Lab 9 Flashcards
Identify this structure:
Viral papilloma
This is from the skin of the left elbow, provide a morphological diagnosis for this mass.
skin mass, left elbow: viral papilloma, exophytic
Identify this structure:
keratin pearl
This is from the eyelid and ocular bone, provide a histologic morphologic diagnosis. (Note: there is metastasis to the lung)
ocular squamous cell carcinoma with local bone invasion and pulmonary metastasis
Trace the probable route of metastasis from the primary site in the eye to the secondary metastatic sites in the lung.
Lymphatic invasion is likely, which would mean invasion by single or clumps of neoplastic squamous cells into the lymphatic vessels within and surrounding the eye. Arrest of these cells in local lymph nodes and regional chains (parotid, retropharyngeal, cervical chain) and progressive movement with the lymph flow to empty into the right lymphatic duct, the thoracic duct, or directly into the vena cava near the thoracic inlet. The neoplastic cells then become blood borne and flow through the cranial vena cava, right atrium, right ventricle, pulmonary arteries and lodge in the small pulmonary arteries and capillaries where clusters of cells may take hold and set up secondary sites.
Which tissue layers are affected by the neoplasm?
mucosal surface, muscle layers, and submucosa
Is the cell of origin a round cell, epithelial, or mesenchymal population?
epithelial - formation of cords, nests by cohesive groups of polygonal cells
This is from a feline larynx, is this benign or malignant and why?
malignant, the presence of neoplastic clusters within the blood vessels, severe stromal invasion, lack of differentiation, increased mitotic rate, cellular variability
Describe this lesion to the lungs.
Lungs: Multifocal, small, raised, pale tan to white cavitated masses are scattered diffusely over the surface of all lung lobes. Masses range in size from 1 mm to 5 mm in diameter. On cut surface, the masses pale in color, firm, and extended into the lung parenchyma.
What are these?
multifocal, white, raised, cavitated pulmonary masses
What is happening here?
focal, white to tan mass located on the right medial liver lobe
Describe what is happening on cut surface.
the mass penetrates into the liver parenchyma
Describe this lesion to the liver.
Focally, a circular, white to yellow, firm mass is present in the right medial liver lobe. Smaller, white to yellow nodules surrounded the larger mass. On cut surface, the mass is cream colored, smooth, and extended almost all the way through the liver lobe.
Provide a morphological diagnosis for the lungs.
multifocal, chronic pulmonary masses
Provide a morphological diagnosis for the liver.
multifocal, chronic hepatic masses
Histologic examination of the hepatic and pulmonary the masses reveals similar findings. Histology shows polygonal (epithelial origin) neoplastic cells arranged in various sized tubules and acini that are somewhat similar to bile duct. There is a high mitotic rate and evidence of neoplastic invasion into blood and lymphatic vessels. If this tumor originated in the liver, what is the main differential for an epithelial tumor originating from the liver that has characteristics of bile ducts?
primary cholangiocarcinoma of the liver with secondary metastasis to the lung
Describe this lesion.
Skin and right cranial mammary gland: An ulcerate mass located within the skin associated with the right cranial mammary gland. The mass is firmly adhered to the overlying skin and underlying mammary gland. On cut surface, the mass is mottled pink to tan and has multiple small cavitations and central necrosis.
Describe this lesion.
Lungs: Multifocal firm white nodules that are seen on the surface of all lung lobes. On cut surface, the masses are white and extending into the lung parenchyma.
Provide a morphological diagnosis for the skin and mammary gland.
Skin and mammary gland: chronic focal mammary gland masss with locally extensive ulcerative dermatitis
Provide a morphological diagnosis for the lungs.
chornic, multifocal pulmonary nodules
Histologic examination of the mammary mass and the lungs are similar. Histology reveals lobules and nests of neoplastic epithelial cells with a high mitotic index and marked anisocytosis and anisokaryosis. There are numerous areas of necrosis throughout the mass with heavy infiltrates of neutrophils. What would be a good differential for this neoplasm in the mammary gland? What is the biologic behavior of your differential?
the nest a lobules of neoplastic epithelial cells with a high mitotic index and marked anisocytosis and anisokaryosis are consistent with mammary gland carcinoma
Histology shows that neoplasm in the mammary gland is the same as the neoplasms found in the lungs. Assuming the neoplasm originated in the mammary gland, propose a pathogenesis for how the neoplasm made its way to the lungs.
Original transformed mammary epithelial cells to cellular division, growth, angiogenesis, and formation of a mass to Metastatic cells invade and break through the basement membrane to migration of metastatic cells to veins to invasion or intravasation into a vein to metastatic cells embolus to neoplastic embolus wedges in smaller vessel to extravasion and colonization of a new tissue/organ
Identify this structure:
subscapular sinus
The lymph nodes associated with this neoplasia have mammary carcinoma cells present, how would these cells get to the lymph node?
metastatic cells invade through the mammary gland stroma to the lymphatic vessels to metastatic embolus to neoplastic embolus travels to the draining lymph node through the afferent lymph vessels to neoplastic cells enter the subscapular sinuses and get wedged to neoplastic cells proliferate and efface normal lymph node architecture
