Section 8 Epithelial Tumor. 1. Benign epithelial tumors (1) Papilloma Origin: coverage epithelium...

Section 8 Epithelial Tumor

1. Benign epithelial tumors

(1) Papilloma

Origin: coverage epithelium

Shape: finger-like projections into the lumen or on the surface of skin

Site: commonly in skin or bladder.

Papilloma

(2) Adenoma

Origin: adenocytes

Type① Typical adenoma

② Cystadenoma: having single or multiple cysts containing watery secretion. Commonly in ovary

Cystadenoma

③ Fibroademoma: both adenocytes and fibrous are parenchymal compositions. commonly in breast

④ Plesmorphic adenoma: having gland, mucoid, and cartilage-like tissues. Commonly in salivary gland.

⑤ Polypous adenoma: single or multiple. commonly in gastrointestinal track.

乳腺纤维腺瘤

息肉状腺瘤( 黄尚文教授提供 )

Polypous adenoma

2. Malignant epithehal tumors

(1) Squamous cell carcinoma

Origin: squamous cell

Morphology: grossly: cauliflower-like, polyp, mushroom-like, ulceration.

Histological: Well-differentiated type are similar

to normal squamous epithelial cells, with intercellular bridges and nets of keratin pearls (carcinoma pearls).

But poor-differentiated type are pleomorphism, no intercellular bridges and keratin pearls.

Squamous cell carcinoma

(2) Basal cell carcinoma

Origin: basal cells of skin

Features: locally invasive growth, almost never metastasis commonly in face of oldster.

Basal cell carcinoma

(3) Transitional cell carcinoma

Origin: transitional cells

Features: exoteric, finger-like, commonly in bladder, renal pelvis.

膀胱移行细胞乳头状癌 100倍

(4) Adenocarcinoma

Origin: adenocytes large quantities of type:

① Typical adenocarcinoma

② Mucoid carcinoma or colloid Signet-ring cell and carcinoma mucin

③ Solid carcinoma or carcinoma simplex Poor differentiation adenoma

carcinoma, and the tumor cells arrange in solid columns, or masses.

Adenocarcinoma

Signet-ring cell carcinoma

carcinoma simplex

Type:

a. Sclerous carcinoma: dense stroma

b. Medullary carcinoma encephaloid carcinoma:

Little stroma, and large masses of tumor cells.

c. Carcinoma simplex: Poor differentiation adenocarcinoma with

equal quantities of tumor cells and stroma.

3. Premalignant diseases dysplasia, and carcinoma in situ.

(1) Premalignant diseases

Definition: the benign diseases acquired the character of developing potentially into malignancy.

Dysplasia and carcinoma in situ (right) (Quoted from Robbins 《 Pathology Basis of disease 》 )

Grade 1: above changes are just limited in low 1/3 layer.

Grade 2: Above change are limited between in 1/3-2/3.

Grade 3: above changes breakthrough 3/2 layers

If above changes occupy whole layer, it is considered as carcinoma in situ.

Kinds:① Leucoplakia② Chronic cervicitis with cervical erosion③ Fibrocystic disease of breast④ Familial adenomatous polyps of the

colon⑤ Chronic atrophic gastritis and chronic

peptic ulcer of stomach.⑥ Chronic ulcer of skin⑦ Others: pigmented nevus, hidden

testis, goiter, liver cirrhosis

女阴粘膜白斑 (Prof. Orr 提供 )

(2) Carcinoma in situ

Definition: carcinoma in situ denotes carcinomatous changes just limited in the epithelium without evidence of invasion, not breakthrough basement membrane.

Carcinoma in situ is the earliest stage of carcinoma.

carcinoma in situ

(3) Dysplasia

Definition: a disturbance of growth which is usually considered to be premalignant.

Features: The changes are made up of pleomorphism of the cells, loss of polarity of the cells, hyperchromatic nucle, increastd mitosis, but no invasion.