Histopathology Flashcards
What is cell atypia?
Changes in the cell type/structure/shape/contents.
What type of stain is needed to demonstrate hyperplastic candidosis pathology?
Periodic Schiff Stain (PAS)
What does the arrow indicate on this slide, and what implication do these cells have with regards to diagnosis?
Cell atypia - changes within the cell.
They can be found in both cancerous and non-cancerous cells, so not necessarily and indication of cancer.
What is abnormal about the epithelium of these tissues, and what may that indicate with regards to malignancy?
Epithelial dysplasia.
Does not necessarily indicate cancer, however they can develop into cancer.
What are the WHO 2005 grades for dysplasia?
Mild
Moderate
Severe
Carcinoma-in-situ
The higher the grade, the higher malignant potential of the cells.
How is cell dysplasia assessed?
Architecture changes
Mild - only in basal third
Moderate - extends to middle third
Severe - extends to upper third
What do points A and B indicate? Describe the dysplasia of this tissue.
A = Pleomorphism/hyperchromatisism
B = Basal cell hyperplasia
Architecture changes confined to lower third, indicating mild dysplasia. Cell atypia is mild.
What can be seen in this tissue, and comment on its malignant potential?
Moderate dysplasia extending from basal third to middle third. Moderate cellular atypia.
Moderate chance of malignant potential.
What can be seen in this tissue, and comment on its malignant potential?
Severe dysplasia extending from basal third to upper third. Severe Atypia and numerous mitosis.
Severe chance of malignant potential.
What is a potentially malginant lesion?
Altered tissue in which cancer is more likely to form.
What is a potentially malignant condition?
General state with increased cancer risk.
Give four examples of potentially malignant conditions?
Lichen planus
Oral submucous fibrosis
Iron deficiency
Tertiary syphilis
Which lesions are potentially malignant?
Leukoplakia:
- Chronic hyperplastic candidosis
- Proliferative verrucous leukoplakia
Erythroplakia
What treatment options are there for chronic hyperplastic candidosis?
Systemic anti-fungal
Biopsy
Smoking cesation
Observation
By what degree is leukoplakia more likely to progress to cancer than clinically healthy mucosa?
50-100 times more likely.
What are the indications that leukoplakia may develop into cancer?
Age and gender
Idopathic lesion
Site (buccal low risk, FoM and tongue high risk)
Clinically how can leukoplakia present?
Homogenous
Non-homogenous: verrucous, ulcerated, leuko-erythroplakia
Proliferated verruvous leukoplakia (highest malignant potential)
What are the best indications for assessing malignant change?
Dysplasia
Atrophy of healthy tissue
Candida infection
Biomarkers (inc DNA in leukoplakia)
What are the two main factors for carcinogenesis?
Genetic and environmental.
What is the molecular environmental basis of cancer development?
Damage
Altered gene expression
Altered cell function