Pathology Review Carousel 4a

Pathology Review Carousel 4a Pathology Review Carousel 4a
Neoplasia (I)

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Image
Slide # Tissue Mag Feature

1 Uterus Gross Uterus with two leiomyomata. notice circumscription (a benign feature), gray-white whirling broad bundles (suggests smooth muscle tumor).

2 Scan residual compressed myometrium with circumscribed leiomyoma

3 LP residual myometrium and circumscribed tumor

4 Leiomyoma MP Longitudinal and cross sections of bundles of smooth muscle. Notice slight increase in cellularity but resemblance of tumor cells to normal smooth muscle.

5 HP bundles of parenchymal cells, smooth muscle cells, surrounded by connective tissue stroma.

7 Leiomyosarcoma LP Longitudinal and cross section of fascicles or bundles of malignant smooth muscle tumor - note how cellular the tumor is and the enlarged pleomorphic nuclei

8 Leiomyosarcoma HP

9 Leiomyosarcoma LP Pleomorphic and anaplastic areas

10 Leiomyosarcoma HP Pleomorphic and anaplastic area with mitosis.

12 Thyroid Gross Thryoid with adenoma - note well circumscribed margin.

13 Parathyroid adenoma LP Note fibrous tissue capsule. The parenchymal cells in this tumor are the epithelial cells resembling chief cells and the stroma is the delicate connective tissue stroma.

14 Parathyroid adenoma HP Endocrine tumors will have different criteria for malignancy than most carcinomas, since they often will not have the usual features of malignancy. Note the uniform features of the cells, lack of mitoses and how much the cells resemble chief cells of a normal parathyroid gland and lack of invasion on previous slide which are in general features indicating a benign neoplasm.

16 Bronchogenic carcinoma (most likely Squamous carcinoma) Gross Note its origin in the bronchus and its irregular infiltrative margin as well as probable extension into adjacent lymph node.

17 LP Note lymphocytes at periphery and poorly defined edge of tumor.

18 Nest of squamous cell carcinoma HP Cohesive (cytoplasm of adjacent cells ar closely apposed to the neighboring cell cytoplasm) nest of polygonal cells, often more crowded at periphery with individual cell keratinization centrally (some individual tumor cell necrosis) fibrosis of stoma.

19 HP Squamous cell carcinoma with keratin pearl

20 HP Squamous cell carcinoma with less differentiation (no keratinization and less orderly pattern).

21 HP Squamous cell carcinoma note poorly defined edge of tumor periphery and surrounding lymphocytes.

23 Colon carcinoma Gross Obstruction and proximal dilatation

24 Colon carcinoma Gross Obstruction and proximal dilatation

25 Junction of normal colon and adenocarcinoma (forms glands)

26 Adenocarcinoma HP Note high N/C ratio, nuclear hyperchromasia and in many areas lack of orientation (polarity) of cells and nuclei

27 Adenocarcinoma invading into muscularis propria

29 Liver Gross Liver with metastatic carcinoma (multiple nodules) note congestiion of liver (red) at periphery of tumor nodules.

30 Liver LP Liver (pink) with metastatic small cell undifferentiated carcinoma (dark blue areas)

31 Liver Micro (HP) Small cell undifferentiated carcinoma (small cell carcinoma). Note anaplasia (lack of differentiation) , and hyperchromatic, oval, round or slightly elongated nuclei with almost no cytoplasm. Often nuclei are very fragile and smudged and tumor necrosis is frequently seen.

34 Pituitary adenoma Gross Note that benign tumors can cause problems because of their location and impinging on adjacent structures such as the optic chiasm.

35 Adrenal adenoma Gross Note circumscription

36 Small intestine Gross Circumscribed leiomyoma of muscularis

37 Colon Gross Pedunculated - sessile polyps

38 Uterus Gross Uterus with bilateral ovarian cysts

39 Ovarian cyst opened Gross Cystadenoma - (cystadenoma means benign tumor of glandular epithelium that is largely cystic grossly).

40 Benign cystic teratoma Gross Teratoma means a benign tumor arising from germ cells and containing derivatives of different germ layers.

Image	Slide #	Tissue	Mag	Feature
	1	Uterus	Gross	Uterus with two leiomyomata. notice circumscription (a benign feature), gray-white whirling broad bundles (suggests smooth muscle tumor).
	2		Scan	residual compressed myometrium with circumscribed leiomyoma
	3		LP	residual myometrium and circumscribed tumor
	4	Leiomyoma	MP	Longitudinal and cross sections of bundles of smooth muscle. Notice slight increase in cellularity but resemblance of tumor cells to normal smooth muscle.
	5		HP	bundles of parenchymal cells, smooth muscle cells, surrounded by connective tissue stroma.
	7	Leiomyosarcoma	LP	Longitudinal and cross section of fascicles or bundles of malignant smooth muscle tumor - note how cellular the tumor is and the enlarged pleomorphic nuclei
	8	Leiomyosarcoma	HP
	9	Leiomyosarcoma	LP	Pleomorphic and anaplastic areas
	10	Leiomyosarcoma	HP	Pleomorphic and anaplastic area with mitosis.
	12	Thyroid	Gross	Thryoid with adenoma - note well circumscribed margin.
	13	Parathyroid adenoma	LP	Note fibrous tissue capsule. The parenchymal cells in this tumor are the epithelial cells resembling chief cells and the stroma is the delicate connective tissue stroma.
	14	Parathyroid adenoma	HP	Endocrine tumors will have different criteria for malignancy than most carcinomas, since they often will not have the usual features of malignancy. Note the uniform features of the cells, lack of mitoses and how much the cells resemble chief cells of a normal parathyroid gland and lack of invasion on previous slide which are in general features indicating a benign neoplasm.
	16	Bronchogenic carcinoma (most likely Squamous carcinoma)	Gross	Note its origin in the bronchus and its irregular infiltrative margin as well as probable extension into adjacent lymph node.
	17		LP	Note lymphocytes at periphery and poorly defined edge of tumor.
	18	Nest of squamous cell carcinoma	HP	Cohesive (cytoplasm of adjacent cells ar closely apposed to the neighboring cell cytoplasm) nest of polygonal cells, often more crowded at periphery with individual cell keratinization centrally (some individual tumor cell necrosis) fibrosis of stoma.
	19		HP	Squamous cell carcinoma with keratin pearl
	20		HP	Squamous cell carcinoma with less differentiation (no keratinization and less orderly pattern).
	21		HP	Squamous cell carcinoma note poorly defined edge of tumor periphery and surrounding lymphocytes.
	23	Colon carcinoma	Gross	Obstruction and proximal dilatation
	24	Colon carcinoma	Gross	Obstruction and proximal dilatation
	25			Junction of normal colon and adenocarcinoma (forms glands)
	26	Adenocarcinoma	HP	Note high N/C ratio, nuclear hyperchromasia and in many areas lack of orientation (polarity) of cells and nuclei
	27			Adenocarcinoma invading into muscularis propria
	29	Liver	Gross	Liver with metastatic carcinoma (multiple nodules) note congestiion of liver (red) at periphery of tumor nodules.
	30	Liver	LP	Liver (pink) with metastatic small cell undifferentiated carcinoma (dark blue areas)
	31	Liver	Micro (HP)	Small cell undifferentiated carcinoma (small cell carcinoma). Note anaplasia (lack of differentiation) , and hyperchromatic, oval, round or slightly elongated nuclei with almost no cytoplasm. Often nuclei are very fragile and smudged and tumor necrosis is frequently seen.
	34	Pituitary adenoma	Gross	Note that benign tumors can cause problems because of their location and impinging on adjacent structures such as the optic chiasm.
	35	Adrenal adenoma	Gross	Note circumscription
	36	Small intestine	Gross	Circumscribed leiomyoma of muscularis
	37	Colon	Gross	Pedunculated - sessile polyps
	38	Uterus	Gross	Uterus with bilateral ovarian cysts
	39	Ovarian cyst opened	Gross	Cystadenoma - (cystadenoma means benign tumor of glandular epithelium that is largely cystic grossly).
	40	Benign cystic teratoma	Gross	Teratoma means a benign tumor arising from germ cells and containing derivatives of different germ layers.