Neoplasia LAB

Question 1

Adenoma, colon: what changes are seen? (5)

Answer 1

Changes: still moderately well differentiated

• -Pedunculated polyp - stalk of smooth muscle
• -Thickened epithelium - piled up, hyperplastic
• -Glands now very complex rather than straight: multiple branchings
• -Polarity of cells still relative good (nuclei at bottom, apex clear)
• -Small amount of fibrovascular stroma between glands

Question 2

Adenocarcinoma, colon: what changes are seen? (7)

Answer 2

Changes:

• -Can no longer identify the colonic epithelium
• -Polarity of cells totally lost
• -Gland lumens hardly visible
• -Increased nucleus/cytoplasm ratio
• -Virtually no intervening stroma present
• -Can still tell it is glandular, but not where it is from
• -Fully invaded through gut wall -> serosal surface

Question 3

Carcinoma, oropharynx: what changes are seen? (6)

Answer 3

Changes: well differentiated SCC

• -Can still tell that it is squamous
• -Still get keratin formation, can be in weird places/hyperkeratotic (looks white)
• -Cells have broken through basement membrane -> stroma
• -Polarity of differentiation is lost
• -Areas in between cells: little pink spines (desmosomes)
• -Nuclei pleomorphic: all very different from one another

Question 4

Carcinoma, lung: what changes are seen?

Answer 4

Changes: poorly differentiated SCC

• -Sheet of cells with no hint as to the nature of their origin
• -Rampant pleomorphism
• -Large, prominent nucleoli
• -Anaplastic forms: giant, atypical, undifferentiated
• -Areas of tumor necrosis (tumor outgrowing its vascular supply)
• -Breach of lymphatics/blood vessels = ability to metastasize