Ca colon , pleomorphic adenoma

1. GI tract

2. SALIVARY GLAND STRUCTURES

3. NORMAL
HISTOLOGY

5. Salivary gland neoplasms

6. Some interesting facts
● < less than 2% of all tumors in humans
○ 80% arise within parotid
○ 10% in submandibular gland,
○ Remainder in minor salivary glands
● Majority parotid tumors are benign
● 40% of submandibular, 50% of minor salivary gland, and 70% to 90%
of sublingual tumors are malignant.
● The malignant potential of salivary gland tumors is inversely
proportional to gland size

7. Presentation
Swelling in the angle of mandible

8. Pleomorphic adenoma
● MC salivary gland neoplasm
● Majority occur in the parotid
● PA are benign tumors that consist of a mixture of ductal (epithelial),
myoepithelial, and mesenchymal cells
● Aka MIXED TUMORS
● Misnomer
● Neoplastic cells are of either myoepithelial or ductal reserve cell
origin.

9. Morphology: Gross

10. Morphology
● Heterogenous
● The tumor cells form ducts, acini,
tubules or sheets of cells.
● The epithelial cells are small and
dark and
● Cuboidal to spindle forms
● Epithelial elements are
intermingled with a loose, often
myxoid connective tissue stroma
● Sometime containing cartilage
islands, rarely bone.
Microscopy

13. Malignant transformation
● Malignant transformation in PA adenoma correlate with age of lesion
● 2% of tumors that have been present for < 5 years harbor cancers
● Increases to 10% for those present for >15 years
● Cancers are usually adenocarcinomas or undifferentiated carcinomas

14. CARCINOMA COLON

16. WHO CLASSIFICATION OF TUMORS OF
COLON AND RECTUM
▪ EPITHELIAL POLYPS
▪ Adenoma
Tubular
Villous
Tubulovillous
▪ Dysplasia(IEN), low grade
▪ Dysplasia, high grade
▪ Serrated lesions
Hyperplastic polyps Sessile
serrated polyp
Traditional serrated adenoma
▪ Hamartomatous
Cowden-associated polyp
Juvenile polyp
Peutz-Jeghers polyp

17. CARCINOMAS
▪ Adenocarcinom
a
▪ Other types
MESENCHYMAL TUMORS
▪ Lipoma
▪ Leiomyoma
▪ Gastrointestinal stromal
tumor
▪ Leiomyosarcoma
▪ Angiosarcoma
▪ Kaposi sarcoma

18. LYMPHOMAS
▪ B-cell lymphoma,unclassifiable
▪ Burkitt lymphoma
▪ Diffuse large B-cell lymphoma
▪ Mantle cell lymphoma
▪ Marginal zone lymphoma of
mucosa- associated lymphoid
tissue(MALT)
▪ Secondary tumors

24. MICROSCOPY
▪ Usually well or moderately
differentiated gland forming
carcinoma
▪ Glands often filled with necrotic
debris ("dirty necrosis")
▪ Inflammatory cells are
common

27. ▪ Well differentiated:
�15% - 20% of all carcinomas
�Well formed glands or simple tubules with uniform, basally
oriented nuclei
▪ Moderately differentiated:
�60% - 70% of all carcinomas
�Tubules may be simple, complex or slightly irregular
▪ Poorly differentiated:
�15% - 20% all of carcinomas
�Less than 50% gland formation
�Majority of tumor consists of sheets of cells without gland
formation

29. MODERATELY DIFFERENTIATED ADENOCARCINOMA