Morphopathology

Madness Table: only tumors and cancers classica8on

Chapter
Cardiac

Name
Mixoma

review for the 2 semester exam Alessandro Mo6a, UVVG, 3rd year Morphological Aspects

Extras

More o:en localized in the the le: atrium. The tumor appears as a pedunculated polypoid mass, gela8nous, with a diameter of about 5 cm. Some8mes it can ll the en8re atrial cavity, blocking the atrioventricular orice. Microscopically the tumor is composed of stellate cells embedded in a myxoid matrix is in the form of mul8ple nodular masses, dispersed more frequently in the ventricular myocardium. Can protrudes into cardiac cavi8es with blocking valve openings. Histologically they are composed of small cells with centrally located nucleus, clear cytoplasm in which bers radiates to the cell membrane (spider aspect) the most common tumor in this loca8on with star8ng point in mucinous glands;

Cardiac

Rabdomioma Epidermoid carcinoma Adenocarcino ma Plasmacytoma Singer Nodule Laryngeal papilloma Epidermoid carcinoma Glo?c carcinoma

Nose and paranasal sinus tumors

small benign polyp, generally occurred as a result of excessive use of voice and smoking. Is localized usually on vocal cords benign tumor usually localized on the vocal cords. In adults appears as a solitary forma8on which frequently become malignant. In children manifests as mul8ple laryngeal forma8ons caused by HPV infec8on common in men over 40, especially those that associate smoking with alcoholism localized on the vocal cords, has a good prognosis, unlike over- or subgloRs loca8ons develops in large bronchi, as a polypoid forma8on, o:en several. Microscopically, the tumor consists of thin conjunc8ve-vascular axis, covered with cylindrical or squamous metaplasia epithelium. Frequently can become malignant formed in large bronchi,, where appears as a pedunculated or sessile endobronchial forma8on. May cause bronchial obstruc8on and may become malignant In terms of localiza8on can be described two types of broncho-pulmonary 1 and cancers: central peripheral.

Laryngeal Tumors

Benign Bronco - Pulmonary

Papilloma Adenoma

Malignant Bronco - Pulmonary

Bronchogenic carcinoma

most common primi8ve pulmonary cancer, the main cause of death from malignancy of men. Among the risk factors for this condi8on could be considered: smoking, air pollu8on, asbestosis etc

Chapter

Name
Benign Mesothelioma

Morphological Aspects
mesothelioma is composed of re8culin and collagen bers between which are broblast-like cells (pleural "broma) mesothelioma is o:en associated with asbestosis. Tumor appears as a gray mass that produces oblitera8on of pleural cavity and pulmonary compression; can contain cys8c cavi8es lled with mucoid material. Microscopic structure is mixed with a mesenchymal component (such as brosarcoma), and an epithelial component (dierent types of adenocarcinoma) are found mostly in the pyloric antrum, where appear as solitary, sessile forma8ons. Microscopically are composed of glandular structures, villous, tubular or tubulo-villous, covered by an intes8nal or gastric epithelium type. Malignisa8on is common, the risk increases propor8onally with polyp size. may be single or mul8ple, may ulcerate, producing symptoms similar to pep8c ulcer

Extras

pleural tumors

Malign Mesothelioma

Benign Gastric Tumors

Adenomatous polyps Gastric leiomyoma

Gastric Cancer

95% Adenocarcino mas

early gastric cancer is dened as a tumor limited to the mucosa and submucosa of the stomach. Macroscopically can present in three forms: Type I, represented by polipid cancer, developed into gastric cavity; Type II, represented by supercial cancer. Can be described here three variants: supercial elevated, supercial at, supercial depressed; Type III, represented by ex-ulcerated form of cancer. advanced gastric cancer is dened as a tumor which at the 8me of ini8al diagnosis has penetrated beyond the submucosa. It has three macroscopic forms: polypoid, ulcerated and inltra8ve diuse. For diuse involvement of the en8re stomach is used the term lini8s plas8ca. occur more frequently in the ileum, as a polyp forma8on, pedicled or sessile, villous structure, tubular or tubulo-villous. Maligniza8on is rare, except villous one represents half of intes8nal malignant tumors, being frequently located in jejunum and ileum. Is presented as tumoral forma8on with polypoid, ulcera8ve or annular- inltra8ve growing, with stenosing eect. May have dierent degrees of dieren8a8on and histological point of view can be found several variants: tubular, papillary, mucinous with signet ring cells etc.
occurs in young men living in poor socio-economic condi8ons; aec8ng predominantly duodenum and proximal jejunum, where the tumor appears as a diuse inltra8on of the mucosa and submucosa with lymphocytes of plasmocytoid type. Prognosis is good, but o:en occurs a severe malabsorp8on syndrome. frequently located in ileum, where it appears as a polypoid, ulcera8ve or diuse inltra8ve growing tumoral forma8on. Histological may be found dierent variants of non-Hodgkin's lymphomas. The prognosis is severe, with frequent occurrence of intes8nal obstruc8on and perfora8on.

Gastric cancer disseminates, giving rise to metastases:lymph path, in loco-regional lymph nodes. Notably, le: supraclavicular lymph node involvement at distance (Virchow sign) hematogenous path, in liver, lung, etc. Peritoneal serous path, with bilateral ovarian involvement (Krukenberg tumor).

Adenoma Small Intes8ne

Adenocarcino ma

Primi8ve intes8nal lymphoma

Mediterranea n-type Occidental type

Chapter

Name

Morphological Aspects are derived from intes8nal neuroendocrine system cells (APUD system), being located more frequently in the ileum, and especially in the appendix. Tumor may present polypoid, ulcera8ve or inltra8ve growth. Microscopically, it consists of islands, cords or rosebes of small, round, uniform cells; nuclei are equal, hyperchrome and presents rare mitoses. Are tumors with mild evolu8on that rarely metastasize. When develops secondary loca8ons in the liver, can occur so-called carcinoid syndrome, caused by the secre8on of vasoac8ve substances, par8cularly serotonin. Benign, may present mul8ple histological aspects: Tubular polyps are the most frequent polyps of the colon. Are in the form of small nodules, with smooth surface, pedunculated or sessile. Consists of glandular tubes rela8vely uniform, separated by stromal 8ssue. Malignancy is rare, the risk is directly propor8onal to the size of polyps. Villous polyps develop predominated in recto-sigmoid region; have larger sizes than tubular ones, are sessile, conopidiform aspect. Microscopically, consists of thin digi8forme forma8ons, consis8ng of conjunc8ve-vascular axis covered by mucous- secre8ng cylinder cells. Malignancy is common. Tubulo-villous polyps with mixed structure. Macroscopic, colon cancer can be polypoid (common in proximal colon), inltra8ve annular- stenosing (common in the distal colon) or as an ulcerated mass. Most of them have rectal localiza8on (colorectal cancer) and are mucinous adenocarcinomas, more or less dieren8ated. Metastasa8on is done by lympha8c path in the locoregional lymph nodes, and by venous path frequently in the liver.
originates in hepatocyte cells; in the e8ology are involved hepa88s with B and C virus, liver cirrhosis, exposure to aatoxins and polyvinyl chloride. Macroscopically, neoplasms may appear as a single tumoral forma8on (carcinoma in 'orange'), as disemniate mul8ple micronodular forma8ons throughout the hepa8c area or as diuse inltra8ve form. Microscopically, the tumor is composed of malignant cells which remember more or less of hepatocyte cells (varying degrees of dieren8a8on), arranged in cords or acini, separated by a poor stroma. Scirrhoid form is rarely encountered with connec8ve stroma richly represented. is an adenocarcinoma of the bile ducts. Consists of glandular tubes covered with cuboidal atypical cells that do not secrete bile, separated by a dense, brous stroma. Has a beber prognosis than hepatocellular carcinoma. has as star8ng point endothelium of sinusoids capillary of liver. Appear as mul8ple hemorrhagic nodules, some8mes merged.

Extras

Small intes8ne Cancer

Carcinoid tumors

Large Intes8ne

adenomatous polyps

Familial polyposis is a hereditary condi8on characterized by the appearance of a large number of recto-sigmoid adenomatous polyps. Almost always becomes malignant. Recto-sigmoid localiza8on have the more reserved prognosis, progress depends primarily on tumor stage (depth of invasion) at ini8al diagnosis. Metastases are most commonly located in the lungs and periportal lymph nodes.

Large intes8ne Cancer (usually colon- rectal)

Mucinous adenocarcino ma

Hepatocellular Carcinoma Liver Cancer Colangiocarcin oma Angiosarcoma

Chapter
Liver Cancer

Name
Hepatoblasto ma

Morphological Aspects is a rare tumor that aects children under 5 years. Appears as a large tumor, composed of embryonic and fetal type liver cells. Prognosis is reserved. Benign tumors of the exocrine pancreas are rare, mainly localized in the body and tail of pancreas. Are represented by serous and mucinous cystadenomas, which have malignant poten8al Malignant tumors of the exocrine pancreas are represented especially by adenocarcinomas, developed at the level of glandular ducts. Are most common located in the head of the pancreas. Clinically, are manifested through uncharacteris8c signs (anorexia, epi-gastric pain, through mechanical jaundice (due to tumoral compression of the common bile duct) or migratory thrombophlebi8s. Morphologically, the cancer may appear as a mul8nodular tumoral mass or as a diuse inltra8ve pancrea8c process. Histologically more common forms are mucinous and scirrhoid adenocarinomas. Give metastasis throught lympha8c path (in regional lymph nodes), vascular path (splenic vein) or perineural path, hence the atrocious pain in this condi8on.

Extras

Cystadenomas

Pancreas (exocrine)

Adenocarcino mas

Pancreas (Endocrine)

are rare, with origin in components cells of islets of Langerhans. Are func8onal or non-func8onal, benign or malign, the most common forms are: Insulinomas, are benign tumors of beta cells. Neoplas8c cells may secrete insulin, which can cause severe hypoglycaemia. Gastrinomas are malignant tumors with similar structure to intes8nal carcinoid tumor. May secrete gastrin, leading to gastric hypersecre8on and the occurrence of pep8c ulcers (Zollinger-Ellison syndrome). Glucagonomas are malignant tumors of alpha cells, secre8ng glucagon. It can manifest clinically by slightly diabetes associated with skin erythema, anemia and venous thrombosis. Somatosta8nomas are malignant tumors of delta cells, clinically are manifested through slightly diabetes associated with cholelithiasis, steatorrhea and hypochlorhydria. Prolac8noma is the most common pituitary tumor. It is accompanied by hyperprolac8nemia and produces amenorrhea and galactorrhea in women. Somatotrope adenoma (acidophilic adenoma) is characterized by hypersecre8on of growth hormone. Occur in children, produces gigan8sm and in adults is accompanied by acromegaly. Can give and phenomena of compression on the intracranial structures. Cor8cotrop adenoma (basophilic adenoma) is manifested by hypecor8cism due to ACTH hypersecre8on. Clinically, there is so called Cushing's syndrome characterized by facio-truncal obesity, osteoporosis, muscle atrophy, arterial hypertension etc. Non-secre8ng pituitary adenoma is manifested by compression of surrounding organs (headache, visual disturbances and so on). Craniopharyngioma (adaman8noma) is a benign tumor of the child. Is not a true pituitary gland tumor, actually develops from Rathke's bag remnants. Microscopically, consists of islands of stra8ed squamous 8ssue included in a poor stroma, reminiscent of embryonic structure of tooth bud. Can cause atrophy of hypophysis or of the op8c chiasm.

Hyper- funcHonal tumors Hypophysis Non- funcHonal tumors

Chapter

Name

Morphological Aspects appear as nodular forma8ons, solitary or mul8ple, well-dened, encapsulated, with growth compressive on the surrounding thyroid 8ssue. They are usually nonfunc8onal but some8mes can be accompany and by hyperthyroidism. From histological point of view can be dis8nguish several forms: follicular adenomas (micro-or macro-follicular), papillary adenomas, adenomas of fetal or embryonic type, and Hurtle cell adenoma. Their malignancy is possible. are the most common malignant tumors of the endocrine glands. May occur on a preexis8ng goiter; usually starts in one thyroidian lobe, where remain long 8me localized, that in the end to invade the whole gland and surrounding organs. From histological point of view, can be described several thyroidian carcinoma, most common are: It consists of a core of bro-vascular 8ssue covered by a non kera8nized squamous epithelium. May be single or mul8ple, usually small, less than 5 mm with origin in the apocrine sweat glands, which appears as a intradermally node located in the interlabial sulcus. It consists of tubular and cys8c-papillary structures, separated by two layers of cells: epithelial and myoepithelial is preceded by the development of dysplas8c lesions of the vulvar squamous epithelium, currently embedded in the term vulvar intraepithelial neoplasia (VIN). Is o:en associated with acuminate condylomas. Macroscopically may present as exophy8c papillomatous mass or, more commonly, as an endophy8c ulcer. It is a solitary tumor, most commonly located on labia. Microscopically consists of large, polyhedral cell showing various degrees of atypia. The most common are epidermoid kera8nized carcinomas (spinocellular) with a variable number of kerato8c pearls.
is a malignant tumor of striated muscle epithelium, that occurs in girls up to age 10. Appears as a polypoid forma8on, eshy, located at hymen level. Microscopically consists of a myxomatous mass containing malign rhabdomyoblasts, covered by a abened squamous epithelium. It usually appears as a pedunculate forma8on with a diameter of 4 cm, gray-white, developed on the sidewalls of the vagina. Histologically, prolifera8on is composed of stromal conjunc8ve 8ssue, more or less cell rich, covered by a intact squamous epithelium.

Extras

Thyroidian adenomas Thyroid Thyroidian carcinomas VesHbular Papilloma papilifer hydradenoma

Papillary Follicular Medullary Anaplas8c

Vulvar Tumors

Epidermoid carcinoma

Embryonal rhabdomyosar coma (botrioid) Stromal polyp (bening) Vaginal Tumors Epidermoid carcinoma

Other benign tumors are: leiomyoma, rhabdomyoma, hemangioma etc. Malignant tumor of mesenchymal origin o:en aec8ng vagina is embryonic rhabdomyosarcoma. 5

usually preceded by a vaginal intraepithelial neoplasia (VAIN), macroscopic presen8ng as a ulcerated nodular or exophy8c forma8on. Microscopically have varying degrees of dieren8a8on, nonkera8nised form is most common.

Chapter

Name
Polyps

Morphological Aspects are the most common benign tumoral prolifera8on of the cervix. Macroscopically appears as pediculated nodular forma8ons, o:en unique, reddish- gray, hard or cys8c with a variable diameter on average 2-3 cm. have viral e8ology (HPV) and are rarely encountered. Are resul8ng through exocervical squamous epithelium prolifera8on, making an unique tumor, vegetans and microscopic appearance of acuminate condyloma. accounts for approximately 95% of cervical malignancies. Based on evolu8onary and prognos8c criteria can be classied into two broad categories: microinvasive and invasive cacinoma. Uterine cervix carcinoma disseminates by direct extending, aec8ng surrounding organs (urinary bladder, ureters, rectum), via lympha8c path (metastases in paracervical, hypogastric and external iliac lymph nodes), and rarely by hematogenous path. are by far the most common tumors of women, being more common in premenopausal period. Are estrogen-dependent tumors that grow in volume during pregnancy and regresses a:er menopause. Clinically are manifested by pain and pressure sensa8on in the pelvis, associated with abnormal uterine bleedings. Macroscopically, tumor may have a diuse growth, aec8ng whole thickness of myometrium, or can have a focal aspect, with single or mul8ple nodules. Tumor size varies greatly, from a few millimeters up to impressive sizes (over 30 cen8meters), with phenomena of compression on surrounding organs. Their consistency is high, pale-gray in color and on sec8on has a fascicular characteris8c aspect Usually aects postmenopausal women, in their e8opathogenesis intervening prolonged estrogen s8mula8on of mucosa of the uterus. Risk factors more frequently involved are: obesity, arterial hypertension, diabetes, and estrogen replacement therapy, endometrial hyperplasia etc. Interes8ng to note is that smoking reduces the risk of endometrial cancer. Most aected part is the fundic uterine region, endometrium appeared thickened, polypoid, with areas of necrosis and hemorrhage. At uterine curebage expresses an abundant, cerebroid, necro8c material. Serous Mucionus Endometrioid Clear cell Brenner Ovarian teratomas develop from germ cells through a process of parthenogenesis. The most common tumor in this category is dermoid cyst Ovarian dysgerminoma is a malignant tumor that is the female equivalent of tes8cular seminoma

Extras

Uterine Cervix

Cervical Papilloma

Can be a precancerous condi8on It is a long and boring story and classica8on with thousands of useless details I decided to forget.

Epidermoid carcinoma

Myometriu m

Leyomioma

Endometriu m

Adenocarcino ma

Ovarian

Ovarian surface epithelium tumors

Germ cells tumors

Chapter

Name

Morphological Aspects
Ovarian broma is a benign solid tumor composed of fascicles of elongated cells of broblas8c type. It is usually associated with ascites and hydrothorax (Meigs syndrome) Ovarian tecoma is a func8onal benign tumor (estrogen hormone secre8on) that occurs a:er menopause. It consists of fascicles of broblasts that separates groups of large cells with vacuolar cytoplasm, rich in lipids. Granulosa tumor is estrogen-secre8ng tumor, usually with benign evolu8on. It consists of small, cuboid cells, aspect of coee beans, reminiscent of granulosa cells. Some8mes these can delimit small follicles that contain eosinophilic material (Call-Exner corpuscle). Arenoblastoma (androblastoma) is a rare tumor, usually with benign evolu8on, characterized by the secre8on of androgen hormones with masculinizing eect.

Extras

Ovaries

Tumors of stromal sex cordons

Fetal throphobla st

GestaHonal choriocarcino ma

malignant tumor of fetal trophoblast. May occur a:er hyda8form mole, an aborted ectopic pregnancy or, less commonly, a:er a normal pregnancy to term. Clinically is manifested by abnormal uterine bleeding and a marked increase of serum and urinary level of chorionic gonadotropin. Some8mes the rst symptoms are due to lung or brain metastases, which fortunately respond favorably to chemotherapy. Tumor may present as a forma8on with exophy8c growth that lls the uterine cavity or endophy8c with myometrium thickness development. Is friable, imprecise delimited, with areas of necrosis and hemorrhage. it is a hormone-dependent tumors with accelerated growth during pregnancy and regression in menopause. It is characterized by the appearance, o:en in supero-external quadrant of the breast, of a hard nodular forma8ons, elas8c, mobile, well delimited, diameter generally up to 5 cen8meters. Histologically, it is a bi-8ssular prolifera8on: of glandular structures and inters88al mammary brous 8ssue. Depending on the predominant neoplas8c 8ssue can be described two microscopically forms: is a giant broadenoma, with sizes up to 20 cen8meters. It is characterized by a rich myxomatous stroma with areas of necrosis, hemorrhage and cys8c forma8ons on the sec8on. Conjunc8ve cells present elements of atypia and mito8c ac8vity, malignancy is inevitable. is a small tumor (2-4 mm), developed in preareolars ducts. Consists of conjunc8ve-vascular axes covered by a double layer of cells: glandular and myoepithelial cells. Rupture of these axes can cause small hemorrhagic leaks in mamelon, making clinical picture of hemorrhagic breast. Intraductal papilloma is not a preneoplas8c state. It is the most common malignant tumor of women. Metastasis of mammary carcinomas is done primarily by lympha8c path, in axillary lymph nodes, internal mammary and supraclavicular, and late by hematogenous path in lungs, liver, bones etc. Prognosis of these cancers depends on several factors: tumor size at the 8me of ini8al diagnosis, histological type, histological grade, presence of estrogen and progesterone receptors etc. In terms of evolu8on can be described non-inltra8ng and inltra8ng carcinomas.
intracanaliculaire boadenoma, with marked conjunc8ve prolifera8on pericanaliculaire boadenoma, with lible connec8ve 8ssue arranged in periductale mantles.

Fibroadenoma Benign tumors of the mammary gland

Phylodes tumor

Intraductal papilloma

Cancers of Mammary gland

Carcinomas

Chapter

Name

Morphological Aspects

Extras

Tes8s

are mostly malignant, with origin in germ cells. Rarely are encountered Leydig or Sertoli cell tumors. Seminoma is the most common tes8cular tumor, analogue to ovarian dysgerminoma. Appears around the age of 30, and manifests as an unilateral painless tes8cular swelling. Microscopically, the tumor is composed of groups of uniform round cells with well-dened limits, clear cytoplasm and hyperchromic nuclei, groups are separated by thin conjunc8ve septa, inltrated with lymphocytes. Seminoma is a radiosensi8ve tumor with favorable evolu8on. Embryonal carcinoma is a malignant tumor composed of compact plaques of large cells with imprecise limits and frequent mitoses. It is a very aggressive neoplasm with early metastasis. Tes8cular teratomas are germ cell tumors, malignant generally, derived from two or three embryonic foils. Containing many 8ssular varie8es such as car8lage, liver cells, striated muscle, etc. Can be subclassied into mature and immature teratomas.

Benign prostaHc hyperplasia

Prostate

(nodular prosta8c hyperplasia, prosta8c broleiomyoadenoma) denes a benign growth of the prostate, this being the equivalent of incorrect no8on of prostate adenoma. It is a very common condi8on a:er 60 years. E8opathogenesis is not perfectly elucidated, it is assumed that the key role in triggering the process it has increased estrogen synthesis with age, resul8ng in increased sensi8vity of prosta8c receptors for residual dihydrotestosterone. Its ac8on determines hyperplasia of prosta8c structures, even in the condi8ons of testosterone levels drop. It is the most common cause of urinary obstruc8on. Histologically, it is a tri8ssular prolifera8on in varying degrees: of glandular epithelial 8ssue, brous 8ssue and prosta8c smooth muscle. Typical for the benign nature of the process is that hyperplasied glandular acini are bounded by a double layer of epithelial cells. O:en intraglandulare limestones deposits can occur (amylaceous body) as well as a chronic inammatory inltrate. accounts for approximately 98% of malignant tumors at this level. Frequently aects men with advanced age, illness can o:en remains dormant. Diagnosis can be established by rectal examina8on, a characteris8c being and increased serum level of prostate specic an8gen and prosta8c acid phosphatase. Cancer of the prostate o:en starts in the peripheral zone of the prostate, especially in its posterior area. Histologically, can be iden8ed several types of architectural adenocarcinomas: with large and small acini, cribriform, papilliferous etc. Characteris8cs is that proliferated acini are wallpapers by a single layer of atypical cuboidal cells. The tumor, in evolu8on, invades surrounding organs, neural spaces and give metastases on lympha8c and hematogenous path. Frequently is occurrence of skeletal dissemina8on (vertebrae, ribs, pelvis). are malignant neoplasms of leucoforma8ve structures (mul8potent stem cells), characterized by inltra8on of bone marrow and peripheral blood with a large number of immature leukocy8c cells, atypical, nonfunc8onal. In advanced stages these cells can inltrate and other 8ssue, with the advent of tumoral masses with various sites (spleen, liver, lymph nodes). Simultaneously are aected and hematopoiesis and thrombocytopoiesis, processes manifested clinically by anemia and hemorrhage, plus severe and repeated infec8ous episodes. is expressed by the appearance of large numbers of malignant lymphoblasts. The disease is the most common malignant neoplasm of the child, being fortunately the form of acute leukemia that responds best to treatment. Clinically, nonspecic signs associated with anemia (fa8gue, pallor) gums and cutaneous hemorrhages, bacterial infec8ons. On general examina8on there was a generalized lymphadenopathy, localized predominantly at cervical level in associa8on with hepatosplenomegaly.The bone marrow is hypercellular due to accumula8on of lymphoblasts that 8 gradually replace normal hematopoie8c 8ssue.

adenocarcino mas

Leukemias

Blood Acute lymphocyHc leukemia

Chapter

Name

Morphological Aspects
is also known as acute non-lymphoblas8c leukemia or acute granulocy8c leukemia. Occurs more frequently in adults, and is expressed by the appearance of large numbers of atypical myeloblasts. Evolu8on is severe with a poor response to therapy. Clinically, in the early stages of the disease, general nonspecic manifesta8ons occur, because later appear hepato- splenomegaly and lymphadenopathy. The bone marrow is usually hypercellular (there are normo-or hypocellular forms) with the massive presence of myeloblasts. Is the result of neoplas8c prolifera8on of lymphocytes (most o:en type B), with consecu8vely inltra8on of bone marrow, peripheral blood, liver, spleen and other organs. Proliferated lymphocytes are immunologically immature and func8onally incompetent (unable to dieren8ate into an8bodies synthesizing plasmocytes). The disease o:en aects older men, having a asymptoma8c long-term evolu8on, of up to 10-20 years. In severe forms appear lymphadenopathy, hepato-splenomegaly and complica8ons such as infec8ous or hemoly8c anemia type. Bone marrow contains a higher concentra8on of lymphocytes (40% versus 20% normally), similar morphologically with normal peripheral blood, achieving at this level diuse or nodular inltrates. also called chronic granulocy8c leukemia is characterized by neoplas8c prolifera8on of mature cells of the granulocy8c series. Characteris8c is the appearance in karyotype of pa8ents with this disease of Philadelphia chromosome (transloca8on of a por8on from the chromosome 9 on chromosome 22). The disease has a chronic evolu8on, prolonged, characterized by general nonspecic manifesta8ons, splenomegaly, and hemorrhagic or thrombo8c episodes. Usually, at the end, occur a turning to acute myeloid leukemia with the appearance in blood of myeloblasts, anemia and severe thrombocytopenia. The bone marrow is hypercellular due to hyperplasia of all cell lines. Hematopie8c 8ssue extends and into the bone marrow of long bones.

Extras

Acute myeloid leukemia

Blood

Chronic lymphocyHc leukemia

Chronic myeloid leukemia

Central Nervous System

Gliomas

Astrocytomas can be of 4 types, type IV (glioblastoma mul8forme) represen8ng the most common intracranial neoplasm. It is a tumor with high malignancy and rapid growth that occurs in the elderly, is localized in the cerebral hemispheres. Oligodendroglioma is a slow-growing tumor developed in the cerebral hemispheres. Macroscopic appears as a well circumscribed forma8on, with outbreaks of calcica8on visible on the sec8on. Microscopically the tumor is composed of cells with large round nucleus surrounded by a clear halo. Ependymoma occurs more frequently in adolescence, located in the fourth ventricle. It is a slow-growing tumor but which produce disturbances in CSF circula8on (hydrocephalus). Macroscopic has a papilifer aspect and low consistency, composed of cells arranged in rosebes around blood vessels. Medulloblastoma is derived from primi8ve nerve cells; occurs in children, with cerebellar localiza8on. The tumor is so:, friable, consis8ng of small cells with lible cytoplasm and hyperchrome nucleus; mitoses are frequent. Meningiomas originate in meningeal arachnoid granula8ons; are usually slow-growing benign tumors; is the 3rd in frequency tumor of CNS. Most o:en it locates on brain convexity, in the region parasagital. Tumors appear as well delimited, solid, spherical or abened. From the microscopic point of view can be described several types of meningiomas: endotheliomatous, psamomatous, angioblast etc.

CNS

Others

9 Renal Tumors are rare, and Im too sleepy :D ------ May the force be with You ------- Ale Mo6a