Neoplasia ospe rapid review

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Neoplasia ospe rapid review general pathology

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Neoplasia ospe rapid review

  1. 1. By: Abbas Naseem (BDS) abbas_naseem@yahoo.comNeoplasia OSPE Rapid Review - By Abbas Naseem (bds) Dated: June 27, 2010
  2. 2. • ADENOMA: A benign tumor with glands.• LIPOMA: A benign tumor filled with empty looking cells.• >> A benign Tumor will be Encapsulated in most cases.• >> A benign Tumor cells resemble like normal parenchyma cells. If a tumor exhibits Anaplasia, Necrosis, easy to find mitotic figures, hemorrhage &/OR obvious Invasion, this is probably a cancer …. Otherwise it is probably a Benign tumor.
  3. 3. CARCINOMA : Cells lining up, adhering to one another & moulding one another.ADENOCARCINOMA : Papillae, signet ring cells, lumen, back to back glands (swiss cheese; easy to cell part of two different glands) & lakes of mucin.SQUAMOUS CELL CARCINOMA : Squamous keratin pearls, desmosomes, & lone apoptotic cells.OAT CELL CARCINOMAFeatures small blue, about 20 microns across, : Moulding each other, without a visible stroma.SARCOMA :Spindle cell cancers( i.e those with lots of nuclei oriented parallel)MELANOMA : Melanin in cancer cells.LYMPHOMA: Features sheets of relatively uniform round cells, not moulding each other, but effacing the architechture of lymphoid organ.
  4. 4. NOW SEE Some SLIDES with Q & A’s To Improve SkillsThis 57 year old man gave a history of a lesion of the face which was removed and irradiated.Recently he noted a recurrent lesion which was firm and nodular with an area of ulceration atthe angle of the left nares.The disease process which best characterizes this slide is squamous cell carcinoma Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  5. 5. Mr. Helms sure enjoyed his smokes. Now after 20 years he is coughingup blood. This photomicrograph of his bronchial biopsy specimen bestillustrates carcinoma in situ Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  6. 6. This 54-year-old woman was admitted for the acute onset of abdominal pain and nausea andvomiting for 24 hours. A mass was felt in the lower abdomen and the abdomen was tender. Atoperation a fistula was found between the transverse and sigmoid colon. A biopsy was taken.The disease process which best characterizes these pictures is adenocarcinoma Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  7. 7. The following two pictures are of a radical mastectomy specimen removed forinfiltrative duct cell carcinoma. Note the skin retraction in the first picture. Theabundance of non-neoplastic connective tissue in association with neoplastic cells iscalled desmoplasia Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  8. 8. A 35 year-old woman was found to have several firm, rubbery nodules on thedome of the uterus four years ago. These had slowly increased in size and nowwere about twice the size it was when first discovered. She is asymptomatic.These well encapsulated uterine nodules most likely representbenign neoplasm Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  9. 9. This is a section of duodenum showing anaggregate of pancreatic tissue in the wall. Thepancreatic tissue is normal in appearance butin an abnormal location. This is a non-neoplastic process Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  10. 10. Hyperplastic polyps These are hamartomatous polyps of the GI tract which are the MOST COMMON type of non-neoplastic polyp. Microscopically, they show increased numbers of goblet cells.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  11. 11. Bronchial hamartoma This is a non-neoplastic lesion composed of tissues normally found in the organ where the hamartoma arises. The tissues in the hamartoma are typically disorganized in their arrangementNeoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  12. 12. Malignant lymphoma This slide shows diffuse involvement of the mediastinum by a tan "fish- flesh" mass. This is a classic pattern seen in malignant lymphomas involving this area. The tumor arises from solid lymphoid tissueNeoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  13. 13. Hemangioma This is a benign neoplasm arising from endothelial cells of blood vessels. Hemangioma This is the microscopic appearance of a hemangioma showing dilated blood vessels filled with red blood cells and lined by benign endothelial cells.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  14. 14. Malignant cells This slide shows several features of malignancy. The cell in the central portion of the slide shows a TETRAPOLAR mitotic figure which is abnormal. Other cells show hyperchromatic nuclei or large and irregular nuclei and nucleoli all of which are features of malignancy.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  15. 15. Retinoblastoma This is a retinoblastoma. This malignant tumor is associated with inactivation of the Rb tumor suppressor gene.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  16. 16. Burkitts lymphoma This lymphoma, especially the African type, is associated with a 8;14 chromosomal translocation.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  17. 17. Kaposi sarcoma Multiple vascular lesions are noted. This tumor is associated with HIV and arises from endothelial cells. There is a high correlation with Kaposi sarcoma herpesvirus (KSHV) or human herpesvirus-8 (HHV-8)Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  18. 18. Squamous cell carcinoma of skin This neoplasm is associated with UVB light damage and immunosuppression. It is found on sun-exposed areas, particularly the face.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  19. 19. Metastasis Each of the organ systems featured on the slides represent favored sites for metastasis. The bone is a common site for metastasis from prostate, lung, and thyroid cancers. CNS is a common site of metastasis from small cell carcinomas of lung and breast cancers. Liver is a common site of metastasis from lung and colon tumors.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  20. 20. Metastasis The lung is a common site of metastasis from colon and other visceral neoplasms. "Cannon-ball" metastasis is produced by hematogenous spread of choriocarcinoma, osteogenic sarcomas, and renal cell carcinoma.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  21. 21. Lymphangitic spread This slide shows a lymphatic vessel containing nests of malignant adenocarcinoma cells.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  22. 22. Lymph node metastasis This is an example of a papillary carcinoma of the thyroid which has metastasized to a lymph node.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  23. 23. Osteoblastic metastasisCertain neoplasms have atendency to metastasize tobone and if so, producestimulation of the osteoblastswith new bone formation. Thebone alkaline phosphatase willbe elevated in theserum. Tumors associatedwith osteoblastic metastasisinclude prostate, thyroid,breast, and carcinoid.
  24. 24. Well-differentiated squamous cell carcinomaThis slide shows two nests of well-differentiated squamous cells (low grade)demonstrating features of normal squamouscells. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  25. 25. Well-differentiated adenocarcinoma This slide shows a well- differentiated adenocarcinoma with well formed glands and distinct lumensNeoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  26. 26. Squamous cell carcinoma of the larynxNote the fungating mass on the lateral borderof the larynx with central ulceration. Thesetumors are associated with smoking andchronic alcohol use. The first symptom ishoarseness. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  27. 27. Squamous cell carcinoma of the lung This slide shows an airway that is opened. The mucosa appears rough and there is an infiltrating mass involving the wall of the bronchi before and after the branching. This is most likely a squamous cell carcinoma.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  28. 28. Adenocarcinoma of colonThis tumor is a fungating mass with centralnecrosis which arises from colonic mucosa. Ittends to infiltrate the wall of the colon in a"napkin-ring" fashion producingobstruction. Obstructive lesions occur in thedescending colon. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  29. 29. Adenocarcinoma of the colon This lesion is growing as a polypoid mass into the lumen of the ascending colon. Right sided colonic masses typically present with anemia and bleeding.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  30. 30. Familial polyposis This autosomal dominant condition is associated with multiple tubular adenomas and tubulovillous tumors in the colon. The patient has > 100 polyps and is at risk for colon cancer. There is an association with the APC tumor suppressor gene.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  31. 31. Hepatocellular carcinoma This tumor arises from hepatocytes. Conditions which predispose to this tumor include post-necrotic (post- infectious) cirrhosis, pigment cirrhosis (hemosiderosis), alcoholic cirrhosis, aflatoxins, and thorotrast.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  32. 32. Renal cell carcinoma This tumor arises from proximal tubular cells in the kidney and is typically in the upper pole of the kidney. It will be very vascular. The tumor presents with hematuria, flank mass, flank pain, or with paraneoplastic hormone production. The tumor tends to invade the renal vein and spread to the lungs with cannon-ball metastasis.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  33. 33. Transitional cell carcinoma This slide shows a papillary tumor by cytoscopy. It is arising from the transitional mucosa of the bladder and usually presents with hematuria.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  34. 34. Leiomyosarcoma This is the most common sarcoma of the female genital tract, although rare. It usually arises de novo. It is bulky and hemorrhagic. Microscopic grading is based on the numbers of mitoses counted per high powered field.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  35. 35. Choriocarcinoma Multiple slides show an invasive choriocarcinoma. This tumor is very aggressive and arises from gestational trophoblastic epithelium. It is common in the Asian population. No chorionic villi are formed, only cytotrophoblast and syncytiotrophoblast tissues.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  36. 36. Neuroblastoma This is a small cell tumor arising from the medullary portion of the adrenal or other sites in the sympathetic nervous system. It is one of the most common extracranial childhood solid tumors. The circular structures within the tumor are called Homer- Wright pseudorosettes. A marker is the n-myc oncogene.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  37. 37. Osteogenic sarcoma This tumor arises from bone forming cells. Excluding multiple myeloma, it is the most common primary malignant tumor of bone. It usually occurs in the second decade of life. Most common site is in the area around the knee. It may occur in an older age group in association with Pagets disease of bone.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  38. 38. ChrondrosarcomaThis tumor arises frommesenchymal cells thatproduce a cartilaginousmatrix. Chrondrosarcomasoccur in older patients with apeak incidence in the sixthdecade. These tumors arise incentral portionsof the skeletonsuch as the shoulder area,pelvis, proximal femur, andribs.
  39. 39. Basal cell carcinoma This tumor is associated with sun exposure. They are typically "pearly grey" papules on the side of the nose or upper lip. They rarely, if ever, metastasize.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  40. 40. Basal cell carcinoma This is a microscopic section of a basal cell carcinoma showing the tumor cell nests. The peripheral group of cells in a nest are oriented perpendicular to the rest of the cells similar to a picket fence.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  41. 41. Astrocytoma The left side of the cortex shows loss of the normal demarcation between grey and white matter. This is an area where the tumor has infiltrated the brain tissue with indistinct margins. Astrocytomas are the most common histologic type of primary brain tumors. They occur in the supra tentorial areas in adults and in the cerebellum in children.Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  42. 42. BRAIN Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  43. 43. UTERUS FIBROID + LIEOMYOMA Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  44. 44. POLIPS Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  45. 45. NEURAL TUMOUR SHAWANOMA Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  46. 46. TUMOUR OF BREAST ( FIBROADENOMA) Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  47. 47. LIPOMA IN INTESTINE Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  48. 48. CARCINOMA OF CERVIX Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  49. 49. Neoplasia OSPE Rapid Review - By Abbas LUNG CARCINOMA Naseem (bds)
  50. 50. HCCNeoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  51. 51. RCC Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  52. 52. MELANOMA Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  53. 53. BREAST FIBROUS TISSUECALCIFICATION Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  54. 54. LIPOSARCOMA Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  55. 55. Mixed or pleomorphic adenoma: Tumor that contain that more than 1 type of parenchymal cells derived from same germ layer Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  56. 56. • Teratoma: tumor that contain recognizable mature or immature cell or tissues representative of more than 1 germ layer Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  57. 57. Teratoma, ovary • Teratomas: more than one germ layer Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  58. 58. • Choristoma(ectopic rest of normal tissue) presence of mass of well developed n normally organized tissue of 1 organ in another. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  59. 59. • Hamartoma: mass of disorganized overgrowth of mature cells normally found in an organ. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  60. 60. ADENOMANeoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  61. 61. DYSPLASIANeoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  62. 62. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  63. 63. CARCINOMA IN SITU Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  64. 64. LIVER WITH METSNeoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  65. 65. PSEDUOMAXOMA PERITONEAI Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  66. 66. CANCER Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  67. 67. SQUAMOUIS CELL CARCINOMADESMOSOME Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  68. 68. ADENOACRCINIMA GAINT CELLS ABNORMAL MITOSIS Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  69. 69. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  70. 70. SQUAMOUS CELL CARCINOMA KERATIN EPITHELIAL PEARLS Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  71. 71. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  72. 72. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  73. 73. ADENOMA BACK TO BACK Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  74. 74. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  75. 75. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  76. 76. • Pleomorphism: variation in size and shape Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  77. 77. • Abnormal nuclear morphology: hyperchormatic (abundant DNA), increased N:C ratio (normal 1:4- 1:6) Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  78. 78. • Mitoses: increased, bizarre Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  79. 79. • Loss of polarity Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  80. 80. • Tumor giant cells Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  81. 81. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  82. 82. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  83. 83. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  84. 84. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  85. 85. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  86. 86. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  87. 87. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  88. 88. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  89. 89. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  90. 90. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  91. 91. Normal Adenoma Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  92. 92. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  93. 93. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  94. 94. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  95. 95. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  96. 96. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  97. 97. Retinoblastoma Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  98. 98. Retinblastoma Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  99. 99. Neoplasia OSPE Rapid Review - By Abbas Naseem (bds)
  100. 100. “ Yesterday I dared to struggle Today I dare to win ” Bernadette Devlin For Comments & Suggestions abbas_naseem@yahoo.com Abbas Naseem Dated: June 27, 2010

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