This document discusses methods for cancer diagnosis including clinical examination, imaging, biochemical assays, and morphological and molecular techniques. Histological diagnosis through microscopic examination of tissue specimens is the gold standard for cancer diagnosis. Several sampling methods can be used including excision or biopsy, fine-needle aspiration, and cytologic smears. Immunocytochemistry, flow cytometry, and molecular techniques like PCR and FISH can also provide diagnostic information. Proper sampling and preservation of specimens is important for accurate histological diagnosis of cancer.

1. Faculty of Medicine
NEOPLSIA
2021 Cancer Lab
diagnosis
King Abdulaziz University
Rabigh Branch

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. 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. 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. 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. 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. 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. 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. 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. 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. 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. Bilateral Cystadenoma Ovary

13. Lipoma Intestine

14. Meningioma

15. Lung carcinoma

16. Hepatic Adenoma

17. Carcinoma Breast

18. Carcinoma Lung

19. Osteo-sarcoma

20. Colon Polyp

21. Hepatic Adenoma
Normal Adenoma

22. Metastatic Adenocarcinoma

23. Hepatic Adenocarcinoma