Oncology 2 - Benign And Malignant Tumors

Front 1

The mesenchymal stromal cell derives following tissues:

- CT proper
- Adipose tissue
- Bone tissue
- Cartilage
- Muscle tissue
- Blood & lymphatic vessels

What are their respective cells?

Back 1

CT - fibroblasts
Adipose - adipocytes
Bone - osteocytes
Cartilage - chondrocytes
Muscle - myocyte / cardiomyocyte / syncytial myocyte

Front 2

Definition fibroma?

Back 2

Benign tumor arising from fibrocytes of CT proper

Smaller tumors are called 'fibrous cortical defect' and are considered congenital developmental disorder

Front 3

Typical sites for fibromas?

Back 3

Ovaries, fallopian tubes
Skin

Front 4

Definition neurofibroma?

Back 4

Benign, peripheral nerve sheath tumor

Front 5

Neurofibroma are composed of which cells?

Back 5

Fibrocytes of endoneurium

Front 6

3 types of neurofibroma & basic characteristics?

Back 6

1. Localized cutaneous
- Solitary / multiple (NF1) - hard lumps

2. Plexiform
- Group of nerves thickens. Pathognomonic for NF1

3. Diffuse
- Larger hard areas, subcutaneous

Front 7

Compare neurofibroma with schwannoma?

Back 7

Neurofibroma
- Not encapsulated
- From non-myelinating schwann cells (Steiner) (also read fibrocytes of endoneurium)
- Mesenchymal derived
- Malignant potential

Schwannoma
- Encapsulated
- Arise from scwhann cells around nerves
- Compress - but benign

Front 8

Definition myxoma?

Back 8

Single, small to massive (10cm) tumors growing from multipotential mesenchymal tumor cells.

Front 9

Histology of a myxoma?

Back 9

We see:
- Multinucleated myxoma cells (hyperchromatic)

Mixed with
- Endothelial cells
- Smooth muscle cells
- Fibroblastic cells
- Undifferentiated cells

All which derive from mesenchymal SC

Surrounded by abundant mucus

Front 10

Typical location for a myxoma?

Back 10

LA of heart. Growing from fossa ovalis

Front 11

Complications of a LA myxoma?

Back 11

It usually create a 'wrecking-ball' which may:

1. Occlude mitral valve
2. Damage mitral valve
3. Emolise

Front 12

Definition lipoma?

Back 12

Subcutaneous lesion of adipose tissue - consisting of adipocytes and a fibrous capsule

Usually solitary

Front 13

Most common subtype of lipoma?

Back 13

'Conventional lipoma' - soft, yellow, mature white adipocytes with no pleomorphism

Front 14

Definition chondroma?

Back 14

Benign neoplasm of hyaline cartilage

Front 15

2 subtypes of chondroma?

Back 15

1. Enchondroma
2. Juxtacortical chondroma

Front 16

Enchondroma?

Back 16

Most typical chondroma.

Arise in medulla of long bones - expand the bone. Usually solitary

Typical for 'Ollier disease'

Front 17

Juxtacortical chondroma?

Back 17

When chondroma arise on surface of bone

Typical for 'Maffucci syndrome'

Front 18

Definition osteoma?

Back 18

Benign lesions of bone tissue mostly in head and neck

Usually solitary - multiple = Gardner syndrome

Mix of lamellar and woven bone

Front 19

Other similar types of osteoma?

Back 19

Osteoid osteoma - Tibia

Osteoblastomas - Vertebral column

Consist both of woven bone with osteoblasts

Front 20

Osteoma + chondroma = ?

Back 20

Osteochondroma

Front 21

2 angiomas?

Back 21

1. Hemangioma - of blood vessels
2. Lymphangioma - of lymph vessels

Front 22

4 types of hemangiomas?

Back 22

1. Capillary hemangioma
2. Juvenile hemangioma
3. Cavernous hemangioma
4. Pyogenic granulomas

Front 23

Capillary hemangioma?

Back 23

Superficial hemangioma of capillaries of oral cavities and lips in:
- Skin
- Mucus membranes

Often regress spontaneously or are left as 'birth marks'
Red or purple

Front 24

Juvenile hemangioma?

Back 24

'Strawberry hemangioma'

Occur in newborns - and usually regress

Really look like strawberry

Front 25

Cavernous hemangioma?

Back 25

Large dilated vessels - often internal organs - do not regress

Front 26

Typical location of cavernous hemangioma and what is it often associated with?

Back 26

1. Liver
2. DIC & dystrophic calcification

Front 27

Pyogenic granuloma?

Back 27

Collection of capillary hemangiomas that grow as a red protruding lesion from skin, gingiva or oral mucosa

May bleed or be ulcerated

Microscopically we see granulation tissue

Seen as a rare pregnancy tumor, which regress

Front 28

Lymphangiomas?

Back 28

Lymphatic vessel counterpart of hemangiomas

Front 29

2 types of lymphangiomas?

Back 29

1. Simple capillary lymphangioma
2. Cavernous lymphangioma (cystic hygroma)

Front 30

Simple capillary lymphangioma?

Size, histology, distinguish from hemangiomas?

Back 30

Small lesions of 2 cm of head & neck

Form networks of endothelium lined spaces

Only distinguish from hemangioma with absence of blood cells!

Front 31

Cavernous lymphangioma?

Back 31

Larger lesions up to 15 cm

Composed of dilated lymphatic spaces:
- Lined by endothelium
- Separated by CT stroma with lymphoid aggregates

Front 32

Another name of cavernous lymphangiomas and why?

Back 32

Cystic hygromas

A swelling on typically the neck of children - due to distended lymphatic vessels

Front 33

2 types of myomas?

Back 33

1. Leiomyoma
2. Rhabdomyoma

Front 34

Leiomyoma - definition?

Back 34

Definition
- Benign tumors arising from smooth muscle cells - most typical in myometrium

Front 35

Another name for myometrial leiomyoma? Why?

Back 35

'Fibroid' - due to its firm character - done by clinicians

The commonest tumor among females

Front 36

Morphology of leiomyoma?

Back 36

- Sharply demarcated
- Whorled, spindle muscle cells growing in intercalated bundles
- From mm --> cm

Front 37

3 types of myometral leiomyomas?

Back 37

1. Intramural
2. Submucosal
3. Subserosal

Front 38

Complications of myometrial leiomyomas?

Back 38

1. Submucosal polyp
- Necrosis & hemorrhage

2. Subserosal polyp
- Torsion
- Create stalk and attach to other organs

3. Infertility
4. Degeneration
- Dystrophic calcification
5. Sarcoma development (rare)

Front 39

What is it called when a subserosal polyp of myometrium attaches to other organs?

Back 39

Parasitic leiomyoma - develop a blood supply!

Front 40

Risk factors for leiomyoma?

Symptoms?

Back 40

Risk factors
- Chromosomal abnormalities
- Estrogens & oral contraceptives - shrink postmenopausally!

Symptoms
- Menorrhagia
- Large produce lump

Front 41

Cardiac rhabdomyoma?

Back 41

Gray-white masses (cm) growing into ventricular chambers

Often seen in childhood associated with 'tuberous sclerosis'

Front 42

What are the cardiac 'spider cells'?

Back 42

Large, rounded polygonal cells with glycogen-filled vacuoles - compressing cytoplasm between - to give a 'spider'-like appearance

Front 43

Fibrosarcoma?

Back 43

Malignant neoplasms composed of fibroblasts

Front 44

Typical locations for fibrosarcomas?

Back 44

Retroperitoneum, thigh, knee

Front 45

Characteristics of fibrosarcoma?

Back 45

- Slow growth - discovered late
- Often hemorrhage & necrosis
- All degree of differentiation

Front 46

Histology of fibrosarcoma?

Back 46

- Herringbone pattern
- Spindle cells
- Sometimes myxoid stroma - myxofibrosarcoma

Front 47

Liposarcoma?

Back 47

Malignant neoplasm with adipocyte differentiation.

Means a typical trait is fetal fat cells: 'Lipoblasts'

Front 48

2 subtypes of liposarcoma?

Back 48

1. Well-differentiated liposarcoma
2. Myxoid / round cell liposarcoma

Front 49

Histology of a lipoblast?

Back 49

Pleomorphic cells filled of lipid droplets

Front 50

Prognosis of well-differentiated liposarcoma?

Back 50

Quite good - rarely metastasizes

May be difficult to distinguish from normal lipoma

Front 51

Prognosis of myxoid / round cell liposarcoma?

Why myxoid?

Back 51

Quite bad - highly aggressive and metastasizing

Lipoblasts and adipocytes scattered in myxoid ECM

Front 52

Typical locations for liposarcomas?

Back 52

- Deep fats of retroperitoneum
- Lower extremities

Front 53

Chondrosarcoma?

Back 53

Malignant CT tumor (sarcoma) of chondrocytes - producing and secreting cartilage matrix

Slow growth - typically 4-7th decade

Front 54

Classification of chondrosarcoma according to site?

Back 54

1. Intramedullary chondrosarcoma
2. Juxtacortical chondrosarcoma

Just like bone

Front 55

Classification of chondrosarcoma according to morphology?

Back 55

1. Conventional chondrosarcoma
2. Myxoid chondrosarcoma

Front 56

Conventional chondrosarcoma?

Back 56

Most common
Grow in medullary cavity of bones (intramedullary)
Consist of hyaline and myxoid cartilage

Front 57

Myxoid chondrosarcoma?

Back 57

Gelatinous
Tumor grows from cortex (juxtacortical) - pushing into marrow and adjacent soft tissue

Front 58

Conventional chondrosarcoma may also be associated with?

Back 58

Fibro- and osteosarcomas.

These are poorly differentiated chondrosarcomas

Front 59

Other histological variants of chondrosarcomas?

Back 59

Clear cell chondrosarcoma

Mesenchymal chondrosarcoma

Front 60

Osteosarcoma?

Back 60

Bone-producing (osteoid) malignant mesenchymal tumor

Front 61

Age-groups of osteocarcinoma patients?

Back 61

1. Young - up to 20 years - long bones
2. Elderly - over 60 years - long bones, vertebrae, pelvis

Front 62

Typical cause of elderly patients with osteosarcoma?

Back 62

- Paget disease
- Post irradiation
- Bone infarct

Front 63

Typical subtypes of osteosarcoma?

Back 63

According to:
- Level of differentiation
- Site involved (medullary vs cortical)
- Underlying disease
- Histological features

Front 64

Most common subtype of osteocarcinoma?

Back 64

Primary, solitary, intramedullary and poorly differentiated osteosarcoma

Front 65

Histological picture of osteocarcionma?

Back 65

1. Replace bone marrow
2. Large hyperchromatic, bizarre giant cells with high mitotic activity
3. Oteoid, woven bone, sometimes islands of primitive cartilage

Front 66

If malignant cartilage is abundant in osteosarcoma - it is called what?

Back 66

Chondroblastic osteosarcoma

Front 67

Leiomyosarcoma?

Back 67

Malignant neoplasia of smooth muscles - typically postmenopausal women

Front 68

Common sites of leiomyosarcoma?

Back 68

1. Myometrium
2. Skin smooth muscles
3. Retroperitoneum and inferior vena cava

Front 69

Histological picture of leimyosarcoma?

Back 69

Cigar-shaped spindle shaped growing in interwoven fascicles - quite bizarrely

- Necrosis
- Cytologic atypia
- Mitotic activity

Front 70

2 subtypes of myometral leiomyosarcomas?

Back 70

1. Superficial/cutaneous - good prognosis
2. Retroperitoneal - bad prognosis (hard to excise & recur)

Front 71

Clinical presentation, recurrence & metastasis of leiomyosarcomas?

Back 71

- Hard, painless lumpbs
- Often recurrence in retroperitoneal types
- If recurrence - then often metastasis to lungs

Front 72

Rhabdomyosarcoma?

Back 72

Malignant neoplasm of skeletal muscle cells - with 'rhabdomyoblast' as diagnostic cell

Happens usually before age 20, very aggressive

Typically arise in head / neck or genitourinary tract - where there are little or no skeletal muscles from before

Front 73

3 different histologic types of rhabdomyosarcoma?

Back 73

1. Embryonal
2. Alveolar
3. Pleomorphic

Front 74

Embryonal rhabdomyosarcoma?

Back 74

At mucosal surface of bladder or vagina.

Typical soft 'boytroid' growth

Front 75

What is sarcoma boytroides?

Back 75

Embryonal rhabdomyosarcoma - growing in a grape-like fashion in mucosal surfaces of bladder or vagina

Front 76

Histology of rhabdomyoblast?

Back 76

Granular eosinophilic cytoplasm
Loads of thick and thin filaments
Round or elongated

Front 77

How is the diagnosis of rhabdomyosarcoma made?

Back 77

1. Sarcomeres in EM
2. Transcription factors (myogenin) in immunohistochemistry - if highly undifferentiated

Front 78

Typical treatment of rhabdomyosarcomas?

Back 78

Surgery, chemotherapy and radiation - due to its aggressive and metastatic nature

Front 79

Angiosarcomas?

Back 79

Malignant endothelial neoplasms - ranging from highly differentiated

Typically affects older adults

Front 80

Causes of hepatic angiosarcomas?

Back 80

Carciongens:
- Arsenic pepticides
- Thorotrast
- Polyvinyl chloride

Front 81

Thorotrast?

Back 81

Earlier used for radiological imaging

Front 82

Polyvinyl chloride?

Back 82

Maybe the best known example of human chemical carcinogen

Front 83

Histology of angiosarcoma?

Back 83

Early
- Sharp borders, red nodules

- Larger, grey-white masses interblending with surrounding tissue

- Differentiation is extremely variable, and extremely difficult to determine in LM - so need to use immunohistochemistry

Front 84

What markers are used in angiosarcoma identification?

Back 84

CD31
von Willebrant factor

Front 85

Does lymphangiosarcoma exist?

Back 85

Yes, rarely:
- Eg. radical mastectomy with lymph node resection in breast cancer.

Here tumor typically arise from lymphatic vessels!

Front 86

Malignant mesothelioma?

Back 86

Malignant cancer of mesothelial cells - covering the serous cavities of the body.

Typically:
- Parietal and visceral pleura - seen as large white plaques

But also
- Peritoneum
- Periardium

Front 87

Lung mesothelioma is associated with?

Back 87

Asbestos inhalation either: (50%)
- Workers
- Living close to factory
- Relative who is worker

May be exposed shortly up to 40 years earlier

Front 88

Combination of cigarette smoking and asbestos increase lung carcinoma risk. Does the risk for mesothelioma also increase?

Back 88

No - since it seems to only be dependent on the asbestos. And the asbestos inhaled will always be there, so risk will not decrease with cessation of asbestos inhalation.

Front 89

What is the pathogenesis of asbestos and lung mesothelioma?

Back 89

Asbestos fibers tend to accumulate close to the pleurae, and there they will create reactive oxygen species - causing DNA damage with possible oncogenic mutations.

Often manifested with malignant pleural effusion

Front 90

3 histological types of mesothelioma?

Back 90

1. Epithelial
2. Sarcomatous
3. Biphasic

Front 91

Epithelial mesothelioma?

Back 91

Cuboidal cells line tubular spaces.

May be mistaken for pulmonary adenocarcinoma

Front 92

Sarcomatous mesothelioma?

Back 92

Spindled fibroblastic cells growing in sheets

Front 93

Biphasic mesothelioma?

Back 93

Both sarcomatous and epithelial areas

Front 94

Synovial sarcoma origin from?

Back 94

Not synovium (synoviocyte) like everyone thought

It comes from epithelia or spindle-cells

Front 95

Typical locations of synovial sarcoma?

Back 95

Large joints of extremities like
- Knee

Front 96

2 types of synovial sarcomas?

Back 96

1. Biphasic
2. Monophasic

Front 97

Biphasic synovial sarcoma?

Back 97

2 types of cells:
- Cuboidal to columnar epithelial cells, forming glands

- Spindle cells arranged in dense fascicles

Front 98

Monophasic synovial carcinoma?

Back 98

Only spindle cells - may be mistaken for fibrosarcoma!

Front 99

How to distinguish fibrosarcoma and monophasic synovial carcioma?

Back 99

Immunohistochemistry for
- Keratin
- Epithelial membrane

(synovial sarcoma has both - which differentiate them from moth other sarcomas)

Front 100

Definition papilloma?

Back 100

Benign epithelial neoplasia growing in a cauli-flower fashion. A 'wart'

Front 101

Structure of a papilloma?

Back 101

1. Hyperplastic epithelium on surface
2. Fibrous tissue core with CT and blood vessels

Front 102

Special characteristics of papillomas?

Back 102

1. Normal epithelial arrangement maintained
2. Relationship epithelium to CT is normal
3. Blood vessels are well formed

Front 103

Papillomas are either single or?

Back 103

Multiple - in papilloma virus infection

Front 104

What HPV's cause benign squamous papillomas?

Back 104

HPV 1, 2, 4, 7

Front 105

What HPV's cause condyloma acuminatum - or veneral warts - on penis or female genitalia?

Back 105

HPV 6, 11

Front 106

What HPV's cause high risk for lesions of squamous cell carcinoma - in cervix and anogenital region - but also oropharynx?

Back 106

HPV 16, 18

Front 107

A papilloma may either grow outwards or be?

Back 107

Inverted - as in transitional papillomas

Front 108

Transitional papillomas occur where?

Back 108

Urinary system - cause hematuria

Front 109

What is a polypoid tumor?

Back 109

Any tumor - benign or malignant - looking like a polyp.

Front 110

Squamous papilloma are similar to the papillary tumours of?

Back 110

Larynx.

Young people, may cause partial bronchial obstruction
- Stridor.

Due to HPV 6, 11

Front 111

Columnar papillomas may occur where?

Back 111

Colon
Breast duct papilloma

Front 112

Characteristics of breast duct papilloma?

Back 112

Grow from lacteal sinuses

- Columnar epithelium
- Solitary or multiple
- If multiple - higher risk for cancer and haemorrhagic nipple discharge

Front 113

Definition adenoma?

Back 113

Benign epithelial neoplasms arising from
- Ducts and acini of glands
- Epithelial organs

Front 114

Structure of adenomas?

Back 114

1. Capsulated (most important)
2. Form tubules which branches
3. Tend to break of parent gland duct / budding

Front 115

When do we call an adenoma a 'cystadenoma'?

Back 115

In case of retention of secretion

May become up to 30-40 cm in diameter (e.g. ovary)

Front 116

When do we call an adenoma a 'papillary cystadenoma'?

Back 116

When the proliferating glandular epithelium form papillomas

Front 117

Example of papillary cystadenoma?

Back 117

- Ovarian serous cystadenoma with intracystic papilla

Front 118

When do we call an adenoma a 'fibroadenoma'?

Back 118

When a small nodule consist of a mixture of acinar elements and supporting fibrous tissue

- But not considered a true neoplasm

Front 119

Examples of fibroadenomas?

Back 119

Fibroadenoma of breast

Front 120

Definition adenomatous polyp?

Back 120

Combination between
- Papilloma
- Adenoma

Like in FAP

Front 121

Definition FAP?

Back 121

Familial adenomatous polyposis

Mutation in APC gene with over 100 polyps before 30y

AD disease - inevitably will lead to adenocarcinoma

Front 122

What is a hyperplastic polyp?

Back 122

- Epithelial proliferations with no malignant potential

- Typical for left colon

- Consist of goblet and absorptive cells

Front 123

Colorectal adenomas are characterized by?

Back 123

Epithelial dysplasia
- Hyperchromatic nuclei
- Stratification

Front 124

2 types of typical colorectal adenomas?

Back 124

1. Pedunculated
2. Sessile

Front 125

Characteristics of pedunculated adenoma?

Back 125

Fibromuscular stalks - covered by normal epithelium

Front 126

Classification of pedunculated adenomas?

Back 126

1. Tubular - Tubular glands
2. Tubulovillous - mix
3. Villous - Villi covers

Front 127

Characteristics of sessile serrated adenomas?

Back 127

- No dysplasia
- Right colon
- Malignant potential

Front 128

How to distinguish between:
- Hyperplastic polyp
- Sessile serrated adenoma

Back 128

Hyperplastic polyp
- Left colon
- Serration only on surface
- Never malignant

Sessile serrated adenoma
- Right colon & caecum
- Serration through whole length of gland
- Malignant potential

Front 129

What is the most important characteristics that show risk for malignancy in adenomas?

Back 129

Size - 4cm high risk, 1 cm low risk

Front 130

Name the most common pituitary adenomas from commonest to least common?

Back 130

1. Prolactinoma
2. Somatotroph adenoma
3. Corticotroph adenoma
4. Non-functioning pituitary adenoma
5. Gonadotroph adenoma
6. Thyrotroph adenoma

Front 131

2 size-related types of pituitary adenoma?

Back 131

1. Macroadenoma (>10mm)
- Detected by compression of e.g. optic chiasm or on gland for hypopituitarism

2. Microadenoma (<10mm)
- Detected only if secretes hormones

Front 132

Hemorrhage into pituitary adenoma - causing raised intracranial pressure is called?

Back 132

Pituitary apoplexy

Front 133

Hyperfunction of somatotroph cause?

Back 133

Children: Giantism
Adult: Acromegaly

Since it secrete somatotropin which stimulate growth hormone release

Front 134

Prolactinoma cause?

Back 134

Hyperprolactinemia
- Amenorrhea
- Infertility
- Galactorrhea

Front 135

Characteristics of adenomas of thyroid gland?

Back 135

- Follicular epithelium
- Solitary
- Compress other thyroid tissue

Front 136

Most adenomas of thyroid gland are non-functional. But if it is functional and produce thyroid hormones - it is called and manifested by?

Back 136

'Toxic adenoma'

Manifested by thyrotoxicosis

Front 137

Most important sign to distinguish thyroid gland adenoma from multinodular goiter?

Back 137

Adenoma is covered by a capsule

Front 138

The most common reason for parathyroid hyperfunction is?

Back 138

Adenoma (80%)

Front 139

Corticotroph adenoma cause?

Back 139

Hypercortisolism - manifesting as Cushing disease

Small tumor - stimulating ACTH on adrenal cortex

Front 140

What is 'Nelson syndrome'?

Back 140

Large, agressive corticotroph adenomas developing after adrenal gland removal - for treatment of Cushing disease

Due to lack of inhibitory signal from adrenal corticosteroids

Front 141

Renal papillary adenoma develops from?

Back 141

Tubular epithelium

Front 142

What is the commonest tumor of salivary gland?

Back 142

Pleomorphic salivary adenoma

Front 143

Characteristics of pleomoprhic salivary adenoma?

Back 143

- Lobulated
- Encapsulated - but not completely so protrusions into surrounding tissue may occur

Front 144

Pleomorphic salivary adenoma derives it cells from?

Back 144

Both epithelial and myoepithelial (mesenchymal) cells

Front 145

Histology of pleomorphic salivary adenoma?

Back 145

Epithelial cells growing in
- Ducts, acini, tubules, trabeculae

Dispersed around in mixtures of:
- Myxoid tissue
- Cartilage tissue
- Bone tissue
= 'fibromyxoid stroma'

Front 146

Types of papillary carcinomas?

Back 146

1. Squamous cell carcinoma
2. Basal cell carcioma

Front 147

Characteristics of squamous cell carcinoma?

Back 147

- Found on skin, UV exposed areas, but also other sites with str.sq.epith.
- Often arise from in-situ lesions or actinic keratoses
- Slow growing

Front 148

Locations of squamous cell carcinoma?

Back 148

Skin
Oral cavity
Esophagus
Cervix
Vulva

All squamous epithelial locations or any place with potentially squamous cell metaplasia

Front 149

Histology of squamous cell carcinoma?

Back 149

- Atypical cells on all levels of epidermis
- Strands invading epithelium
- Well differentiated produce keratin - may form cell nests

Front 150

What is actinic keratoses?

Back 150

Progressive dysplastic changes - caused by sun exposure

May evolve to carcinoma with time - or may regress

Front 151

What is seborrheic keratosis?

Back 151

Pigmented epidermal tumors - in older persons

Composed of basal cells of normal epidermis, with horn cysts

Front 152

What is a horn cyst?

Back 152

Keratin-filled cyst

Front 153

What is basal cell carcinoma?

Back 153

Slow-growing cancer of basal cells of epidermis

- Never metastasize
- Pearly papules with telangiectasia

Due to sun exposure

Front 154

Stages of basal cell carcinoma?

Back 154

1. Flattened papilloma - enlarges over time
2. Small ulcer is formed
3. Local invasion - may be very destructive

Front 155

When a basal cell carcinoma invade locally - it is called?

Back 155

Rodent ulcer

Front 156

2 classifications of papillary carcinomas?

Back 156

1. Carcinoma in situ
2. Invasive carcinoma

-- Depend on stage

Front 157

Histology of papillary carcinoma of thyroid gland?

Back 157

- Small papillary structures
- Optically clear nuclei (Orphan Annie)
- Psammoma bodies (conc. calcification)

Front 158

Papillary carcinoma of transitional epithelium occurs where?

Back 158

Urinary tract

Front 159

Papillary carcinoma of columnar epithelium occurs where?

Back 159

GIT
Liver
Pancreas

Front 160

Adenocarcinoma can arise form?

Back 160

Any endocrine or exocrine gland

- Acini
- Ducts
- Glandular epithelium

Front 161

Classification of adenocarcinomas?

Back 161

1. Scirrhotic adenocarcinoma
2. Mucinous adenocarcinoma

Front 162

Characteristics of scirrhotic adenocarcinoma?

Back 162

Firm appearance
Tendency to contract

Front 163

Characteristics of mucinous adenocarcinoma?

Back 163

- Lakes of mucus, fewer carcinoma cells
- Signet ring cell - mucin fills cell and compress nucleus

Front 164

Typical cancer with signet ring cells?

Back 164

'Linitis plastica' adenocarcinoma of stomach