1. The document summarizes various malignant tumors and special tumors observed in the pathology lab, including basal cell carcinoma of the skin, infiltrating ductal carcinoma of the breast, squamous cell carcinoma of the skin, and adenocarcinoma of the rectum. 2. It also describes cases of papillary carcinoma that metastasized to lymph nodes and a pulmonary embolism, as well as an H-mole, dermoid cyst, thyroid hyperplasia, amyloid thyroid, and Hashimoto's thyroiditis. 3. Key cellular features of malignant tumors are described such as anaplasia, pleomorphism, increased mitosis and nuclear-cytoplasmic ratio, hyperchromatic

1. Pathology LabMalignant TumoursNeoplasia-2 5th November Ravi A Patel

2. Memory (M++) Picture of Metastatic Tumour in Liver Papillary Carcinoma Metastasizing To Lymph node Dermoid Cyst Gross & Microscopic Basal Cell CA Well pink stained H-mole Gross & Microscopic Pulmonary Embolus Hashimoto’s Thyroiditis Basal Cell CA Skin Infiltrating Ductal CA Breast Squamous Cell CA Skin Adeno Carcinoma Rectum Thyroid Hyperplasia Amyloid Thyroid Hemangioma Chart demo

3. Malignant tumours Basal cell CA-Skin Squamous cell CA-Skin 3. Infiltrating ductal CA -Breast 4. Adenocarcinoma-Rectum

4. Pathways of Spread Papillary CA- Metastatic to Lymph node 2. Tumor Embolus

5. Special Tumour H-mole (Microscopic + Gross) Dermoid Cyst

6. Immune Thyroid Hyperplasia Amyloid Thyroid Hashimoto’s Thyroidoitis

7. Cellular Features of Malignant Tumours Anaplasia- No differentiation Pleomorphism (Size,shape and nucleus) Mitosis increases(Atypical increase in mitosis) Increase in N:C ratio Hyperchromatic nucleus(highly stained)

8. Malignant Tumours

10. Basal cell CA-Skin Non-Invasive (No metastasis) Epidermis + Nest of tumour cells Peripherally arranged in Palisading/Picket Fence

11. Nests are formed by downward growth of Basal cells deep into dermis Nests are Formed in columns and sheets of basophilic cells Stroma around tends to seperate And forms well defined space Nests of Tumour cells

12. Well stained section of Basal cell CA Palisading formation/Picket fencing is clear

17. Infiltrating Ductal Carcinoma of Breast Due to abnormally proliferating ductal lining cells, there is invasion of stroma In normal breast tissue Ducts= Stroma Whereas in Infiltrating ductal carcinoma there is very little stroma

18. Normal Breast tissue is not found HPO Malignant Ductal lining cells Observed to be arranged in sheets Pleomorphism And Hyperchromatic nuclei Of the ductal lining cells

19. LPO

20. LPO

21. HPO

23. Squamous cell carcinoma-Skin Most common tumour arising from sun-exposed sites in older people. Locating the area where epidermis show atypical cells Keratinization of the squamous cells Cells show Keratin pearls like structure within Rest of cellular changes would be same as those manifested by all malignant tumours.

24. Keratin pearl Within squamous cell Atypical epidermal cells Hyperchromatic Nuclei

25. Observing keratinization Within the squamous cells Seen in HPO Next slide

26. Keratin pearls

28. Adencarcinoma of Rectum More differentiated There is abnormal proliferation of the rectal glands

30. Usually arising from Adenomatous polyps Atypical Gland in mucosa layer Well differentiated slide Goblet cells are numerous

31. Pathways of Spread

33. Papillary Carcinoma metastatic to lymph node From Thyroid gland Lyphoid follicle with germinal center It metastasize evenly

35. LPO Psamomma Body

36. HPO Psamomma Body

37. Orphan Annie- Nuclei HPO

39. Tumour Embolus-Lung Hematogenous spread of cancer cells result to embolization of the cells to distant site from the primary tumour There are neoplastic cells with in the blood vessel which will lead to congestion caused by the obstruction in blood flow.

43. Special Tumours

45. Hydatidiform Mole It is a benign tumour but can be converted to chorio carcinoma Occurs in pregnancy, uterus becomes large.. 3 Microscopic Changes Occurs Hydrophic degeneration- stroma enlarges due to accumulation of water. Cystic swelling Proliferation of trophoblastic cells.

46. Gross Description Endometrial cavity is occupied by grayish irregular to nodular tissues. Nodules resemble – small,cystic,translucent structures similar to small FISH EGGS. These are actually swollen chorionic villi which have undergone hydrophic degeneration.

48. Grayish Nodular Tissue FISH EGGS- they are enlarged Chorionic villi which have undergone Hydrophic degeneration

49. At the pointer Enlarged Chorionic VIlli Syncitio-Trophoblast Proliferation

50. Syncitio-Trophoblast Proliferation

51. HPO At the pointer Enlarged Chorionic VIlli Syncitio-Trophoblast Proliferation

53. Mature Cystic Teratoma-DermoidCyst,Ovary A.K.A Mature Benign teratoma of totipotent cells. Things to observe under microscope Cystic wall & Ectodermal elements as stratified squamous epithelium with underlying hair follicles and sweat glands.

54. Gross Ovary opened Revelaing Inner lining epithelium of the cystic wall Hair shafts and protruding incisor tooth from the wall.

57. Hair Shafts & Protruding incisor Tooth from the wall

59. Cystic Wall Ectodermal stratified Sqamous epithelium Sweat glands Hair Follicle

60. Immune

62. Thyroid Hyperplasia It is an Autoimmune disease A.K.A Grave’s Disease Body produces Antibodies There is increased thyroid hormones-Hyperthyroidism Metabolism:- Increased Thyroid function Tremors Weight loss after eating.

63. Increase in number of thyroid follicular cells surrounding the Acini.

65. Amyloid Thyroid Amyloid is a proteinaceous substance deposited between the adjacent cells. Amyloid is pink hyalinized material. Amyloid is seen to be compressing the thyroid acini.

66. Deposition of amyloid Around the acini

68. Hashimoto’s Throiditis It is a disease occuring due to T-lymphocyte defect, b lymphocyte also produces antibodies against the thyroid antigens. There is replacement of thyroid parenchyma by Lymphocytic infiltrates. In some areas lymphoid follicles are found. Remnants of thyroid follicles show atrophy but some are swollen with pinkish,granular cytoplasm– Hurthle cells

69. Hurthle cells Lymphocyte infiltrates At the pointer

70. Thanking to the entire Universe