This document summarizes two bone tumors - osteosarcoma and synovial sarcoma - and the epithelial tumor spindle cell carcinoma. It discusses the definition, demographics, clinical features, histopathology, differential diagnosis, treatment and prognosis of each tumor type. Key information includes that osteosarcoma commonly affects long bones and jaws in children and young adults. Synovial sarcoma has a poor prognosis with high recurrence and metastasis rates. Spindle cell carcinoma is an aggressive form of squamous cell carcinoma with spindle-shaped epithelial cells.
describes various clear cell lesions of head and neck region, its classification, origin, their immunohistochemistry profiles, various clear cell types, physiological and pathological clear cells, their causes.with histopathological images.
describes various clear cell lesions of head and neck region, its classification, origin, their immunohistochemistry profiles, various clear cell types, physiological and pathological clear cells, their causes.with histopathological images.
Ghost cells are translucent balloon shaped , elliptical epithelial cells are recognized as swollen, pale, eosinophilic cells.
They are seen either singly or in sheets with a clear conservation of basic cellular outline, generally with apparent clear areas or with some remnants indicative of the site previously occupied by the nucleus.
The transformation of epithelial cells into more resistant terminally differentiated apoptotic cells i.e., ghost cells are responsible for the banal behavior of neoplasms and they also help in relieving the stress of the forming neoplasm.
The most accepted nature of ghost cells is aberrant keratinization that is altered form of keratin as it doesn’t stain with normal cytokeratin antibodies.
Tonofilaments have been observed universally in the ghost cells of all the odontogenic or non-odontogenic tumors but these solely don’t satisfy their nature which is also found to be positive for enamel proteins in odontogenic tumors.
Although, studies prove an intricate functional relationship exists between Wnt and Notch signalling during development of neoplasms and in assigning cells to particular fates.
Their relationship along with other signalling pathways complex interaction during tumorigenesis also needs intensive evaluation and this would help revealing the missing link between odontogenic and non-odontogenic tumors exhibiting these similar looking mysterious ghost cells.
Central Giant Cell Granuloma :
WHO has defined it as an intraosseous lesion consisting of cellular and fibrous tissue that contains multiple foci of hemorrhage, aggregation of multinucleated giant cells and occasionally trabaculae of woven bone
Etiology JAFFE (1953): considered this lesion to be a local reparative reaction of bone, possibly to intramedullary hemorrhage or trauma, hence the term reparative giant cell granuloma was accepted.
Charles A Waldron & W G Shafer (1966) suggested trauma be an important etiological factor in the initiation of the CGCG of the jaws
Thoma K H (1986) suggested that the lesion may be due to capillary injury caused by defective wall due to some type of trauma
J V Soames and J C Southam (1997) suggested that it could be a reaction to some form of hemodynamic disturbance in bone marrow, perhaps associated with trauma and hemorrhage REGEZI AND SCIUBBA(1999) :
Suggested that
Response to previous traumatic or inflammatory episodes.
This lesion is charecterised by proliferation of fibroblasts and multinucleated giant cells, in a densely packed stromaThe CGCG is a benign process that occurs almost exclusively within the jaw bones
CLINICAL PRESENTATION
Found predominantly in children and young adult
It has a female predilection (2:1)
Most commonly affected site is the anterior portion of the jaws, with an increased frequency of occurrence in the mandible
Majority of the CGCG of jaws are painless, expansion of bone is detected on routine examination
Few cases may be associated with pain, paresthesia or perforation of a cortical bone plate, occasionally resulting in the ulceration of the mucosal surface by the underlying lesion
Radiographic featuresCentral giant cell lesions present as radiolucent defects. Which may be unilocular or multilocular.
The defect is usually well delineated
The lesion may vary from a 5×5mm incidental radiographic findings to a destructive lesion greater than 10cm in size.
radiographic findings
A small unilocular lesion may be confused with periapical granuloma or cysts.
multilocular giant cell lesions cannot be radiographically distinguished from ameloblastomas or other multilocular lesions. Based on clinical and radiological features CGCG may be divided into two categories
- Non-aggressive lesion
- Aggressive lesion
The non aggressive lesion makes up most cases and exhibit few or no symptoms, they demonstrate slow growth and do not show cortical perforation or root resorption of teeth involved in the lesion. The aggressive lesions are characterized by pain, rapid growth, cortical perforation and root resorption and show marked tendency to recur when compared with non aggressive typeSoft spongy, brownish to reddish friable tissue of various size.
A specimen is usually coated with fresh or coagulated blood. Giant cell lesions of the jaws show a variety of features. Common to all is the presence of few to many multinucleated
Ghost cells are translucent balloon shaped , elliptical epithelial cells are recognized as swollen, pale, eosinophilic cells.
They are seen either singly or in sheets with a clear conservation of basic cellular outline, generally with apparent clear areas or with some remnants indicative of the site previously occupied by the nucleus.
The transformation of epithelial cells into more resistant terminally differentiated apoptotic cells i.e., ghost cells are responsible for the banal behavior of neoplasms and they also help in relieving the stress of the forming neoplasm.
The most accepted nature of ghost cells is aberrant keratinization that is altered form of keratin as it doesn’t stain with normal cytokeratin antibodies.
Tonofilaments have been observed universally in the ghost cells of all the odontogenic or non-odontogenic tumors but these solely don’t satisfy their nature which is also found to be positive for enamel proteins in odontogenic tumors.
Although, studies prove an intricate functional relationship exists between Wnt and Notch signalling during development of neoplasms and in assigning cells to particular fates.
Their relationship along with other signalling pathways complex interaction during tumorigenesis also needs intensive evaluation and this would help revealing the missing link between odontogenic and non-odontogenic tumors exhibiting these similar looking mysterious ghost cells.
Central Giant Cell Granuloma :
WHO has defined it as an intraosseous lesion consisting of cellular and fibrous tissue that contains multiple foci of hemorrhage, aggregation of multinucleated giant cells and occasionally trabaculae of woven bone
Etiology JAFFE (1953): considered this lesion to be a local reparative reaction of bone, possibly to intramedullary hemorrhage or trauma, hence the term reparative giant cell granuloma was accepted.
Charles A Waldron & W G Shafer (1966) suggested trauma be an important etiological factor in the initiation of the CGCG of the jaws
Thoma K H (1986) suggested that the lesion may be due to capillary injury caused by defective wall due to some type of trauma
J V Soames and J C Southam (1997) suggested that it could be a reaction to some form of hemodynamic disturbance in bone marrow, perhaps associated with trauma and hemorrhage REGEZI AND SCIUBBA(1999) :
Suggested that
Response to previous traumatic or inflammatory episodes.
This lesion is charecterised by proliferation of fibroblasts and multinucleated giant cells, in a densely packed stromaThe CGCG is a benign process that occurs almost exclusively within the jaw bones
CLINICAL PRESENTATION
Found predominantly in children and young adult
It has a female predilection (2:1)
Most commonly affected site is the anterior portion of the jaws, with an increased frequency of occurrence in the mandible
Majority of the CGCG of jaws are painless, expansion of bone is detected on routine examination
Few cases may be associated with pain, paresthesia or perforation of a cortical bone plate, occasionally resulting in the ulceration of the mucosal surface by the underlying lesion
Radiographic featuresCentral giant cell lesions present as radiolucent defects. Which may be unilocular or multilocular.
The defect is usually well delineated
The lesion may vary from a 5×5mm incidental radiographic findings to a destructive lesion greater than 10cm in size.
radiographic findings
A small unilocular lesion may be confused with periapical granuloma or cysts.
multilocular giant cell lesions cannot be radiographically distinguished from ameloblastomas or other multilocular lesions. Based on clinical and radiological features CGCG may be divided into two categories
- Non-aggressive lesion
- Aggressive lesion
The non aggressive lesion makes up most cases and exhibit few or no symptoms, they demonstrate slow growth and do not show cortical perforation or root resorption of teeth involved in the lesion. The aggressive lesions are characterized by pain, rapid growth, cortical perforation and root resorption and show marked tendency to recur when compared with non aggressive typeSoft spongy, brownish to reddish friable tissue of various size.
A specimen is usually coated with fresh or coagulated blood. Giant cell lesions of the jaws show a variety of features. Common to all is the presence of few to many multinucleated
this ppt is about malignant tumours of connective tissue origin. classifications, clinical features, radiological features and histological features of all tumors are discussed with pictures.
Malignant Bone Tumours - A lecture for undergraduate students and demonstrators / Tutors featuring general aspects and three common malignant bone tumours viz. Osteosarcoma, Ewing's Sarcoma and Multiple Myeloma
Presentation about the the second most common type of ovarian tumors which have a very unique property of being similar to the testicular germ cell tumors.
Presentation on bone tumors for undergraduate 2nd year MBBS medical students. The information for this presentation has been taken from texbook of Robbins & Cotran Pathologic Basis of Disease 8th ed.
Detailed Description about soft tissue sarcoma.
Deals with topics including etiology, histopathology,clinical presentation ,staging and prognostic factors and management methods including surgery and adjuvent therapy .
Soft tissue sarcomas are a heterogeneous group of malignant tumours derived from primitive mesenchymal cells.
They are aggressive tumours which are locally invasive and recurrent.
They are named based on the cell of origin .
They require multimodal treatment including surgery and certain adjuvent therapies
this ppt describes about benign connective tissue tumors arising from fibroblasts, fat cells, nerves, bone and cartilage. clinical & histological features of all tumors are discussed with pictures.
mandibular premolars, common triats and differences between mandibular first and second premolar. buccal aspect, lingual aspect, mesial aspect, distal aspect, occlusal aspect of mandibular premolars
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
1. Seminar on
Spindle cell tumors of the oral cavity
Part - III
By: Dr. Madhusudhan reddy
III yearPG
VDC
2. • Part I seminar
I. Tumors of fibrous origin
II. Tumors of Fibro histiocytic origin
III.Tumors of adipose tissue origin
IV.Tumors of Smooth muscle origin
• Part II seminar
I. Tumors of Skeletal muscle origin
II. Tumors of Nerve tissue origin
III.Tumors of Vascular origin
3. • Part III seminar
I. Tumors of Bone
II. Tumors of epithelial origin
6. • Definition: Malignant, bone-forming tumor in which the
neoplastic cells form bone
• Account for approximately 20% of primary malignant
bone tumors
• Representing the most common primary
(nonhematopoietic) malignancy of the skeletal system
• Osteosarcomas of the jaws are uncommon and represent
6% to 8% of all osteosarcomas
7. • Demographics
• Age: Bimodal age distribution
– 60% occurring before age 25
– 13% to 30% occurring in individuals older than 40
years
• Sex: Slightly more common in male individuals
8. • Site: Long bones commonly affected, although any bone
may be involved
• maxilla and mandible are involved with about equal
frequency
• Mandible - posterior body and horizontal ramus rather
than the ascending ramus.
• Maxilla - inferior portion (alveolar ridge, sinus floor,
palate) than the superior aspects (zygoma, orbital rim).
9. • Common type – intramedullary
• Other types – juxtra cortical
– Paraosteal
– Periosteal
10. • Clinical features
• Localized pain with or without a mass
• Pathologic fracture
• Low-grade surface osteosarcoma may present as a
painless mass
• Swelling and pain are the most common symptoms
Loosening of teeth, paresthesia, and nasal obstruction
11.
12. • Radiographic features:
• Radiographic appearance is extremely variable
– High-grade osteosarcomas are usually large, poorly
defined, destructive, mixed lytic, and blastic, and often
have a soft tissue Mass
– Low-grade osteosarcomas are sclerotic and frequently
arise on the cortical surface
13.
14.
15.
16. Right maxilla - large osteoblastic destructive
mass, hair-on-end periosteal reaction
S Wang, H Shi; Osteosarcoma of the jaws: demographic and CT imaging features;
Dentomaxillofacial Radiology (2012) 41, 37–42
Body of the mandible showing periosteal
reaction
21. spindle cells can grow in sheets in
parosteal osteosarcoma
Intramedullary well-differentiated
osteosarcoma - trabeculae of neoplastic
woven bone are surrounded
by minimally atypical spindle cells
22. • Histological differential diagnosis
• Aggressive osteoblastoma
• Psuedomalignant osteoblastoma
• Myofibroblastic tumors
• Malignant neoplasms of bone
• Intraosseous squamous cell carcinoma
• Primary intraosseous neoplasm
• Malignant tumor of odontogenic origin
• IHC markers
• Variable and usually not helpful in diagnosing osteosarcoma
23. • Treatment
• Combination of surgery and chemotherapy
• Neoadjuvant (preoperative) chemotherapy followed by
radical surgical excision
• Adjuvant (postoperative) chemotherapy is used and
may be modified if poor histopathologic response to the
neo adjuvant regimen is noted
• Survival rate for localized conventional high-grade
osteosarcoma is 50% to 80%
• Low-grade surface osteosarcoma has a 90% to 100%
survival rate
25. • The term synovioma was coined by Smith in 1927
• Later in 1936 Knox suggested the name synovial sarcoma
(SS)
• Most common soft tissue malignancy after MFH,
liposarcoma, and rhabdomyosarcoma.
• H&N SS account for 6.8% of all SS occurring in the body
• Definition: Malignant mesenchymal tumor showing epithelial
differentiation
• Arises from primitive cells that have the potential to
differentiate into either mesenchymal or epithelial
components
26. • Demographics
• Age: Most common in young adults but may be seen at any
age
• Sex: No sex or race predilection
• Site: primary SSs of oral and maxillofacial sites
– Buccal mucosa
– Maxillary sinus
– Mandible
– Tongue
– Floor of the mouth
29. • Histological classification of SS
– Biphasic type with distinct epithelial and spindle cell
components present in various proportions and
patterns
– Monophasic spindle cell type with little or no evidence
of epithelial differentiation
– Monophasic epithelial type
– Poorly differentiated type
30. Histopathology
Monophasic synovial sarcoma -
hypercellularity and hypocellularity,
moderately long fascicles, uniform
hyperchromatic spindled cells
Biphasic synovial sarcoma with
occult glandular differentiation
31. Poorly differentiated synovial sarcoma,
showing a malignant hemangiopericytoma
growth pattern
Biphasic synovial sarcoma, with overt
glandular differentiation
32. • Histological differential diagnosis
• Malignant peripheral nerve sheath tumor
• Fibrosarcoma
• Solitary fibrous tumor
• Benign fibrous histiocytoma
• IHC markers
• Limited expression of low- and high-molecular-weight
cytokeratins
• Limited expression of EMA
• S-100 protein expression in 20% of cases
• CD34 negative
• CD99 expression is common - in poorly differentiated
tumors
• Nuclear expression of TLE-1
33. • Treatment
• Adequate surgical excision with follow-up
• Recurrence rates is upto 70% (2 – 20 years)
• Metastasis - usually blood borne to lungs (94%)
• Five-year survival rate is about 36–51%
• Prognosis is affected
– Tumor size
– Location
– Patient age
– Histological subtype
– Extent
– Mitotic activity
– Margin of resection
37. • Melanocytes are non keratinocytes
• Melanocytes in skin – protects against harmfull effects of
sun light.
• Present in the basal layers of the oral mucosa. along the
tips and peripheries of the rete ridges.
• 1 melanocyte to 15 keratinocytes
• Function – unknown
MS Hashemi Pour; Malignant melanoma of the oral cavity: A review of litrature; IJDR, 19
(1), 2008
38. • Melanocytes, nevus cells, and melanoma cells differ
– Cellular appearance
– Organization
– Biological characters
• Nevus cells
– Dendritic processes
– Round to spindle shaped cells
• Nevus cells lack
– Cytological atypia
– Pleomorphism
– Mitotic activity
MS Hashemi Pour; Malignant melanoma of the oral cavity: A review of litrature; IJDR, 19
(1), 2008
39. • Definition: Oral melanocytic nevi are hamartomas that
derive from nevomelanocytes cells that originate from the
neural crest
• Demographics
• Age: Third to fourth decade
• Sex: No Sex Predelection
• Site:
– Palatal mucosa (34% to 44%)
– mucobuccal fold (24%)
– buccal mucosa (11% to 22%)
– lip vermilion (18%)
– gingiva (12% to 23%).
40. Varient of nevus Clinical
appearance
% of nevus Histopathology
Intramucosal nevi Plaques or Nodules 64% to 80% Type A- epithelioid cells just
beneath the epithelium
Type B -lymphocyte-like or
neuroid spindle Cells
Type C- deeper in the lamina
propria
Blue nevi Macules or Plaques 8% to 17% Nevus cells with benign nuclei
Without junctional nests
Compound nevus Plaques or Nodules 6% to 17% Combination of intramucosal
and junctional nevus
Junctional nevi Macules or Plaques Rare Many nests of benign nevus cells
in the basal layer
Combined nevi Plaques or Nodules Rare Presence of both intramucosal
and Blue nevus
51. • Definition: malignant tumor of melanocytic origin
• Most common skin malignancy in
• Demographics
• Age: Fourth and the seventh decade of life, with an
average of 55-57 years old
• Sex: males are more commonly effected M:F – 2:1
• Site: hard palate (40%) > upper gingiva > lower
gingiva > buccal mucosa > tongue > floor of the mouth
52. Clinical features
• Macular lesions, nodular, sometimes
ulceration with regular or irregular edges
• Dark blue to black
• The symptoms
• Bleeding
• Pain
• Presence of melanotic pigmentation
53. • Criteria for diagnosis of melanoma is based on
“ABCD” system
– A – Asymmetry
– B – Border irregularity
– C – Color variegation
– D – Diameter greater than 6mm
• Growth patterns in melanoma
– Radial growth pattern – spreads horizontally
through basal layers
– Vertical growth pattern – invade the underlying
connective tissue
54. • Based on clinicopathological features
– Superficial spreading melanoma (70% of cutaneous)
– Nodular melanoma (15% of cutaneous)
– Lentigo maligna melanoma (5-10% of cutaneous)
– Acral lentigenous malanoma (common form of oral
melanoma)
62. • Definition: Spindle cell carcinoma is an unusual form of
poorly differentiated squamous cell carcinoma (SCC)
consisting of elongated (spindle) epithelial cells that
resemble a sarcoma
• First applied by Shervin et al
• also called
– Carcinosarcoma
– Pseudosarcoma
– Sarcomatoid SCC
– “Collision” tumor
– Sarcomatoid carcinoma,
• Biphasic tumor composed of SCC cells and pleomorphic
spindle-shaped cells
63. • Demographics
• Age: Mean Age 57 years, with a range of 29 to 93 years
• Sex: Males have a slight predilection
• Site: Commonly - oral cavity , larynx,
• less frequently - Sinonasal area and pharynx
• In oral cavity – alveolar ridge, lateral border of tongue,
floor of the mouth
66. Histopathology
Spindle cell proliferation in
short fascicles with storiform
pattern, ulcerated
Interface of invasive spindle cells
and mildy dysplastic surface
epithelium
71. • Treatment
• SPCC is biologically aggressive than the conventional
SQCC
• Treatment is similar to that of SQCC
• 90% of cases have 3-year survival rate