1. NEOPLASIA
Dr. Manal Maher Hussein

2. 44.1 - Thyroid, follicular adenoma
Characteristics of benign tumors:
fibrous pseudocapsule separating
the adenoma
from adjacent non-neoplastic thyroid tissue.
Adenoma resemble the tissue from which they arose, = well differentiated.
Very low power
Dr. Manal Maher Hussein

3. –Well differentiated-
What term is used to describe the resemblance of tumor cells to the tissue from which they arose?
–Well differentiated-
What histological features would you look for to rule out follicular carcinoma?
Follicular carcinomas may be very well differentiated; hence, the presence of capsular invasion is essential to make the diagnosis of carcinoma.
Dr. Manal Maher Hussein

4. 44.2 - Thyroid, follicular adenoma
This neoplastic tissue is very well differentiated showing follicles containing colloid.
The nuclei are uniform and round and no mitotic figures are seen, and polarity of the cuboidal cells toward follicular lumens is preserved.
Dr. Manal Maher Hussein

5. How do follicular cells in an adenoma compare with normal thyroid parenchyma?
Follicular cells in adenomas tend to have larger nuclei and a slightly higher N:C ratio than non-neoplastic thyroid tissue.
Dr. Manal Maher Hussein

6. Thyroid, follicular adenoma
Very low power
low power
high power
Thyroid, follicular adenoma
Normal thyroid
Dr. Manal Maher Hussein

7. 45.1 - Colon, multiple adenomatous polyps
Normal mucosal surface.
Note many round smooth projections arising from the mucosa (polyps). They are benign glandular tumors (adenomas) Polyps are attached to the mucosa by stalks (not seen).
Dr. Manal Maher Hussein

8. 45.2 - Colon, adenomatous polyp
Mucosa
Submucosa
Is there evidence of malignancy at this magnification?
No, the adenoma seems to be confined to the mucosa with no evidence of invasion of the submucosa.
Dr. Manal Maher Hussein

9. 45.2 - Colon, adenomatous polyp
normal mucosa
stalk
muscular layer
Attached to the normal mucosa by a stalk is a well- demarcated polyp.
It is apparent that the polyp is made up of glandular structures; hence, it is an adenoma.
Adenomatous polyps in the colon may be solitary or multiple.
Dr. Manal Maher Hussein

10. What is the term for a malignant tumor of glandular tissues?
Adenocarcinoma. -
Are all polyps neoplastic?
No. Polyps can result from focal hyperplasia of the mucosa. Hyperplastic polyps do not have malignant potential.
Dr. Manal Maher Hussein

11. 45.3 - Colon, adenomatous polyp
the junction of
normal mucosa
and the mucosa of the adenomatous polyp.
Normal mucosa shows evidence of normal differentiation because the cells have clear vacuoles containing mucin.
By contrast, the epithelial cells of the polyp have lost the specialized function of mucin production.
The adenomatous cells are hyperchromatic.
Dr. Manal Maher Hussein

12. Colon, adenomatous polyp
the junction of normal mucosa and the mucosa of the adenomatous polyp.
the epithelial cells of the polyp have lost the function of mucin production. The adenomatous cells are hyperchromatic.
Attached to the normal mucosa by a stalk is a well- demarcated polyp.

13. What term is used to describe the intense staining of the adenomatous cells?
- Hyperchromatic
Dr. Manal Maher Hussein

14. 46.1 - Colon, adenocarcinoma
Dr. Manal Maher Hussein

15. 46.1 - Colon, adenocarcinoma
The mucosa on either side of the ulcer shows normal transverse folds.
The edges of the ulcer are elevated and irregular.
This is an indication of local invasion at the peripheral parts of the adenocarcinoma
The adenocarcinoma is seen as a large, irregular mass
How is ulceration of the mucosa used to diagnose the disease clinically?
Ulceration causes bleeding, and this is detected as blood in the stools.
Dr. Manal Maher Hussein

16. 47 - Colon, adenocarcinoma
The carcinoma is composed of irregular glands infiltrating the submucosa, muscularis propria, serosa, and mesentery
The deeper the tumor extends into the muscularis propria and as lymph nodes become involved, the worse the prognosis.
Dr. Manal Maher Hussein

17. 46.2 - Colon, adenocarcinoma
Note the ulceration of the mucosa and the deep invasion of the colon wall by malignant glands.
Muscularis
Serosal fibro-fatty tissue
Dr. Manal Maher Hussein

18. Local invasion is highly related to distant spread.
ulceration of the mucosa
deep invasion of the colon wall by malignant glands.
Serosal fibro-fatty tissue
Muscularis
What is the relation between the extent of local invasion and the possibility of distant metastases in this disease?
Local invasion is highly related to distant spread.
Dr. Manal Maher Hussein

19. 46.3 - Colon, adenocarcinoma
serosa
Invasion of the muscular layer of the colon wall by irregular (malignant) glands.
This tumor arose in the mucosa and is penetrating the muscular layer as it advances toward the serosa.
Dr. Manal Maher Hussein

20. 46.4 - Colon, adenocarcinoma
Note the morphology of the malignant glands: irregular shapes, varying sizes, dark nuclei, multiple layers of cells, lack of mucin producing cells, and loss of normal architecture.
They exist in abnormal site as submucosa, muscular layer or serosa due to infiltration (invasion)
Dr. Manal Maher Hussein

21. 46.4 - Colon, adenocarcinoma
What term is used to describe cells and nuclei with irregular sizes and shapes Pleomorphism.
Dr. Manal Maher Hussein

22. 47 - Colon, adenocarcinoma
What is the relation between local invasion and prognosis?
The deeper the tumor extends into the muscularis propria, and as lymph nodes become involved, the worse the prognosis.
Dr. Manal Maher Hussein

23. Dr. Manal Maher Hussein Adenocarcinoma Normal mucosa
muscularis propria
Mesentery
Uninvolved lymph nodes
Dr. Manal Maher Hussein

24. 48 – Neurofibroma
Arise within or are attached to the nerve trunks in the skin & may also be found internally, attached to nerves.
Dr. Manal Maher Hussein

25. 48 – Neurofibroma
Spindle-shaped cells that have the features of fibroblasts.
The cells are arranged in wavy bundles, cells are uniform in shape and size.
The nuclei are elongated or sometimes curved.
There is no nuclear pleomorphism, and mitotic figures are very rare.
This is a typical neurofibroma.
Dr. Manal Maher Hussein

26. 49 – Neurofibrosarcoma
What route of metastasis is commonly used by sarcomas?
blood vessels
This neurofibrosarcoma consists of large, spindle-shaped cells with large, irregular, deeply stained nuclei.
variation in the shape and size of the cells and nuclei (pleomorphism), mitotic figures.
nuclear/cytoplasmic ratio is increased
Red blood cells in poorly formed capillaries.
Dr. Manal Maher Hussein

27. 52 - Normal adipose tissue
Thin cytoplasmic membrane that bounds a large fat globule
Nucleus is peripheral and flat
Connective tissue septa divide lobules of fat and carry the vascular supply.
Dr. Manal Maher Hussein

28. 52.1-Lipoma, small intestine
Here is a benign lipoma on the serosal surface of the small intestine.
What are the characteristics of benign lipoma?
Well bounded,
non-invasive,
closely resembles the tissue of origin (fat).
Dr. Manal Maher Hussein

29. 52.2 - Lipoma, small intestine
capsulated lipoma of the small intestine
It is composed of groups of fat cells.
This neoplasm is so well differentiated that, except for its appearance as a localized mass, it is impossible to distinguish from normal adipose tissue.
Dr. Manal Maher Hussein

30. 52.3 - Lipoma, small intestine
Well differentiated
The fat cells appear large, polyhedral with vacuolated cytoplasm. These neoplastic adipocytes are indistinguishable from normal adipocytes.
Dr. Manal Maher Hussein

31. 53 – Liposarcoma
This liposarcoma has enough differentiation to determine the cell of origin
How do these tissue changes differ from those in normal one?
pleomorphism
Hyperchromatic nuclei, blood cells
large strange lipoblasts are seen in this liposarcoma.
Dr. Manal Maher Hussein