1. Malignant Epithelial Tumors

2. Fig.9.1.Histological features of differentiation of the neoplasms
Behavior
Benign
tumor
Malignant
Rate of growth
Progressive, slow growth
Local and expansive growth
Rapid growth;
Expansive and invasive growth;
Local invasion
Expansive and cohesive masses, well demarcated, no invading adjacent normal tissues
Local invasive masses, infiltrating adjacent normal tissues
Metastasis
Absent
Present
Differentiation cytological features
Well differentiated-are resembling with cell of origin
cell differentiation failure
Few mitosis
Many mitosis, some abnormal
normal N/C Ratio=(1/4)
increased N/C Ratio=(1/1)
Homogenous cell shape and size
Cell and nuclear pleomorphism; anizocytosis.
Differentiation and anaplasia; The rate of growth; Local invasion; Metastasis

3. Fig.9.2. Differentiation and anaplasia: WD
Differentiation=morphological and functional similarity of neoplastic cells with cells of origin From: Stevens A. J Lowe J. Pathology. Mosby 1995
Normal
Fig.9.2. Differentiation and anaplasia: WD

4. normal WD ND MD
Fig.9.3. TM are more or less differentiated, showing various degrees of differentiation ranging from well-differentiated forms (BD) to non-differentiated (ND) or anaplastic forms.

5. Precancerous lesion-progression to neoplasia From: Stevens A. J Lowe J
Precancerous lesion-progression to neoplasia From: Stevens A. J Lowe J. Pathology. Mosby 1995 I II
III
Fig.9.4. I-Normal epithelium; II-Dysplastic epithelium (DP mild, moderate and severe); CIS – carcinoma in situ; III-Microinvasive carcinoma; Invasive carcinoma.

6. CIS – carcinoma in situ-skin
Fig.9.5. CIS-cell and nuclear pleomorphysm; intact BM.

7. Cancer cell morphology
From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.6. 7

8. Fig.9.7.
Fig Cellular and nuclear abnormalities: Cellular and nuclear pleomorphism and size; Increase of nucleo/cytoplasmic ratio; Nuclear hypercromasia; Single or multiple nucleoli; Atypical mitoses. 8

9. Fig.9.8. Vegetative carcinoma
Scuamocellular carcinoma From: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.8. Vegetative carcinoma

10. Fig.9.9. Ulcerative carcinoma

11. Scuamocellular carcinoma From cases of the Pathology Department - U. M
Scuamocellular carcinoma From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.10.
Fig.9.10.Ulcerative and invasive SCC into dermis

12. Fig.9.11.
Fig Islands of polygonal atypical cells separated by a reduced connective stroma. By differentiation the tumoral cells fill with keratin disposed as concentric lamellae (keratin pearls).

13. Basal cell carcinoma (ulcus rodens) From: Stevens A. J Lowe J
Basal cell carcinoma (ulcus rodens) From: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig Ulcus rodens

14. Fig Ulcus rodens

15. Basocellular carcinoma From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.14.

16. Fig.9.15.
Fig The tumour cells resemble with basal layer cells. They penetrate basement membrane and form dermal tumoral islands separated by a reduced stroma.

17. Well differentiated adenocarcinoma of colon From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.16.

18. Fig.9.17.
Fig The tumor wirh origin in the glandular epitheliumpenetrates muscularis mucosae and infiltrates the submucosa and muscular layer. The tumor is composed from tumoral glands separated by a reduced stroma.

19. Local invasion From: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.18.
Fig.9.18.Invasion: infiltrative feature in adjacent tissues

20. Invasive colonic adenocarcinoma From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.19.
Fig.9.19.Invasion: infiltrative feature in adjacent tissues

21. Metastastatic ways of the tumor cells From: Stevens A. J Lowe J
Metastastatic ways of the tumor cells From: Stevens A. J Lowe J. Pathology. Mosby 1995
Local spread
Lymphatic dissemination
Vascular dissemination
Transcelomic dissemination
Fig.9.20.

22. Fig.9.21.
Grading is based on the degree of differentiation and the rate of growth (number of mitosis) of tumour.
Histological spectrum of cancer: Well differentiated --> Poor differentiated-->Undifferentiated
Staging depends on: 1. the size of the primary tumour; 2. the extent of local spread; 3. the extent of
distant spread

23. Lymphatic dissemination: lymph node metastases From: Stevens A
Lymphatic dissemination: lymph node metastases From: Stevens A. J Lowe J. Pathology. Mosby 1995
Fig.9.22.

24. From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi
Fig.9.23.
Fig Lymph node metastasis of adenocarcinoma: The tumoral cells invade lymph node and form tumoral glands limited by an atypical epithelium.
From cases of the Pathology Department - U.M.F. “Gr. T. Popa” Iasi

25. Fig.9.24.
Blood dissemination
Visceral metastases

26. Fig.9.25.