adenomatous polyp)

A
  • most common neoplastic polyps
    -^DISTAL COLON AND RECTUM
  • asymptomatic or rectal bleeding

macro: single/multiple, sessile(pedunculated, varibale size

micro: tumor overlying muscuaris mucosa, branchin tubules in propria , linign eoi with decreased mucus secreting capacity, large nuclei and ^mitotic act

5% mal

58
Q

villous adenoma(villous papilloma)

A
  • ^distal colon and rectum
  • invaribly symptomatic, rectal bleeding, diarrhea

macro: round and oval exophytic masses, sessile, 1-10cm in dia, surface can be hemorrhagic or ulcertated

micro: finger like villi, sometimes excess mucus secretion

30% mal

59
Q

tubulovillous adenoma (papillary adenoma)

A
  • distal colon and rectum
  • macro: sessile or pedunculated, 0,5-5cm in dia
  • micro: intermediate or mixed pattern
    -tubular pattern
60
Q

familial polyposis syndromes

A

group of disoders with multiple polyposis of the colon with autsomal dominant inheritence pattern

61
Q
  1. familai polyposis coli(adenomatosis
A
  • over 100 neoplastic polyps of mucosal surface of colon
    -autosomal dominant
    -germline mutation in APC gnee
    -20-30y
    -hig malignancy
    -micro:^tubular structure
    -colectomy
62
Q

garderns syndroem

A

FAP and extra colonic lesions(mutliple osteomas, sebaceous cysts, CT tumors)

63
Q

tucots syndorme

A

-combinaiton of FAP and malignant neoplasm of central nevorus system

64
Q

juvenile polyposis syndorme

A

multiple juvenile polyps in colon, stomach, SI
-lower nr than in FAP
-no malignant potnetial

65
Q

follicilar adenoma of TG

A
  • most common bening
  • adult woman

macro:
-solitary nodule
- cold noduel, small and spheical
-celarly distinct architercture inside and outside capsule
- compression of thyroid parnchyma outside capsuel

micro:
-tumors cells–>being follicular epi cells

66
Q

type sof follicualr adneoma of TG

A
  1. microfollicualr-fetal: no/little collid
  2. normofollicular-simple: closed packed follicles
  3. macrofollicualr-colloid
  4. trabecular-embryonal
  5. hrutle cells-oxyphilix- solid trabecula or larger cells haveing abundant granular oxyphilic cytoplasm and vesicular nuclei, cells do not form follicles
  6. atypical-follicula adenoma, more cellualr prolif, pleomorphism, ^mitosis, nucelar atypia, no capsular or vascualr invasion
67
Q

cortical adenoma-adrenal gland

A
  • most common
    -small and nonfucntional
  • large adenoma-ecess corticsol, aldosteron, androgens–>cushing/cohn/adrenogenital syndome
  • MEN 1

macro:
- solitary, spehrical, encapsulated tumor, well delineated form surordny

mciro: cells arranged intrabeculae and resemble clles of zona fasciculata

68
Q

breast -fibroadenoma

A
  • during reproductive life, 15-30y
  • single, mutiple, uni or bilateral, discrete, freely mobile noduel

macro:
- small, spherical or ovoid nucleus
, sharply circumsied and clearly separated

micro:
-prolif of loose cellualr stromal CT which surrond varibale number of ductal structure
- intracellualr patter-stroma compresses ductus–>slit like cleft with ductal epi, or pericanalicular-encircling masses of fibrous stroma around patent or dilated ducts

69
Q

pleomorphic adenoma(mixed salivaru tumor

A
  • parotid ecsepsially
  • women, 30-50y
    -soliatry, smooth surfaced, painless, slow growing,

macro:
-circumscribed
-pseudo encapsulated

micro:
-pleomorphic or mixed apperance

70
Q

monomorphic adenoma

A
  • no evidence of mesenchumal liek tissues
    -warthins tumor(papillary cystadenoma)-parotid gland
    -oxyphil adenoma(oncocytoma)-major salivary glands
    -myoepithelioma
    -basal cell adenoma
  • clear cell adenoma

PATHOANA (12 decks)

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