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Cancer lab diagnosis

Cancer lab diagnosis

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Cancer lab diagnosis

  1. 1. Faculty of Medicine NEOPLSIA 2021 Cancer Lab diagnosis King Abdulaziz University Rabigh Branch
  2. 2. Tumor Diagnosis: • History and Clinical examination • Imaging: X-Ray, US, CT, MRI • Biochemical assays – Tumor markers Laboratory analysis • Morphologic methods (Histological diagnosis) – Cytology: Pap smear, FNAB – Biopsy: Histopathology, markers. • Molecular Tech: Gene detection.
  3. 3. Histological diagnosis Microscopic tissue examination is the gold standard of cancer diagnosis. • The specimen must be adequate, representative and properly preserved. Several sampling approaches are available: • Excision or biopsy • fine-needle aspiration • Cytologic (papanicolaou) smears • Immunocytochemistry • Flow cytometry
  4. 4. Excision or biopsy • Awareness in selecting appropriate site for biopsy • In case of large mass: the margins may not be representative and the center may be largely necrotic. • Frozen-section: quick technique permits histologic evaluation within minutes – determining the nature of lesion – Evaluating the margins of an excised cancer to ascertain that the entire neoplasm has been removed.
  5. 5. Excision or biopsy • in breast biopsy, frozen-section allows determination of whether the lesion is malignant and may require wider excision or sampling of axillary lymph nodes for possible spread
  6. 6. Fine-needle aspiration • It involves aspiration of cells from a mass, followed by cytologic examination of the smears. • Useful for palpable lesions affecting the breast, thyroid, lymph nodes, and salivary glands • With modern imaging techniques it can be extended to deeper structures (liver, pancreas, and pelvic lymph nodes)
  7. 7. Cytologic (papanicolaou) smears • It is used widely for detecting cervix carcinoma at an in situ stage. • It is also used for endometrial carcinoma, bronchogenic carcinoma, bladder and prostate tumors. • Neoplastic cells are less cohesive than others and so are shed into fluid or secretion • The shed cells are evaluated for anaplastic features
  8. 8. Immunocytochemistry tumor markers • Monoclonal antibodies against cytokeratin present in epithelial cells (undifferentiated tumor rather than large cell lymphoma) • PSA for prostatic metastasis • Estrogen receptor and Her2 in breast cancer • Carcinoembryonic antigen (CEA): abnormal increase are seen in colorectal Ca, Gastric CA, Pancreatic Ca, Breast Ca. • Alpha fetoprotein: increased in liver cancer, colorectal Ca, pancreatic Ca, lung Ca, and cancer arised from germ cells of testes.
  9. 9. Flow cytometry • Routine classification of leukemias and lymphomas • Fluorescent antibodies against cell surface molecules and differentiation antigens. • Assessing DNA content of the tumor cell
  10. 10. Biochemical assays • Useful for measuring the levels of tumor associated enzymes, hormones, and tumor markers in serum. • Useful in determining the effectiveness of therapy and detection of recurrences after excision
  11. 11. Molecular diagnosis • Polymerase chain reaction (PCR) example: detection of BCR-ABL transcripts in chronic myeloid leukemia. • Fluorescent in situ hybridization (fish) it is useful for detecting translocation characteristic of many tumors • Both PCR and Fish can show amplification of oncogenes (HER2 and N-MYC)
  12. 12. Bilateral Cystadenoma Ovary
  13. 13. Lipoma Intestine
  14. 14. Meningioma
  15. 15. Lung carcinoma
  16. 16. Hepatic Adenoma
  17. 17. Carcinoma Breast
  18. 18. Carcinoma Lung
  19. 19. Osteo-sarcoma
  20. 20. Colon Polyp
  21. 21. Hepatic Adenoma Normal Adenoma
  22. 22. Metastatic Adenocarcinoma
  23. 23. Hepatic Adenocarcinoma

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