This document summarizes changes made to the CAP protocol for reporting on urinary bladder specimens. It includes changes to elements reported for bladder biopsy, transurethral resection of bladder tumor, and cystectomy specimens. New response options were added for microscopic tumor extension, margins, histological type, grading, and the WHO/ISUP classification system for urothelial lesions. Definitions of tumor invasion and involvement of adjacent structures like the prostate were also modified.
This document discusses potential pitfalls in diagnosing soft tissue tumors in children. It begins by noting key differences between pediatric and adult tumors. The main diagnostic challenges are the histological diversity of pediatric soft tissue sarcomas and their infrequent occurrence. Misclassifying tumor subtypes can impact treatment. Potential misdiagnoses include mistaking inflammatory lesions for sarcomas or hematolymphoid malignancies for sarcomas. Careful histological examination and use of immunohistochemistry are important to arrive at an accurate diagnosis.
Bronchial cytology and fine needle aspiration are important techniques for diagnosing lung lesions. Bronchial cytology examines the central airways using bronchoscopy while fine needle aspiration can sample peripheral lung lesions. Normal respiratory cells include ciliated bronchial cells and alveolar macrophages. Benign lesions may show goblet cell or basal cell hyperplasia. Non-neoplastic lung diseases like sarcoidosis and pulmonary alveolar proteinosis can also be diagnosed through their characteristic cytology findings. Cytology is useful for identifying infection causes as well as diagnosing and classifying lung tumors.
Minimal Residual Disease in Acute lymphoblastic leukemiaDr. Liza Bulsara
This document discusses minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL). It provides information on several key points:
1. MRD refers to small amounts of leukemia cells that can be detected through sensitive laboratory techniques like flow cytometry and PCR, but not through standard morphology.
2. Various methods for detecting MRD are discussed, including immunophenotyping, PCR, FISH, and cytogenetics. PCR can detect a single malignant cell among 100,000 normal cells and is the most sensitive method.
3. MRD levels determined at different time points during treatment have prognostic significance and can be used for risk stratification and determining the need for treatment intensification or reduction. Monitoring
This document provides an approach for evaluating undifferentiated tumors. It begins by categorizing undifferentiated tumors into 4 groups based on morphology: small round cell tumors, epithelioid cell tumors, spindle cell tumors, and pleomorphic tumors. It then outlines the diagnostic algorithm which involves determining the main lineage (epithelial, melanocytic, hematopoietic/lymphoid, or mesenchymal), specifying a diagnosis using immunohistochemistry and clinical correlation, and considering the differential diagnoses for each category. A variety of immunohistochemical markers are also described that can help identify the cell or tumor type.
Small round cell tumors are a group of highly aggressive cancers composed of small, undifferentiated cells. The diagnostic approach involves clinical findings, imaging, pathology, and molecular genetics testing. Key small round cell tumors in pediatric patients include Ewing sarcoma, neuroblastoma, nephroblastoma, rhabdomyosarcoma, medulloblastoma, retinoblastoma, and lymphoblastic lymphoma. Immunohistochemistry and genetic testing are used to determine the specific tumor type to help guide treatment.
The document discusses cytology of various bone lesions. It covers classification of bone tumors and describes cytological features of inflammatory conditions like osteomyelitis. It also discusses osteoid forming lesions such as fracture callus and osteoblastoma. Cartilage forming tumors described include chondroma, chondromyxoid fibroma and osteochondroma. Giant cell containing lesions and cystic bone lesions are also mentioned. The document provides cytological details of various bone tumors like osteosarcoma, chondrosarcoma and chondroblastoma through multiple case studies. It highlights differential diagnoses and ancillary techniques used in evaluation of bone lesions.
Squash cytology of cns paediatric tumoursSumanth Deva
This document provides an overview of squash cytology techniques for diagnosing pediatric central nervous system tumors, describing the smear patterns and key cytological features of common tumor types like medulloblastoma, atypical teratoid/rhabdoid tumors, choroid plexus papilloma, and choroid plexus carcinoma. Squash cytology allows rapid examination of biopsy samples during neurosurgery to aid diagnosis and surgical decision making.
This document discusses the role of immunohistochemistry (IHC) in diagnosing soft tissue tumours. It begins by defining soft tissue and the WHO classification of soft tissue tumours. IHC is an important ancillary technique that can be used to identify discrete tissue components using antigen-antibody binding. The document outlines the IHC protocol and discusses various markers that can help diagnose different types of soft tissue tumours, including markers for fibroblastic, adipocytic, vascular, neural, osseous and cartilaginous tumours. Specific markers and the tumours they are useful for identifying are provided. The document emphasizes that IHC should be used along with other techniques as markers sometimes show cross-reactivity.
This document discusses potential pitfalls in diagnosing soft tissue tumors in children. It begins by noting key differences between pediatric and adult tumors. The main diagnostic challenges are the histological diversity of pediatric soft tissue sarcomas and their infrequent occurrence. Misclassifying tumor subtypes can impact treatment. Potential misdiagnoses include mistaking inflammatory lesions for sarcomas or hematolymphoid malignancies for sarcomas. Careful histological examination and use of immunohistochemistry are important to arrive at an accurate diagnosis.
Bronchial cytology and fine needle aspiration are important techniques for diagnosing lung lesions. Bronchial cytology examines the central airways using bronchoscopy while fine needle aspiration can sample peripheral lung lesions. Normal respiratory cells include ciliated bronchial cells and alveolar macrophages. Benign lesions may show goblet cell or basal cell hyperplasia. Non-neoplastic lung diseases like sarcoidosis and pulmonary alveolar proteinosis can also be diagnosed through their characteristic cytology findings. Cytology is useful for identifying infection causes as well as diagnosing and classifying lung tumors.
Minimal Residual Disease in Acute lymphoblastic leukemiaDr. Liza Bulsara
This document discusses minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL). It provides information on several key points:
1. MRD refers to small amounts of leukemia cells that can be detected through sensitive laboratory techniques like flow cytometry and PCR, but not through standard morphology.
2. Various methods for detecting MRD are discussed, including immunophenotyping, PCR, FISH, and cytogenetics. PCR can detect a single malignant cell among 100,000 normal cells and is the most sensitive method.
3. MRD levels determined at different time points during treatment have prognostic significance and can be used for risk stratification and determining the need for treatment intensification or reduction. Monitoring
This document provides an approach for evaluating undifferentiated tumors. It begins by categorizing undifferentiated tumors into 4 groups based on morphology: small round cell tumors, epithelioid cell tumors, spindle cell tumors, and pleomorphic tumors. It then outlines the diagnostic algorithm which involves determining the main lineage (epithelial, melanocytic, hematopoietic/lymphoid, or mesenchymal), specifying a diagnosis using immunohistochemistry and clinical correlation, and considering the differential diagnoses for each category. A variety of immunohistochemical markers are also described that can help identify the cell or tumor type.
Small round cell tumors are a group of highly aggressive cancers composed of small, undifferentiated cells. The diagnostic approach involves clinical findings, imaging, pathology, and molecular genetics testing. Key small round cell tumors in pediatric patients include Ewing sarcoma, neuroblastoma, nephroblastoma, rhabdomyosarcoma, medulloblastoma, retinoblastoma, and lymphoblastic lymphoma. Immunohistochemistry and genetic testing are used to determine the specific tumor type to help guide treatment.
The document discusses cytology of various bone lesions. It covers classification of bone tumors and describes cytological features of inflammatory conditions like osteomyelitis. It also discusses osteoid forming lesions such as fracture callus and osteoblastoma. Cartilage forming tumors described include chondroma, chondromyxoid fibroma and osteochondroma. Giant cell containing lesions and cystic bone lesions are also mentioned. The document provides cytological details of various bone tumors like osteosarcoma, chondrosarcoma and chondroblastoma through multiple case studies. It highlights differential diagnoses and ancillary techniques used in evaluation of bone lesions.
Squash cytology of cns paediatric tumoursSumanth Deva
This document provides an overview of squash cytology techniques for diagnosing pediatric central nervous system tumors, describing the smear patterns and key cytological features of common tumor types like medulloblastoma, atypical teratoid/rhabdoid tumors, choroid plexus papilloma, and choroid plexus carcinoma. Squash cytology allows rapid examination of biopsy samples during neurosurgery to aid diagnosis and surgical decision making.
This document discusses the role of immunohistochemistry (IHC) in diagnosing soft tissue tumours. It begins by defining soft tissue and the WHO classification of soft tissue tumours. IHC is an important ancillary technique that can be used to identify discrete tissue components using antigen-antibody binding. The document outlines the IHC protocol and discusses various markers that can help diagnose different types of soft tissue tumours, including markers for fibroblastic, adipocytic, vascular, neural, osseous and cartilaginous tumours. Specific markers and the tumours they are useful for identifying are provided. The document emphasizes that IHC should be used along with other techniques as markers sometimes show cross-reactivity.
This document summarizes key information about major and minor salivary glands including their location and cell types. It describes common benign and malignant epithelial tumors of the salivary glands such as pleomorphic adenoma, Warthin's tumor, oncocytoma, and mucoepidermoid carcinoma. For each tumor, the clinical features, microscopic appearance, differential diagnosis, and important histological characteristics are outlined. The document provides an overview of salivary gland anatomy, histology, and the spectrum of tumors that can arise in these glands.
Histopathological Grossing of Kidney Tumors with the common gross differentials encountered,
reference - TATA memorial grossing techniques , Rosai and ackerman surgical pathology , Fletcher , Springer histopathology Specimen
This document summarizes key information about renal biopsies and nephrectomies:
1) Renal biopsies are typically performed under ultrasound guidance by a nephrologist and radiologist to evaluate renal function abnormalities. Adequate biopsy specimens contain at least 10 glomeruli and two arteries. Tissue is processed for light microscopy, immunofluorescence, and electron microscopy.
2) Nephrectomies are performed for renal tumors, nonfunctioning transplants, or native kidneys. Radical nephrectomies remove the entire kidney and surrounding tissues while partial nephrectomies resect tumors. Specimens are examined grossly and microscopically, with sections
This document discusses the Gleason grading system for prostate cancer. It provides details on the original Gleason patterns from 1 to 5 based on tumor architecture, with pattern 1 being the most differentiated and pattern 5 being undifferentiated. The Gleason score is determined by adding the primary and secondary patterns. The document reviews reporting of Gleason scores for different specimen types like biopsies and radical prostatectomies. It also discusses modifications to the Gleason system over time with new discoveries in prostate cancer.
Immunohistochemistry in diagnosis of soft tissue tumours seminarPannaga Kumar
This document discusses immunohistochemistry in the diagnosis of soft tissue tumors. It begins by introducing soft tissue and the classification of soft tissue tumors. It then discusses various ancillary techniques used, focusing on immunohistochemistry. It provides details on common markers used to identify muscle, neural, melanocytic, endothelial and other types of differentiation. It discusses the applications and diagnostic utility of various markers for different tumor types. In summary, the document is a comprehensive overview of immunohistochemistry techniques and markers useful in the diagnosis and classification of soft tissue tumors.
This document provides information on fine needle aspiration cytology (FNAC) findings for different types of breast cancers and lesions. It describes the typical cellular appearance and characteristics seen on FNAC for normal breast tissue, ductal carcinoma, lobular carcinoma, medullary carcinoma, mucinous carcinoma, tubular carcinoma, and metaplastic carcinoma. It also outlines the Scarff-Bloom-Richardson grading system used to assess breast cancer prognosis based on histopathological analysis of tumor cells and tissue structure.
The slide presentation summarizes cytology findings of pancreatic cytology from a 28-year-old female. Smears showed loosely cohesive tissue fragments and scattered cells in a clean background with absent or scanty cytoplasm. Nuclei were round to oval with stippled chromatin. Features were consistent with pancreatic neuroendocrine neoplasm rather than solid pseudopapillary tumor. The presentation reviewed pancreatic development, indications for FNA, reporting systems, and findings associated with primary pancreatic neoplasms including neuroendocrine tumors.
This document provides background information on microsatellite instability (MSI). It discusses how microsatellites are short repetitive sequences prone to mutations during DNA replication due to slipped strand mispairing or unequal crossing over. MSI occurs when mutations inactivate DNA mismatch repair genes, leading to length alterations in microsatellite regions. This causes microsatellite instability, which is seen in certain cancers like colorectal cancer and can be assessed through testing tumor DNA for instability in microsatellite markers. Immunohistochemistry for mismatch repair proteins or direct testing for MSI can help identify tumors associated with defective mismatch repair and microsatellite instability.
02 Presentations Ii Vs (14 4 Mb) (3 30 08)vshidham
Part II of Four part symposium: “Diagnostic Cytopathology of Serous Effusion” on April 19, 2007 at Neenah, WI, USA
(2008 Wisconsin Society of Cytology, 40th Anniversary)
This document discusses the use of immunohistochemistry in breast pathology. It covers several topics:
1. Analyzing prognostic markers like hormone receptors in breast cancer and their predictive value.
2. Using myoepithelial cell markers to help solve diagnostic dilemmas and distinguish lesions.
3. Identifying tumor subtypes and assessing diagnoses using markers like luminal vs basal.
4. Evaluating cell populations in proliferative breast lesions and assessing neoplasia vs hyperplasia.
Recent updates and reporting of testicular tumors Dr.Argha BaruahArgha Baruah
1) The document discusses recent updates to the classification and reporting of testicular tumors, including changes to the WHO 2016 classification and TNM staging system.
2) Key pathological findings to report include the presence of GCNIS, serum tumor markers, invasion of rete testis, hilar soft tissue, tunica vaginalis, epididymis, and lymphovascular invasion.
3) Adequate sampling from areas of possible extratesticular extension is important for accurate pathological assessment and staging of testicular tumors.
The document discusses various techniques for preparing cell blocks (CBs) from cytology specimens such as effusions, fine needle aspirations, and scrapings. Traditional methods involved using a celloidin or agar embedding medium but newer automated techniques using filters and cassettes provide higher cellularity. CBs allow morphological examination and ancillary studies to improve diagnostic accuracy compared to smears alone. While useful, CBs require more material and time than smears and may lack sufficient cells for all tests.
Genetic origins of human cancer - recent advancesAnshulekha Patel
1. The classical model of cancer progression proposed that tumors accumulate driver mutations sequentially through selective sweeps, becoming genetically homogeneous.
2. Recent studies show that tumors are genetically heterogeneous, with multiple clones present. Selective sweeps are rare, and mutations do not necessarily occur in a fixed order.
3. A "Big Bang" model proposes that tumors grow as a single expansion with numerous subclones, not driven by selection. Most mutations arise early in tumor growth.
The document discusses the development and benefits of the Milan System for Reporting Salivary Gland Cytopathology. It aims to standardize terminology for salivary gland FNA reports which previously lacked uniformity. The system categorizes specimens as non-diagnostic, non-neoplastic, atypia of undetermined significance, neoplastic (benign or uncertain malignant potential), suspicious for malignancy, or malignant. It is intended to improve communication between pathologists and clinicians, enhance patient care, and facilitate research by allowing standardized data collection across institutions. While validation is ongoing, the system provides a practical framework for uniform reporting of salivary gland cytology.
01 Presentation I VS (8-55MB)- (3-28-08).ppsvshidham
Part I of Four part symposium: “Diagnostic Cytopathology of Serous Effusion” on April 19, 2007 at Neenah, WI, USA
(2008 Wisconsin Society of Cytology, 40th Anniversary)
The document discusses testicular biopsy and interpretation. It provides details on:
- The structure and layers of the normal testis
- The cells present within the seminiferous tubules including Sertoli cells, spermatogonia, and spermatocytes
- Indications for testicular biopsy including male infertility and controversial role in testicular cancer
- Techniques for testicular biopsy including open surgical and percutaneous methods
- Patterns seen in infertile males such as maturation arrest, Sertoli cell only syndrome, and hypospermatogenesis
The document discusses the thyroid FNA procedure and diagnostic categories. It provides details on:
- Performing thyroid FNA under ultrasound guidance using a 25 gauge needle with 3-4 passes.
- Preparing direct smears, cytospins, cell blocks and liquid-based preparations from the aspirated material.
- The Bethesda system for reporting thyroid cytopathology which includes 6 diagnostic categories and their associated cancer risks to guide clinical management.
- Key cytologic features that help diagnose common thyroid lesions and cancers.
The bethesda system for reporting thyroid cytopathologyIndira Shastry
The document describes the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), which was introduced in 2007 to standardize the reporting of thyroid fine needle aspiration (FNA) results. The BSRTC recommends diagnostic categories with implied cancer risks and clinical management guidelines. It provides criteria for adequate samples and defines each diagnostic category, including non-diagnostic, benign, atypia of undetermined significance, follicular neoplasm, suspicious for malignancy, and malignant. The BSRTC aims to improve communication between cytopathologists and clinicians regarding thyroid FNA interpretations and patient management.
The document discusses several pediatric neoplasms that appear as small round blue cell tumors due to their primitive histological features. These include neuroblastoma, Wilms tumor, rhabdomyosarcoma, Ewing's sarcoma, medulloblastoma, retinoblastoma, and lymphoma. For each tumor, the document outlines characteristics such as common age of diagnosis, clinical features, histopathological appearance under the microscope, immunohistochemistry profiles, genetics where relevant, and important prognostic factors. Differential diagnosis of these small round blue cell tumors in children is provided for accurate diagnosis and treatment.
Bladder cancer most commonly presents as hematuria and is usually transitional cell carcinoma. Risk factors include smoking, industrial chemical exposure, and past pelvic radiation. Diagnosis involves cystoscopy and biopsy. Staging uses TNM system and determines prognosis and treatment. Treatment depends on stage and includes transurethral resection for superficial disease or radical cystectomy for invasive disease, with chemotherapy sometimes used as well. Prognosis depends on stage, with 5-year survival rates ranging from 85% for stage Ta to 10-20% for stage IV disease.
This document summarizes rare and unusual types of urological cancers. It discusses rare subtypes of renal cell carcinoma defined by their histology and genetic abnormalities. It also describes rare histological variants of bladder cancer and non-urothelial cancers of the bladder such as squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and lymphomas. Finally, it briefly outlines other rare non-urothelial cancers including sarcomas, carcinoid tumors, and other even less common malignancies of the bladder.
This document summarizes key information about major and minor salivary glands including their location and cell types. It describes common benign and malignant epithelial tumors of the salivary glands such as pleomorphic adenoma, Warthin's tumor, oncocytoma, and mucoepidermoid carcinoma. For each tumor, the clinical features, microscopic appearance, differential diagnosis, and important histological characteristics are outlined. The document provides an overview of salivary gland anatomy, histology, and the spectrum of tumors that can arise in these glands.
Histopathological Grossing of Kidney Tumors with the common gross differentials encountered,
reference - TATA memorial grossing techniques , Rosai and ackerman surgical pathology , Fletcher , Springer histopathology Specimen
This document summarizes key information about renal biopsies and nephrectomies:
1) Renal biopsies are typically performed under ultrasound guidance by a nephrologist and radiologist to evaluate renal function abnormalities. Adequate biopsy specimens contain at least 10 glomeruli and two arteries. Tissue is processed for light microscopy, immunofluorescence, and electron microscopy.
2) Nephrectomies are performed for renal tumors, nonfunctioning transplants, or native kidneys. Radical nephrectomies remove the entire kidney and surrounding tissues while partial nephrectomies resect tumors. Specimens are examined grossly and microscopically, with sections
This document discusses the Gleason grading system for prostate cancer. It provides details on the original Gleason patterns from 1 to 5 based on tumor architecture, with pattern 1 being the most differentiated and pattern 5 being undifferentiated. The Gleason score is determined by adding the primary and secondary patterns. The document reviews reporting of Gleason scores for different specimen types like biopsies and radical prostatectomies. It also discusses modifications to the Gleason system over time with new discoveries in prostate cancer.
Immunohistochemistry in diagnosis of soft tissue tumours seminarPannaga Kumar
This document discusses immunohistochemistry in the diagnosis of soft tissue tumors. It begins by introducing soft tissue and the classification of soft tissue tumors. It then discusses various ancillary techniques used, focusing on immunohistochemistry. It provides details on common markers used to identify muscle, neural, melanocytic, endothelial and other types of differentiation. It discusses the applications and diagnostic utility of various markers for different tumor types. In summary, the document is a comprehensive overview of immunohistochemistry techniques and markers useful in the diagnosis and classification of soft tissue tumors.
This document provides information on fine needle aspiration cytology (FNAC) findings for different types of breast cancers and lesions. It describes the typical cellular appearance and characteristics seen on FNAC for normal breast tissue, ductal carcinoma, lobular carcinoma, medullary carcinoma, mucinous carcinoma, tubular carcinoma, and metaplastic carcinoma. It also outlines the Scarff-Bloom-Richardson grading system used to assess breast cancer prognosis based on histopathological analysis of tumor cells and tissue structure.
The slide presentation summarizes cytology findings of pancreatic cytology from a 28-year-old female. Smears showed loosely cohesive tissue fragments and scattered cells in a clean background with absent or scanty cytoplasm. Nuclei were round to oval with stippled chromatin. Features were consistent with pancreatic neuroendocrine neoplasm rather than solid pseudopapillary tumor. The presentation reviewed pancreatic development, indications for FNA, reporting systems, and findings associated with primary pancreatic neoplasms including neuroendocrine tumors.
This document provides background information on microsatellite instability (MSI). It discusses how microsatellites are short repetitive sequences prone to mutations during DNA replication due to slipped strand mispairing or unequal crossing over. MSI occurs when mutations inactivate DNA mismatch repair genes, leading to length alterations in microsatellite regions. This causes microsatellite instability, which is seen in certain cancers like colorectal cancer and can be assessed through testing tumor DNA for instability in microsatellite markers. Immunohistochemistry for mismatch repair proteins or direct testing for MSI can help identify tumors associated with defective mismatch repair and microsatellite instability.
02 Presentations Ii Vs (14 4 Mb) (3 30 08)vshidham
Part II of Four part symposium: “Diagnostic Cytopathology of Serous Effusion” on April 19, 2007 at Neenah, WI, USA
(2008 Wisconsin Society of Cytology, 40th Anniversary)
This document discusses the use of immunohistochemistry in breast pathology. It covers several topics:
1. Analyzing prognostic markers like hormone receptors in breast cancer and their predictive value.
2. Using myoepithelial cell markers to help solve diagnostic dilemmas and distinguish lesions.
3. Identifying tumor subtypes and assessing diagnoses using markers like luminal vs basal.
4. Evaluating cell populations in proliferative breast lesions and assessing neoplasia vs hyperplasia.
Recent updates and reporting of testicular tumors Dr.Argha BaruahArgha Baruah
1) The document discusses recent updates to the classification and reporting of testicular tumors, including changes to the WHO 2016 classification and TNM staging system.
2) Key pathological findings to report include the presence of GCNIS, serum tumor markers, invasion of rete testis, hilar soft tissue, tunica vaginalis, epididymis, and lymphovascular invasion.
3) Adequate sampling from areas of possible extratesticular extension is important for accurate pathological assessment and staging of testicular tumors.
The document discusses various techniques for preparing cell blocks (CBs) from cytology specimens such as effusions, fine needle aspirations, and scrapings. Traditional methods involved using a celloidin or agar embedding medium but newer automated techniques using filters and cassettes provide higher cellularity. CBs allow morphological examination and ancillary studies to improve diagnostic accuracy compared to smears alone. While useful, CBs require more material and time than smears and may lack sufficient cells for all tests.
Genetic origins of human cancer - recent advancesAnshulekha Patel
1. The classical model of cancer progression proposed that tumors accumulate driver mutations sequentially through selective sweeps, becoming genetically homogeneous.
2. Recent studies show that tumors are genetically heterogeneous, with multiple clones present. Selective sweeps are rare, and mutations do not necessarily occur in a fixed order.
3. A "Big Bang" model proposes that tumors grow as a single expansion with numerous subclones, not driven by selection. Most mutations arise early in tumor growth.
The document discusses the development and benefits of the Milan System for Reporting Salivary Gland Cytopathology. It aims to standardize terminology for salivary gland FNA reports which previously lacked uniformity. The system categorizes specimens as non-diagnostic, non-neoplastic, atypia of undetermined significance, neoplastic (benign or uncertain malignant potential), suspicious for malignancy, or malignant. It is intended to improve communication between pathologists and clinicians, enhance patient care, and facilitate research by allowing standardized data collection across institutions. While validation is ongoing, the system provides a practical framework for uniform reporting of salivary gland cytology.
01 Presentation I VS (8-55MB)- (3-28-08).ppsvshidham
Part I of Four part symposium: “Diagnostic Cytopathology of Serous Effusion” on April 19, 2007 at Neenah, WI, USA
(2008 Wisconsin Society of Cytology, 40th Anniversary)
The document discusses testicular biopsy and interpretation. It provides details on:
- The structure and layers of the normal testis
- The cells present within the seminiferous tubules including Sertoli cells, spermatogonia, and spermatocytes
- Indications for testicular biopsy including male infertility and controversial role in testicular cancer
- Techniques for testicular biopsy including open surgical and percutaneous methods
- Patterns seen in infertile males such as maturation arrest, Sertoli cell only syndrome, and hypospermatogenesis
The document discusses the thyroid FNA procedure and diagnostic categories. It provides details on:
- Performing thyroid FNA under ultrasound guidance using a 25 gauge needle with 3-4 passes.
- Preparing direct smears, cytospins, cell blocks and liquid-based preparations from the aspirated material.
- The Bethesda system for reporting thyroid cytopathology which includes 6 diagnostic categories and their associated cancer risks to guide clinical management.
- Key cytologic features that help diagnose common thyroid lesions and cancers.
The bethesda system for reporting thyroid cytopathologyIndira Shastry
The document describes the Bethesda System for Reporting Thyroid Cytopathology (BSRTC), which was introduced in 2007 to standardize the reporting of thyroid fine needle aspiration (FNA) results. The BSRTC recommends diagnostic categories with implied cancer risks and clinical management guidelines. It provides criteria for adequate samples and defines each diagnostic category, including non-diagnostic, benign, atypia of undetermined significance, follicular neoplasm, suspicious for malignancy, and malignant. The BSRTC aims to improve communication between cytopathologists and clinicians regarding thyroid FNA interpretations and patient management.
The document discusses several pediatric neoplasms that appear as small round blue cell tumors due to their primitive histological features. These include neuroblastoma, Wilms tumor, rhabdomyosarcoma, Ewing's sarcoma, medulloblastoma, retinoblastoma, and lymphoma. For each tumor, the document outlines characteristics such as common age of diagnosis, clinical features, histopathological appearance under the microscope, immunohistochemistry profiles, genetics where relevant, and important prognostic factors. Differential diagnosis of these small round blue cell tumors in children is provided for accurate diagnosis and treatment.
Bladder cancer most commonly presents as hematuria and is usually transitional cell carcinoma. Risk factors include smoking, industrial chemical exposure, and past pelvic radiation. Diagnosis involves cystoscopy and biopsy. Staging uses TNM system and determines prognosis and treatment. Treatment depends on stage and includes transurethral resection for superficial disease or radical cystectomy for invasive disease, with chemotherapy sometimes used as well. Prognosis depends on stage, with 5-year survival rates ranging from 85% for stage Ta to 10-20% for stage IV disease.
This document summarizes rare and unusual types of urological cancers. It discusses rare subtypes of renal cell carcinoma defined by their histology and genetic abnormalities. It also describes rare histological variants of bladder cancer and non-urothelial cancers of the bladder such as squamous cell carcinoma, adenocarcinoma, small cell carcinoma, and lymphomas. Finally, it briefly outlines other rare non-urothelial cancers including sarcomas, carcinoid tumors, and other even less common malignancies of the bladder.
Transitional cell carcinoma of urinary bladederrezauro
The document provides information on transitional cell carcinoma of the urinary bladder, including:
- It is the second most common genitourinary cancer in the US, more common in men than women and blacks than whites.
- Risk factors include smoking, exposure to chemicals like benzidine and cyclophosphamide, and certain medical conditions.
- Diagnosis involves tests like urine cytology, cystoscopy, and imaging. Staging evaluates extent of invasion and spread.
- Treatment depends on stage but may include transurethral resection, chemotherapy, immunotherapy like BCG, and sometimes radical cystectomy.
The document summarizes bladder carcinoma and presents a case report of a 40-year old female patient. It describes that bladder cancers mainly arise from the urothelial lining, with urothelial carcinoma being the most common at 90%. Less common types include squamous cell carcinoma, adenocarcinoma, and non-urothelial carcinomas such as neuroendocrine carcinoma. The case report involves a transurethral resection of a bladder tumor specimen from a 40-year old female patient, which was sent for histopathological assessment to determine if it was urothelial carcinoma, small cell carcinoma, sarcomatoid urothelial carcinoma, or metastatic carcinoma.
1. The majority (95%) of primary bladder tumors originate from the bladder epithelium and are transitional cell carcinoma (90%). Squamous cell carcinoma (5%) and adenocarcinoma (1-2%) can also occur.
2. Risk factors for bladder cancer include occupational exposures like chemicals, smoking, and infections like Schistosomiasis.
3. Evaluation involves urine cytology, cystoscopy, imaging and biopsy. Treatment depends on tumor stage and grade, ranging from transurethral resection for non-muscle invasive tumors to radical cystectomy for muscle-invasive tumors.
1. The document discusses non-muscle invasive bladder cancer (NMIBC), including its incidence, risk factors, pathology, genetics, presentation, diagnosis, grading and staging, imaging, and management.
2. Key points include that NMIBC accounts for 80% of bladder cancers, smoking is a major risk factor, transitional cell carcinoma is the most common type, and hematuria is the typical presenting symptom.
3. Diagnostic evaluation involves cystoscopy, urine cytology, and imaging as needed. Treatment depends on tumor grade and stage determined by these evaluations.
The international federation for cervical pathology and colposcopy courseTariq Mohammed
This document provides an agenda and speaker information for a 3-day international colposcopy workshop taking place in Jeddah, Saudi Arabia from January 12-14, 2014. The workshop will focus on cervical cancer prevention, advances in understanding HPV, and management of lower genital tract diseases. It will include lectures, hands-on training, and case reviews led by experts from Europe, Canada, and Saudi Arabia. The goal is to train participants and raise awareness of cervical cancer screening and prevention methods.
1) Malakoplakia is a chronic inflammatory condition of the bladder characterized by defective macrophage function and the presence of Michaelis-Gutmann bodies. It can be mistaken for bladder cancer.
2) Interstitial cystitis, also known as Hunner's ulcer, is a painful chronic bladder condition seen mainly in young women. It is characterized by suprapubic pain, urgency, and hematuria. Cystoscopy may reveal fissures and punctate hemorrhages.
3) Bladder cancers are mostly transitional cell carcinomas related to smoking, chemicals, radiation, and infections like Schistosoma. Cystoscopy and biopsy are used in diagnosis. Prognosis depends on
This document summarizes bladder cancer, including its definition, epidemiology, risk factors, clinical manifestations, diagnosis, staging, treatment options, complications, nursing diagnoses, and recent research findings. Bladder cancer is the 4th most common cancer in men and 9th in women. Risk factors include smoking, occupational exposures, infections, and prior history of bladder cancer. Symptoms often include hematuria, urinary frequency and urgency. Diagnosis involves tests like cystoscopy, CT scans, and biopsy. Treatment depends on stage but may include surgery, chemotherapy, radiation, and immunotherapy. Complications can be related to alterations after surgery like body image issues or sexual/urinary changes.
Target audience : Oncology fellows and Oncologists.
Four challenging cases of Bladder cancer and managing decisions including latest management principles are discussed here.
Cervical intraepithelial neoplasia (CIN) refers to precancerous changes in the cervix. CIN is graded as mild, moderate, or severe dysplasia based on the level of the epithelium involved. High-risk HPV infection is the main cause. Screening includes Pap testing and HPV testing. Colposcopy is used to examine abnormal areas. Treatment options range from observation to local destruction procedures for mild disease and excision for more severe disease. Vaccination can protect against HPV types 16 and 18.
This document provides information about placental pathology. It describes the structure, development, functions and examination of the placenta. It discusses various anomalies and non-neoplastic lesions seen in placenta such as twin pregnancy, succenturiate lobes, membranacea and infarcts. It also covers tumors and tumor-like conditions including chorioangioma and gestational trophoblastic disease. Complete hydatidiform mole is described as a condition caused by abnormal gametogenesis resulting in trophoblastic hyperplasia and cistern formation.
Pre-invasive and Invasive Lesions of the CervixDJ CrissCross
The document discusses pre-invasive and invasive lesions of the cervix, including normal cervix, cervical intraepithelial neoplasia (CIN), and cervical cancer. It covers carcinogenic factors like human papillomavirus that can lead to CIN I, CIN II, CIN III, and eventual cancer. Screening tools like Pap smears and management approaches for each stage of CIN and cancer are also summarized.
This document provides an overview of pathology related to the cervix and uterus. It discusses topics like endocervical polyps, cervical intraepithelial neoplasia (CIN), carcinoma of the cervix, endometrial hyperplasia, endometrial and uterine cancers, and tumors of the myometrium. Specifically, it covers the etiology, morphological features, clinical presentations, classifications, and complications of various cervical and uterine conditions. HPV infection is highlighted as a major risk factor for cervical cancer development. Screening via Pap smears can detect cervical dysplasia early. Types I and II endometrial cancers are distinguished by their risk factors, histology, and molecular genetics. Leiomyomas
This document summarizes pathology related to the cervix, including inflammation (cervicitis), pre-cancerous lesions (CIN), and cancer. It discusses the following:
1. Cervicitis can be acute or chronic and is characterized by inflammatory cell infiltration and epithelial changes. Specific infections like gonorrhea and chlamydia can cause cervicitis.
2. Pre-cancerous lesions like CIN are graded from I-III based on the thickness of the epithelium involved. CIN I involves the bottom third, CIN II the bottom two-thirds, and CIN III the full thickness. High-grade CIN is more likely to progress to cancer.
3. Cancer
The document discusses various kidney disorders including congenital anomalies, glomerular diseases, tubulointerstitial diseases, urinary stones, obstructive uropathy, and tumors. Specific conditions covered include polycystic kidney disease, glomerulonephritis, pyelonephritis, acute tubular necrosis, urolithiasis, hydronephrosis, and obstructive uropathy. The anatomy, functions, and histopathological features of the kidney are also summarized.
This document discusses various pathologies of the kidney including congenital abnormalities, cystic diseases, glomerular diseases, tubular diseases, vascular diseases, and causes of obstruction. It provides descriptions of diseases such as polycystic kidney disease, glomerulonephritis, pyelonephritis, nephrosclerosis, and renal artery stenosis. Diagrams of kidney anatomy and histopathological images are also included.
This document provides guidance on sampling, allocating, and fixing renal biopsy tissue for light microscopy, immunofluorescence, and electron microscopy evaluation. It discusses obtaining adequate sample sizes from different renal regions and dividing tissue between fixatives. Common stains used for light microscopy like H&E, PAS, trichrome, and silver stains are also described. Normal renal histology of the glomerulus, interstitium, tubules, and vessels is outlined.
This document provides information on various glomerular diseases. It begins by defining glomerulonephritis as inflammation of the glomeruli. The main types of primary glomerular diseases discussed include minimal change disease, focal segmental glomerulosclerosis, membranous glomerulonephritis, membranoproliferative glomerulonephritis, and IgA nephropathy. For each disease, the document covers pathogenesis, morphology, and clinical manifestations. It provides detailed descriptions of the histologic alterations and immune mechanisms involved in the different glomerular diseases.
This document provides information on carcinoma of the stomach, including:
- Risk factors include H. pylori infection, diet, genetics, smoking.
- Types include intestinal and diffuse. Staging uses TNM and other classifications.
- Common symptoms are weight loss, abdominal pain, vomiting. Investigations include endoscopy and biopsy.
- Treatment depends on stage but commonly includes surgery such as gastrectomy along with lymph node dissection. Endoscopic resection may be used for early stages. Adjuvant therapy is sometimes used for later stages.
This document discusses classifications and characteristics of renal tumors. It covers benign tumors such as oncocytoma and angiomyolipoma. It also discusses malignant renal cell carcinoma, the most common type of kidney cancer, noting its high vascularity and overexpression of angiogenic factors. Transitional cell carcinoma of the collecting system is also examined. The document provides details on clinical presentation, diagnostic imaging, and treatment approaches for these various renal tumors.
This document discusses a case of a 60-year-old male diagnosed with rectal cancer. It provides details on his medical history, including a sigmoidoscopy that revealed adenocarcinoma of the rectum. He received neoadjuvant chemoradiation therapy. The document discusses the clinical anatomy of the rectum, risk factors for rectal cancer, staging systems, diagnostic workup, and treatment options like surgery. The main treatment is surgery, with the goal of total mesorectal excision to reduce local recurrence rates.
Urinary bladder cancer is the fourth most common cancer in men and tenth most common in women. About 90% are urothelial in origin. Risk factors include smoking, occupational exposure to chemicals, and genetic predisposition. Tumors are classified as non-invasive papillary or invasive into the muscle. Diagnosis is usually via cystoscopy following hematuria detection. Staging involves CT, MRI, or PET to assess tumor depth, lymph node involvement, and distant metastasis. Treatment depends on stage, with superficial tumors addressed via surgery and chemotherapy or immunotherapy, while muscle-invasive tumors require radical cystectomy.
GB cancer is the 5th most common GIT malignancy(worldwide).200 years later it is still considered to be a highly malignant disease with a poor survival rate
.Here is a brief description regarding
1. Imaging plays an important role in diagnosing and staging bladder cancer. MR imaging is considered superior to CT for local staging to differentiate between non-muscle invasive versus muscle invasive disease.
2. Diffusion-weighted imaging on MRI shows promise for staging and differentiating benign from malignant lymph nodes.
3. Cystoscopy remains important for diagnosis and biopsy, while surveillance after treatment involves cystoscopy, urine cytology and imaging.
This document provides an overview of gastric carcinoma, including:
- Causes of epigastric lumps that may indicate gastric carcinoma
- Risk factors like H. pylori infection, diet, smoking, and genetic factors
- Staging classifications including TNM, Lauren-Jarvi, and Borrmann systems
- Treatment approaches like endoscopic or surgical resection depending on stage, with lymph node dissection and reconstruction techniques described
- Adjuvant therapies including chemotherapy and radiation to improve survival
- 5-year survival rates are improved with neoadjuvant chemotherapy and adjuvant chemoradiation compared to surgery alone.
The document discusses the anatomy, histology, physiology, carcinogenesis, clinical presentation, diagnosis, staging, and treatment of gastric cancer. It notes that gastric cancer typically presents with nonspecific symptoms like abdominal pain or weight loss. Diagnosis involves endoscopy with biopsy. Staging involves endoscopic ultrasound or CT scan to evaluate tumor invasion and lymph node involvement. Treatment depends on stage but may include surgery, chemotherapy, and radiation. Screening high-risk individuals can detect early gastric cancer and improve outcomes.
This document provides an overview of bladder cancer presented by Dr. Vikas Kumar. Some key points:
- Bladder cancer is the 9th most common cancer worldwide and the 13th most common cause of death. Risk factors include smoking, occupational exposures, infections, and genetic factors.
- At initial presentation, 80% of bladder cancers are non-muscle invasive. Staging involves evaluating the extent of primary tumor invasion and spread to lymph nodes and distant organs.
- Diagnosis involves cystoscopy, urine cytology, and imaging tests. Random bladder biopsies are also recommended to detect cancers that cannot be seen.
- For non-muscle invasive cancers, the main treatment is transure
Pancreatic neoplasms can be either solid tumors like adenocarcinomas or cystic neoplasms. Pancreatic adenocarcinoma has an extremely low 5-year survival rate of only 6% and is usually diagnosed at an advanced stage. Risk factors include smoking, chronic pancreatitis, diabetes and family history. Imaging tests like CT, MRI and EUS are used to stage the cancer and determine resectability. Surgical resection through a pancreatoduodenectomy or distal pancreatectomy offers the only chance for cure if the cancer is localized.
1. Bladder tumors can be epithelial like papillomas or carcinomas, or mesenchymal like leiomyomas or sarcomas.
2. In Egypt, bladder cancer is most common in males, with a male to female ratio of 3:1 and peak incidence between ages 30-50 due to bilharziasis.
3. Bilharzial bladder carcinoma presents at a younger age, with higher male predominance and more squamous cell carcinoma histology compared to non-bilharzial bladder cancer.
Benign condition
Rare typically occurring as a small, isolated growth
commonly in younger patients
A discrete papillary growth with a central fibrovascular core
lined by urothelium of normal thickness and normal cytology
simple branching pattern without fusion
The umbrella cell layer is often prominent and may show prominent vacuolization, nuclear enlargement, or cytoplasmic eosinophilia
Overall orderly appearance but with easily recognizable variation of architectural and or cytologic features seen at scanning magnification.
-Architecture is frequently complex with obvious anastomosis of adjacent papillae creating fused, confluent formations
-Variation of polarity and nuclear size, shape, and chromatin texture
- Mitotic figures are infrequent and usually seen in the lower half; but may be seen at any level of the urothelium
Complex, disordered architecture
- A spectrum of pleomorphism ranging from moderate to marked
-The individual neoplastic cells are often more rounded than in lower grade lesions
-Loss of polarity in relation to the basement membrane
-Frequent mitotic figures, including atypical forms
-Much higher risk of progression than low-grade lesions
-High risk of association with invasive disease at the time of diagnosis.
- A spectrum of cytologic and architectural abnormalities may exist within a single lesion, stressing the importance of examining the entire lesion and noting the highest grade of abnormality.
This document provides an outline and overview of gallbladder carcinoma. It discusses the epidemiology, risk factors, presentation, workup, treatment and follow up of gallbladder cancer. Key points include: gallbladder cancer is the most common biliary tract malignancy and 20th most common cancer worldwide. The highest incidence is found in Chilean and Indian women. Risk factors include gallstones, salmonella infection, obesity and genetic predisposition. Presentation is often asymptomatic but can include jaundice, weight loss and palpable mass. Workup involves imaging like ultrasound, CT and MRI to determine extent of disease. Surgical resection along with lymph node dissection is the main treatment but prognosis remains poor with 5-year survival of only
Testicular tumors-Cassification, Biomarkers and Staging by Dr RajeshRajesh Sinwer
This document discusses testicular tumors, including:
- Germ cell tumors are the most common type, comprising 95% of cases. Seminomas and non-seminomatous germ cell tumors are the main subtypes.
- Important biomarkers for testicular cancer include AFP, HCG, LDH, and PLAP. Elevated levels can indicate the presence of a non-seminoma.
- Staging is important and is based on whether the cancer is confined to the testis or has spread to lymph nodes or other organs. Spread beyond the retroperitoneum is considered stage III.
- Diagnostic workup involves imaging like ultrasound, CT, MRI and PET scans
This document provides information on carcinoma of the rectum, including its anatomy, epidemiology, risk factors, clinical presentation, diagnostic workup, staging, treatment options of surgery, chemotherapy and radiotherapy, and prognosis. Key points include:
- The rectum is located in the pelvis and is about 12-15 cm long, divided into upper, middle, and lower thirds.
- Colorectal cancer is the third most common cancer globally and rectal cancer makes up about 28% of cases.
- Risk factors include age over 50, family history, smoking, obesity, and inflammatory bowel disease.
- Treatment involves total mesorectal excision surgery with or without neoadjuvant chemor
This document discusses carcinoma of the rectum. It begins by explaining the anatomy of the rectum and its blood supply, lymphatic drainage and innervation. It then discusses the epidemiology, risk factors, staging systems including Dukes and TNM classification. Signs and symptoms, diagnostic workup including endoscopic, radiological and biopsy evaluation are explained. Principles of surgical treatment including resection margins are outlined. The goal of surgery is eradication of the primary tumor along with adjacent mesorectal tissue.
Special stains in Bone marrow examinationnamrathrs87
This document discusses special stains used in bone marrow examination, including Perls' Prussian blue stain for iron and Periodic acid–Schiff (PAS) stain. Perls' stain demonstrates iron stored as hemosiderin in macrophages and erythroblasts. The percentage of sideroblasts is assessed to evaluate iron availability. Ring sideroblasts are seen in certain myelodysplastic and myeloproliferative disorders. PAS stain demonstrates glycogen in granulocytes and megakaryocytes and can identify abnormal erythropoiesis. The staining patterns in acute leukemias are also described.
The document discusses effusion cytology. It begins by describing the anatomy of serous cavities and membranes that line them, producing serous fluid. Any excess fluid is an effusion, indicating a pathological process. Effusions can be classified as hydrostatic, infectious, inflammatory, or malignant. Samples are collected and prepared as smears for staining.
Normal components in effusions include mesothelial cells, histiocytes, lymphocytes, and other inflammatory cells. Reactive mesothelial cells can appear atypical but maintain a uniform appearance. Malignant effusions result from direct extension or metastasis of cancers. Identifying malignant cells involves comparing size, shape and number to determine the primary tumor type and origin. The most
This document discusses the classification of acute myeloid leukemia (AML). It provides an overview of classifications proposed over time including the French-American-British (FAB) classification from 1976 based on morphology and cytochemistry. The 2008 World Health Organization classification expanded genetic subtypes and incorporated cytogenetic and molecular information along with morphology. Accurate classification involves evaluating blast percentage, cell morphology, dysplasia, immunophenotyping, cytogenetics and molecular genetics to identify distinct biological entities of AML.
The document discusses various types of artefacts that can occur during tissue processing and slide preparation in histopathology. Artefacts are non-natural structures that are introduced and can compromise accurate diagnosis. They can occur during biopsy collection, fixation, processing, embedding, sectioning and staining. Examples include crush artefacts, thermal injury, surgical procedures, delayed fixation, contamination and diffusion of unfixed material. Care must be taken at each step and troubleshooting methods are provided to prevent or reduce artefacts.
The document discusses various types of cystic lung lesions. It defines a cyst as a round circumscribed space surrounded by an epithelial or fibrous wall. Several types of cystic lung lesions are described in detail, including bronchogenic cysts, pulmonary sequestration, congenital cystic adenomatoid malformation (CCAM), and lymphangioleiomyomatosis. CCAM is further classified into 5 types based on appearance and characteristics. The document provides imaging findings, pathological features, complications, and clinical presentations for several common cystic lung lesions.
Comparative genomic hybridization is a molecular cytogenetic method for analysing copy number variations (CNVs) relative to ploidy level in the DNA of a test sample compared to a reference sample, without the need for culturing cells
Gemma Wean- Nutritional solution for Artemiasmuskaan0008
GEMMA Wean is a high end larval co-feeding and weaning diet aimed at Artemia optimisation and is fortified with a high level of proteins and phospholipids. GEMMA Wean provides the early weaned juveniles with dedicated fish nutrition and is an ideal follow on from GEMMA Micro or Artemia.
GEMMA Wean has an optimised nutritional balance and physical quality so that it flows more freely and spreads readily on the water surface. The balance of phospholipid classes to- gether with the production technology based on a low temperature extrusion process improve the physical aspect of the pellets while still retaining the high phospholipid content.
GEMMA Wean is available in 0.1mm, 0.2mm and 0.3mm. There is also a 0.5mm micro-pellet, GEMMA Wean Diamond, which covers the early nursery stage from post-weaning to pre-growing.
PET CT beginners Guide covers some of the underrepresented topics in PET CTMiadAlsulami
This lecture briefly covers some of the underrepresented topics in Molecular imaging with cases , such as:
- Primary pleural tumors and pleural metastases.
- Distinguishing between MPM and Talc Pleurodesis.
- Urological tumors.
- The role of FDG PET in NET.
Chandrima Spa Ajman is one of the leading Massage Center in Ajman, which is open 24 hours exclusively for men. Being one of the most affordable Spa in Ajman, we offer Body to Body massage, Kerala Massage, Malayali Massage, Indian Massage, Pakistani Massage Russian massage, Thai massage, Swedish massage, Hot Stone Massage, Deep Tissue Massage, and many more. Indulge in the ultimate massage experience and book your appointment today. We are confident that you will leave our Massage spa feeling refreshed, rejuvenated, and ready to take on the world.
Visit : https://massagespaajman.com/
Call : 052 987 1315
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - ...rightmanforbloodline
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
TEST BANK FOR Health Assessment in Nursing 7th Edition by Weber Chapters 1 - 34.
The best massage spa Ajman is Chandrima Spa Ajman, which was founded in 2023 and is exclusively for men 24 hours a day. As of right now, our parent firm has been providing massage services to over 50,000+ clients in Ajman for the past 10 years. It has about 8+ branches. This demonstrates that Chandrima Spa Ajman is among the most reasonably priced spas in Ajman and the ideal place to unwind and rejuvenate. We provide a wide range of Spa massage treatments, including Indian, Pakistani, Kerala, Malayali, and body-to-body massages. Numerous massage techniques are available, including deep tissue, Swedish, Thai, Russian, and hot stone massages. Our massage therapists produce genuinely unique treatments that generate a revitalized sense of inner serenely by fusing modern techniques, the cleanest natural substances, and traditional holistic therapists.
Joker Wigs has been a one-stop-shop for hair products for over 26 years. We provide high-quality hair wigs, hair extensions, hair toppers, hair patch, and more for both men and women.
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Comprehensive Rainy Season Advisory: Safety and Preparedness Tips.pdfDr Rachana Gujar
The "Comprehensive Rainy Season Advisory: Safety and Preparedness Tips" offers essential guidance for navigating rainy weather conditions. It covers strategies for staying safe during storms, flood prevention measures, and advice on preparing for inclement weather. This advisory aims to ensure individuals are equipped with the knowledge and resources to handle the challenges of the rainy season effectively, emphasizing safety, preparedness, and resilience.
Let's Talk About It: Breast Cancer (What is Mindset and Does it Really Matter?)bkling
Your mindset is the way you make sense of the world around you. This lens influences the way you think, the way you feel, and how you might behave in certain situations. Let's talk about mindset myths that can get us into trouble and ways to cultivate a mindset to support your cancer survivorship in authentic ways. Let’s Talk About It!
MBC Support Group for Black Women – Insights in Genetic Testing.pdfbkling
Christina Spears, breast cancer genetic counselor at the Ohio State University Comprehensive Cancer Center, joined us for the MBC Support Group for Black Women to discuss the importance of genetic testing in communities of color and answer pressing questions.
International Cancer Survivors Day is celebrated during June, placing the spotlight not only on cancer survivors, but also their caregivers.
CANSA has compiled a list of tips and guidelines of support:
https://cansa.org.za/who-cares-for-cancer-patients-caregivers/
R3 Stem Cell Therapy: A New Hope for Women with Ovarian FailureR3 Stem Cell
Discover the groundbreaking advancements in stem cell therapy by R3 Stem Cell, offering new hope for women with ovarian failure. This innovative treatment aims to restore ovarian function, improve fertility, and enhance overall well-being, revolutionizing reproductive health for women worldwide.
3. SUMMARY OF CHANGES
Bladder biopsy and TURBT
The word checklist was changed to case summary
Histological grade-squamous cell carcinoma and
adenocarcinoma as changed to squamous cell
carcinoma or adenocarcinoma
Microscopic extension-“Urothelial carcinoma in situ”
was changed to “Urothelial carcinoma” as follows:
1. Urothelial carcinoma involving prostatic urethra in
prostatic chips sampled by TURBT
2. Urothelial carcinoma involving prostatic ducts and
acini in prostatic chips sampled by TURBT
“Cystitis cystic glandularis” was changed to “Cystitis
cystica et glandularis.”
4. SUMMARY OF CHANGES-
CYSTECTOMY AND ANTERIOR RESECTION
Microscopic Tumor Extension
Reporting on this element was changed to the following:
Cannot be assessed
No evidence of primary tumor
Noninvasive papillary carcinoma
Carcinoma in situ: “flat tumor”
Tumor invades lamina propria
Tumor invades muscularis propria
1. Tumor invades superficial muscularis propria (inner
half)
2. Tumor invades deep muscularis propria (outer half)
Tumor invades perivesical tissue
Microscopically
Macroscopically (extravesical mass)
6. MARGINS
Reporting on margins was changed to include noninvasive
high-grade urothelial carcinoma and other significant changes
at the margin and a note was added, as follows:
Margins (select all that apply)
1. Cannot be assessed
2. Margin(s) involved by invasive carcinoma
Ureteral margin
Distal urethral margin
Deep soft tissue margin
Other margin(s) (specify)
Margins(s) involved by carcinoma in situ/noninvasive high-
grade urothelial carcinoma
Ureteral margin
Distal urethral margin
Other margin(s) (specify)
7. MARGINS
Margins uninvolved by invasive
carcinoma/carcinoma in situ/noninvasive high-
grade urothelial carcinoma
Distance of carcinoma from closest margin: ___
mm
Specify margin:
____________________________
Other significant changes at margin (specify
margin): ________________________
Low-grade dysplasia
Non-invasive low-grade urothelial carcinoma
9. NOTE A-PROCEDURE
Partial cystectomy
First time tumour recurrence with a solitary tumour
Tumour located at the dome
Carcinoma of urachus or diverticulum
Total cystectomy
Non muscle invasive carcinoma with non functional
bladder
High grade Pt1 non responsive to therapy
Radical cystectomy
Radical cystoprostatectomy
Anterior exenteration
Other (specify)
Not specified
10. TUMOUR SITE-NOTE A
Trigone
Right lateral wall
Left lateral wall
Anterior wall
Posterior wall
Dome
Other (specify)
Not specified
11. TUMOUR SIZE- NOTE A
Greatest dimension: ___ cm
Additional dimensions: __x___ cm
Cannot be determined
12. NOTE A - HISTORY
Symptoms with duration
History of renal stones
History or recent urinary tract procedures
Cystoscopic findings
14. HISTOLOGICAL TYPE
Adenocarcinoma, typical
Adenocarcinoma, variant histology (specify):
Small cell carcinoma
Undifferentiated carcinoma (specify)
Mixed cell type (specify)
Other (specify)
Carcinoma, type cannot be determined
15. CLASSIFICATION OF NEOPLASMS OF THE
URINARY BLADDER
Urothelial (Transitional Cell) Neoplasia
Benign
Urothelial papilloma (World Health Organization
[WHO] 2004/ International Society of Urologic
Pathology [ISUP]), WHO, 1973, grade 0)
Inverted papilloma
Papillary urothelial neoplasm of low malignant
potential (WHO 2004/ISUP); WHO, 1973, grade I)
16.
17.
18.
19. CLASSIFICATION OF NEOPLASMS OF THE
URINARY BLADDER
Malignant
Papillary
Typical, noninvasive
Typical, with invasion
Variant
With squamous or glandular differentiation
Micropapillary
20.
21.
22.
23. CLASSIFICATION OF NEOPLASMS OF THE
URINARY BLADDER
Non papillary
1. Carcinoma in situ
2. Invasive carcinoma
Variants containing or exhibiting Deceptively benign
features
Nested pattern (resembling von Brunn’s nests)
Small tubular pattern
Microcystic pattern
Inverted pattern
Squamous differentiation
Glandular differentiation
Micropapillary histology
Sarcomatoid foci (“sarcomatoid carcinoma”)
24.
25.
26.
27.
28. CLASSIFICATION OF NEOPLASMS OF THE
URINARY BLADDER
Urothelial carcinoma with unusual cytoplasmic
features
Clear cell(glycogen rich)
Plasmacytoid
Rhabdoid
Lipoid rich
Urothelial carcinoma with syncytiotrophoblasts
Unusual stromal reactions
Pseudosarcomatous stroma
Stromal osseous or cartilaginous metaplasia
Osteoclast-type giant cells
With prominent lymphoid infiltrate
29.
30. CLASSIFICATION OF NEOPLASMS OF THE
URINARY BLADDER
Squamous Cell Carcinoma
1. Typical
2. Variant
Verrucous carcinoma
Basaloid squamous cell carcinoma
Sarcomatoid carcinoma
Adenocarcinoma
Anatomic variants
Bladder mucosa
Urachal
With exstrophy
From endometriosis
31.
32.
33.
34.
35. CLASSIFICATION OF NEOPLASMS OF THE
URINARY BLADDER
Histologic variants of adenocarcinoma
Typical intestinal type
Mucinous (including colloid)
Signet-ring cell
Clear cell
Hepatoid
Mixture of above patterns – adenocarcinoma not
otherwise specified (NOS)
Tumors of Mixed Cell Types
36. CLASSIFICATION OF NEOPLASMS OF THE
URINARY BLADDER
Undifferentiated Carcinoma
Small cell carcinoma
Large cell neuroendocrine carcinoma
Lymphoepithelioma-like carcinoma
Osteoclast-rich carcinoma
Giant cell carcinoma
Not otherwise specified
Metastatic Carcinoma
37. GRADING
Histologic Grade (select all that apply) (Note C)
Not applicable
Cannot be determined
Urothelial carcinoma
Low-grade
High-grade
Other (specify):
38. HISTOLOGICAL GRADE- NOTE C
Squamous cell carcinoma or adenocarcinoma
GX: Cannot be assessed
G1: Well differentiated
G2: Moderately differentiated
G3: Poorly differentiated
Other (specify)
Other carcinoma
Low-grade
High-grade
Other (specify)
39. WORLD HEALTH ORGANIZATION (WHO) 2004/ INTERNATIONAL
SOCIETY OF UROLOGIC PATHOLOGY (ISUP) CLASSIFICATION
FOR UROTHELIAL (TRANSITIONAL CELL) LESIONS
Hyperplasia
Flat hyperplasia
Papillary hyperplasia
Flat Lesions with Atypia
Reactive (inflammatory) atypia
Atypia of unknown significance
Dysplasia (low-grade intraurothelial neoplasia)
Carcinoma in situ (high-grade intraurothelial
neoplasia)
44. ADEQUACY OF MATERIAL FOR DETERMINING
MUSCULARIS PROPRIA INVASION- NOTE D IN
BIOPSY AND TURBT
Muscularis propria (detrusor muscle) not identified
Muscularis propria (detrusor muscle) present
Presence of muscularis propria indeterminate
45. MICROSCOPIC TUMOR EXTENSION (SELECT
ALL THAT APPLY) (NOTE D)
Cannot be assessed
No evidence of primary tumor
Noninvasive papillary carcinoma
Carcinoma in situ: “flat tumor”
Tumor invades lamina propria
Tumor invades muscularis propria
Tumor invades superficial muscularis propria
(inner half)
Tumor invades deep muscularis propria (outer
half)
47. MUSCLE INVASION
Muscularis mucosa or muscularis propria
Muscle invasion indeterminate for type of muscle
invasion
Tissue distortion, cautery artefact, poor orientation,
fibrosis, inflammation.
Sub staging of muscle invasion.
48. INVOLVEMENT OF PROSTATE
Prostatic urethra(flat carcinoma in situ, papillary or
invasive carcinoma)
Prostatic gland involvement
Involvement of prostatic ducts and acini
without stromal invasion (carcinoma in situ
involving prostate glands).
Urothelial carcinoma involving prostatic
stroma (either from prostatic urethral carcinoma,
carcinoma extending directly through the bladder
wall, or carcinoma involving prostatic ducts and
acini additionally with stromal invasion
51. STAGING- NOTE F
Pathologic staging is usually performed after surgical
resection of the primary tumor. Pathologic staging
depends on pathologic documentation of the anatomic
extent of disease, whether or not the primary
tumor has been completely removed.
If a biopsied tumor is not resected for any reason (eg,
when technically unfeasible) and if the highest T and N
categories or the M1 category of the tumor can be
confirmed microscopically, the criteria for pathologic
classification and staging have been satisfied
without total removal of the primary cancer.
52.
53. NOTE F- PATHOLOGICAL STAGING
Primary Tumor (pT)
pTX: Primary tumor cannot be assessed
pT0: No evidence of primary tumor
pTa: Noninvasive papillary carcinoma
pTis: Carcinoma in situ: “flat tumor”
pT1: Tumor invades subepithelial connective tissue
(lamina propria)
pT2: Tumor invades muscularis propria (detrusor
muscle)
pT2a: Tumor invades superficial muscularis
propria (inner half)
54. TNM STAGING
pT2b: Tumor invades deep muscularis propria (outer
half)
pT3: Tumor invades perivesical tissue
pT3a: Microscopically
pT3b: Macroscopically (extravesicular mass)
pT4: Tumor invades any of the following: prostatic
stroma, seminal vesicles, uterus, vagina, pelvic wall,
abdominal wall
pT4a: Tumor invades prostatic stroma or uterus or
vagina
pT4b: Tumor invades pelvic wall or abdominal wall
55. Residual Tumor (R)
Tumor remaining in a patient after therapy with
curative intent (eg, surgical resection for cure) is
categorized by a system known as R classification,
shown below.
RX Presence of residual tumor cannot be assessed
R0 No residual tumor
R1 Microscopic residual tumor
R2 Macroscopic residual tumor
56. STAGING
The “m” suffix indicates the presence of multiple
primary tumors in a single site and is recorded in
parentheses: pT(m)NM.
The “y” prefix indicates those cases in which
classification is performed during or following initial
multimodality therapy (ie, neoadjuvant
chemotherapy, radiation therapy, or both
chemotherapy and radiation therapy.
The “r” prefix indicates a recurrent tumor when
staged after a documented disease-free interval,
and is identified by the “r” prefix: rTNM.
57. NOTE G- MARGINS
Cannot be assessed
Margin(s) involved by invasive carcinoma
Ureteral margin
Distal urethral margin
Deep soft tissue margin
Other margin(s) (specify)
Margins(s) involved by carcinoma in situ/noninvasive
high-grade urothelial carcinoma
Ureteral margin
Distal urethral margin
Other margin(s) (specify)
Margins uninvolved by invasive carcinoma/carcinoma in
situ/noninvasive high-grade urothelial carcinoma
58. STAGING
The “m” suffix indicates the presence of multiple primary
tumors in a single site and is recorded in parentheses:
pT(m)NM.
The “y” prefix indicates those cases in which
classification is performed during or following initial
multimodality therapy (ie, neoadjuvant chemotherapy,
radiation therapy, or both chemotherapy and radiation
therapy). The cTNM or pTNM category is identified by a
“y” prefix. The ycTNM or ypTNM categorizes the extent
of tumor actually present at the time of that
examination.).
The “r” prefix indicates a recurrent tumor when staged
after a documented disease-free interval, and is
identified by the “r” prefix: rTNM.
59. REGIONAL NODES (PN) LYMPH
pNX: Lymph nodes cannot be assessed
pN0: No lymph node metastasis
pN1: Single regional lymph node metastasis in the
true pelvis (hypogastric, obturator, external iliac or
presacral lymph node)
pN2: Multiple regional lymph node metastasis in
the true pelvis (hypogastric, obrutrator, external iliac
or presacral lymph node metastasis)
pN3: Lymph node metastasis to the common iliac
lymph nodes
No nodes submitted or found
60. LYMPH NODES
Number of Lymph Nodes Examined
Specify
Number cannot be determined (explain)
Number of Lymph Nodes Involved (any size)
Specify
Number cannot be determined (explain)
62. G -SECTIONS FOR MICROSCOPIC
EVALUATION
Bladder
Sections of bladder for microscopic evaluation are as
follows.
In TURBT specimens, submit 1 section per
centimeter of tumor diameter (up to 10 cassettes).
If the tumor is noninvasive by the initial sampling,
additional submission of tissue (including possibly
submitting all tissue) is necessary to diagnose or rule
out the presence of invasion.
If tumor is invasive into lamina propria in the initial
sampling, additional sections (including possibly
submitting the entire specimen) may be necessary to
diagnose or rule out the possibility of muscularis propria
invasion.
63. G -SECTIONS FOR MICROSCOPIC
EVALUATIONS
In cystectomy specimens, several representative
sections of the tumor, including the macroscopically
deepest penetration, should be sampled.
Submit several sections of the mucosa remote
from the carcinoma, especially if abnormal,
including the lateral wall(s), dome, and trigone.
Submit 1 section of ureteral margin, unless
submitted separately as frozen section specimens,
and 1 section of urethral margin
If a long segment of the ureter(s) is present, then
additional sections from the mid-portion may be
necessary, as urothelial cancer often is multifocal
64. PROSTATE AND PROSTATIC URETHRA
Prostatic urethral involvement should be carefully
investigated in cystectomy specimens.
Sections should include the prostatic urethra,
including at the margin and with the surrounding
prostatic parenchyma.
Representative sections of the peripheral zone,
central zone, and seminal vesicles should
be included.
65. LYMPH NODES
Submit 1 section from each grossly positive lymph
node.
All other lymph nodes should be entirely
submitted, as presence of nodal disease may be
used as an indication for adjuvant therapy.
Lymph nodes may be grossly or microscopically
detected in the perivesical fat.
66. OTHER TISSUES
Submit 1 or more sections of uterus (as indicated)
and 1 or more sections of vagina, seminal vesicles,
and other organs (as indicated).
If the tumor grossly appears to invade the prostate,
uterus, or vagina, sections should be targeted, such
that the relationship of the infiltrating tumor in the
bladder wall and
the adjacent viscus is clearly demonstrable
67. MARGINS (SELECT ALL THAT APPLY) (NOTE H)
Cannot be assessed
Margin(s) involved by invasive carcinoma
Ureteral margin
Distal urethral margin
Deep soft tissue margin
Other margin(s) (specify)
Margins(s) involved by carcinoma in
situ/noninvasive high-grade urothelial carcinoma
Ureteral margin
Distal urethral margin
Other margin(s) (specify).
68. MARGINS
Margins uninvolved by invasive carcinoma/carcinoma
in situ/noninvasive high-grade urothelial carcinoma
Distance of carcinoma from closest margin: ___
mm
Specify margin#:
____________________________
Other significant changes at margin (specify
margin)#: ________________________
Low-grade dysplasia
Non-invasive low-grade urothelial carcinoma
For partial cystectomies, if the specimen is received
unoriented precluding identification of specific
margins, it should be denoted here.