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Pathology Practical
Premalignant lesions and
    conditions CPC
Mild Epithelial
      Dysplasia
H&E showing :
1. Stratified squamous
   epithelium .
2. Hyper chromatism.
3. Cellular polymorphism.
4. Loss of polority .
5. Basal hyperplasia .
6. Some cell in mitosis.
7. Some chronic
   inflammatory cells
Moderate Epithelial
    Dysplasia
H&E showing :
1. Hyperplatic Stratified
   squamous epithelium .
2. Hyper chromatism.
3. Loss of polority
   Basal cell .
4. Loss of adhesion.
5. Increase mitotic cell
6. Presence of abnormal
   mitotic cell
7. Infiltration of chronic
   inflammatory cells
Carcinoma in situ
H&E showing :
1. Stratified squamous
   epithelium .
2. Bulbus retroprocess
3. Dysplastic change from
   top to bottom.
4. Loss of adhesion.
5. Increase mitotic cell
6. Presence of abnormal
   mitotic cell.
7. Cellular polymorphism.
8. Nuclear polymorphism.
9. Infiltration of chronic
   inflammatory cells
Lichen planus
H&E showing :
1. Atrophy of Stratified
   squamous epithelium .
2. Hyper chratosis .
3. Diffuse of chronic
   inflammatory cells.
4. Basal cell degeneration.
5. Leuko faction.
6. Sirett`s body & breakle
   cell in basal layer.
Oral Submucous
        Fibrosis
H&E showing :
1. Atrophy of Stratified
   squamous epithelium .
2. Hyper chratosis .
3. Hyper paarachratosis.
4. Absence of retroprocess.
5. Fibrosis of sup epith. &
   underling CT
Salivary Gland Disease & Benign
            Tumors
Necrotizing silometaplasia




• H&E section showing degenerated acini of minor salivary glands .
• Metaplasia of ductal epithelium forming nest-like structures .
• Infiltration of chronic inflammatory cells .
Cont….




• H&E section showing degenerated acini of minor salivary glands .
• Metaplasia of ductal epithelium forming nest-like structures .
• Infiltration of chronic inflammatory cells .
Cont….




• H&E section showing degenerated acini of minor salivary glands .
• Metaplasia of ductal epithelium forming nest-like structures .
• Infiltration of chronic inflammatory cells .
Chronic sialadenitis




• H&E section showing atrophy of acini and dilatation of the duct .
• Infiltration of chronic inflammatory cells .
Cont….




• H&E section showing atrophy of acini and dilatation of the duct .
• Infiltration of chronic inflammatory cells .
Pleomorphic adenoma




• H&E Proliferation of ductal epithelial and myoepithelial cells in the
  form of sheet-like structures .
• Many ductal-like structures and myxoid-like structures .
Cont….




• Proliferation of ductal epithelial and myoepithelial cells in the form of
  sheet-like structures .
• Many ductal-like structures and myxoid-like structures .
Cont….




• H&E Proliferation of ductal epithelial and myoepithelial cells in the
  form of sheet-like structures .
• Many ductal-like structures and myxoid-like structures .
Warthin’s tumor




• H&E section showing composed of papillary projections and cystic
  spaces . Forms of two types of oncocytic eosinophilic cells : basal cells (
  cuboidal ) and columnar cells . Between these projections, there is
  proliferation of diffuse chronic inflammatory cells and germinal cells
Oncocytoma




H&E section showing polyhedral cells with granular eosinophilic
cytoplasm arranged in sheets or duct-like structures .
MucoepidermoidCarcinoma




• H&E Many cystic spaces and two types of cells : Mucous cells
  surrounding cystic space , Dark-stained epidermoid cells in fibrous C.T.
  stroma .
Cont….




• H&E Many cystic spaces and two types of cells : Mucous cells
  surrounding cystic space , Dark-stained epidermoid cells in fibrous C.T.
  stroma .
Cribriform Pattern of Adenoid Cystic Carcinoma




H&E section showing proliferation of isomorphic basophilic basalloid
( basal-like ) cells surrounding many cystic spaces in C.T. stroma taking
Swiss-cheese pattern ( cribri-form pattern ) .
Solid pattern of Adenoid Cystic Carcinoma




H&E section showing proliferation of isomorphic basophilic basalloid (
basal-like ) cells surrounding many cystic spaces in C.T.
Perineural Invasion




H&E section showing proliferation of isomorphic basophilic basalloid
( basal-like ) cells surrounding many cystic spaces in C.T. and there is
perineural invasion
Benign & malignant neoplasma
Squamouscell Papilloma




• H&E section showing finger like projection of hyperplastic Stratified
  keratinized squamous epithelium supported by vascular CT. core .
• Superficial epithelial cell showing pernuclear vaculization
Keratoacanthoma




H&E section showing exophytic growth of hyperplastic Stratified squamous
epithelium with central crater containing keratin plug & CT. showing Infiltration
of chronic inflammatory cells .
Fibroma




H&E section showing proliferated of collagen in form of bundles and
fibroblast surrounded by fibers CT. capsule and covered by stretched
Stratified squamous epithelium.
Squamouscell Carcinoma




• Tuomur showing malignant epithelial cell forming nests invading CT
  stroma. The Malignant cell is hyperchromatic and mitosis can be seen.
• keratin pearl & indivdul cell keratinization also present . Infiltration of
  chronic inflammatory cells in CT stroma. and degenrated muscle also seen
Fibrosarcoma




• Malignant fibroblast arranged in vascicels & delicate CT. fibers
• The fibroblast are hyperchromatic polymorphic and some mitosis.
Thank you …….

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Pathology Practical Guide to Premalignant Lesions, Salivary Gland Diseases, and Oral Neoplasms

  • 2. Premalignant lesions and conditions CPC
  • 3. Mild Epithelial Dysplasia H&E showing : 1. Stratified squamous epithelium . 2. Hyper chromatism. 3. Cellular polymorphism. 4. Loss of polority . 5. Basal hyperplasia . 6. Some cell in mitosis. 7. Some chronic inflammatory cells
  • 4. Moderate Epithelial Dysplasia H&E showing : 1. Hyperplatic Stratified squamous epithelium . 2. Hyper chromatism. 3. Loss of polority Basal cell . 4. Loss of adhesion. 5. Increase mitotic cell 6. Presence of abnormal mitotic cell 7. Infiltration of chronic inflammatory cells
  • 5. Carcinoma in situ H&E showing : 1. Stratified squamous epithelium . 2. Bulbus retroprocess 3. Dysplastic change from top to bottom. 4. Loss of adhesion. 5. Increase mitotic cell 6. Presence of abnormal mitotic cell. 7. Cellular polymorphism. 8. Nuclear polymorphism. 9. Infiltration of chronic inflammatory cells
  • 6. Lichen planus H&E showing : 1. Atrophy of Stratified squamous epithelium . 2. Hyper chratosis . 3. Diffuse of chronic inflammatory cells. 4. Basal cell degeneration. 5. Leuko faction. 6. Sirett`s body & breakle cell in basal layer.
  • 7. Oral Submucous Fibrosis H&E showing : 1. Atrophy of Stratified squamous epithelium . 2. Hyper chratosis . 3. Hyper paarachratosis. 4. Absence of retroprocess. 5. Fibrosis of sup epith. & underling CT
  • 8. Salivary Gland Disease & Benign Tumors
  • 9. Necrotizing silometaplasia • H&E section showing degenerated acini of minor salivary glands . • Metaplasia of ductal epithelium forming nest-like structures . • Infiltration of chronic inflammatory cells .
  • 10. Cont…. • H&E section showing degenerated acini of minor salivary glands . • Metaplasia of ductal epithelium forming nest-like structures . • Infiltration of chronic inflammatory cells .
  • 11. Cont…. • H&E section showing degenerated acini of minor salivary glands . • Metaplasia of ductal epithelium forming nest-like structures . • Infiltration of chronic inflammatory cells .
  • 12. Chronic sialadenitis • H&E section showing atrophy of acini and dilatation of the duct . • Infiltration of chronic inflammatory cells .
  • 13. Cont…. • H&E section showing atrophy of acini and dilatation of the duct . • Infiltration of chronic inflammatory cells .
  • 14. Pleomorphic adenoma • H&E Proliferation of ductal epithelial and myoepithelial cells in the form of sheet-like structures . • Many ductal-like structures and myxoid-like structures .
  • 15. Cont…. • Proliferation of ductal epithelial and myoepithelial cells in the form of sheet-like structures . • Many ductal-like structures and myxoid-like structures .
  • 16. Cont…. • H&E Proliferation of ductal epithelial and myoepithelial cells in the form of sheet-like structures . • Many ductal-like structures and myxoid-like structures .
  • 17. Warthin’s tumor • H&E section showing composed of papillary projections and cystic spaces . Forms of two types of oncocytic eosinophilic cells : basal cells ( cuboidal ) and columnar cells . Between these projections, there is proliferation of diffuse chronic inflammatory cells and germinal cells
  • 18. Oncocytoma H&E section showing polyhedral cells with granular eosinophilic cytoplasm arranged in sheets or duct-like structures .
  • 19. MucoepidermoidCarcinoma • H&E Many cystic spaces and two types of cells : Mucous cells surrounding cystic space , Dark-stained epidermoid cells in fibrous C.T. stroma .
  • 20. Cont…. • H&E Many cystic spaces and two types of cells : Mucous cells surrounding cystic space , Dark-stained epidermoid cells in fibrous C.T. stroma .
  • 21. Cribriform Pattern of Adenoid Cystic Carcinoma H&E section showing proliferation of isomorphic basophilic basalloid ( basal-like ) cells surrounding many cystic spaces in C.T. stroma taking Swiss-cheese pattern ( cribri-form pattern ) .
  • 22. Solid pattern of Adenoid Cystic Carcinoma H&E section showing proliferation of isomorphic basophilic basalloid ( basal-like ) cells surrounding many cystic spaces in C.T.
  • 23. Perineural Invasion H&E section showing proliferation of isomorphic basophilic basalloid ( basal-like ) cells surrounding many cystic spaces in C.T. and there is perineural invasion
  • 24. Benign & malignant neoplasma
  • 25. Squamouscell Papilloma • H&E section showing finger like projection of hyperplastic Stratified keratinized squamous epithelium supported by vascular CT. core . • Superficial epithelial cell showing pernuclear vaculization
  • 26. Keratoacanthoma H&E section showing exophytic growth of hyperplastic Stratified squamous epithelium with central crater containing keratin plug & CT. showing Infiltration of chronic inflammatory cells .
  • 27. Fibroma H&E section showing proliferated of collagen in form of bundles and fibroblast surrounded by fibers CT. capsule and covered by stretched Stratified squamous epithelium.
  • 28. Squamouscell Carcinoma • Tuomur showing malignant epithelial cell forming nests invading CT stroma. The Malignant cell is hyperchromatic and mitosis can be seen. • keratin pearl & indivdul cell keratinization also present . Infiltration of chronic inflammatory cells in CT stroma. and degenrated muscle also seen
  • 29. Fibrosarcoma • Malignant fibroblast arranged in vascicels & delicate CT. fibers • The fibroblast are hyperchromatic polymorphic and some mitosis.