Malignant Epithelial

Tumors

Fig.9.1.Histological features of differentiation of the

neoplasms
Benign
tumor

Behavior

Rate
growth

of

Progressive, slow growth

Local and expansive growth

Malignant
tumor
Rapid growth;
Expansive and invasive growth;

Local
invasion

Expansive
and
cohesive Local invasive masses,
masses, well demarcated, no adjacent normal tissues
invading adjacent normal
tissues

Metastasis

Absent

Differentiati
on
cytological
features

Well
differentiated-are cell differentiation failure
resembling with cell of origin

infiltrating

Present

Few mitosis

Many mitosis, some abnormal

normal N/C Ratio=(1/4)

increased N/C Ratio=(1/1)

Homogenous cell shape and Cell and nuclear

size
anizocytosis.

pleomorphism;

Differentiation and anaplasia; The rate of growth; Local invasion; Metastasis

Differentiation=morphological and functional similarity

of neoplastic cells with cells of origin
From: Stevens A. J Lowe J. Pathology. Mosby 1995

Normal
Fig.9.2. Differentiation and anaplasia: WD

normal

WD

MD

ND

Fig.9.3. TM are more or less differentiated, showing various degrees of

differentiation ranging from well-differentiated forms (BD) to non-differentiated
(ND) or anaplastic forms.

Precancerous lesion-progression to neoplasia

From: Stevens A. J Lowe J. Pathology. Mosby 1995

II

III

Fig.9.4. I-Normal epithelium; II-Dysplastic epithelium (DP mild, moderate and

severe); CIS carcinoma in situ; III-Microinvasive carcinoma; Invasive
carcinoma.

CIS carcinoma in situ-skin

Fig.9.5. CIS-cell and nuclear pleomorphysm; intact BM.

Cancer cell morphology

From cases of the Pathology Department - U.M.F. Gr. T. Popa Iasi

Fig.9.6.

Fig.9.7.
Fig.9.6-7. Cellular and nuclear abnormalities: Cellular and
nuclear pleomorphism and size; Increase of
nucleo/cytoplasmic ratio; Nuclear hypercromasia; Single or
multiple nucleoli; Atypical mitoses.

Scuamocellular carcinoma
From: Stevens A. J Lowe J. Pathology. Mosby
1995

Fig.9.8. Vegetative carcinoma

Fig.9.9. Ulcerative carcinoma

Scuamocellular carcinoma
From cases of the Pathology Department - U.M.F. Gr. T.
Popa Iasi

Fig.9.10.
Fig.9.10.Ulcerative and invasive SCC into dermis

Fig.9.11.
Fig.9.10-11. Islands of polygonal atypical cells separated
by a reduced connective stroma. By differentiation the
tumoral cells fill with keratin disposed as concentric
lamellae (keratin pearls).

Basal cell carcinoma (ulcus rodens)

From: Stevens A. J Lowe J. Pathology. Mosby 1995

Fig.9.12. Ulcus rodens

Fig.9.13. Ulcus rodens

Basocellular carcinoma
From cases of the Pathology Department - U.M.F. Gr. T.
Popa Iasi

Fig.9.14.

Fig.9.15.
Fig.9. 14-15. The tumour cells resemble with basal
layer cells. They penetrate basement membrane and
form dermal tumoral islands separated by a reduced
stroma.

Well differentiated adenocarcinoma of colon

From cases of the Pathology Department - U.M.F. Gr. T.
Popa Iasi

Fig.9.16.

Fig.9.17.
Fig.9. 14-15. The tumor wirh origin in the glandular
epitheliumpenetrates muscularis mucosae and infiltrates the
submucosa and muscular layer. The tumor is composed from
tumoral glands separated by a reduced stroma.

Local invasion
From: Stevens A. J Lowe J. Pathology. Mosby 1995

Fig.9.18.

Fig.9.18.Invasion: infiltrative feature in adjacent tissues

Invasive colonic adenocarcinoma

From cases of the Pathology Department - U.M.F. Gr. T. Popa
Iasi

Fig.9.19.
Fig.9.19.Invasion: infiltrative feature in adjacent tissues

Metastastatic ways of the tumor cells

From: Stevens A. J Lowe J. Pathology. Mosby 1995

1. Local spread
2. Lymphatic
dissemination
3. Vascular dissemination
4. Transcelomic
dissemination

Fig.9.20.

Fig.9.21.
Grading is based on the degree of differentiation and the rate of growth (number of mitosis) of tumour.
Histological spectrum of cancer: Well differentiated --> Poor differentiated-->Undifferentiated
Staging depends on: 1. the size of the primary tumour; 2. the extent of local spread; 3. the extent of
distant spread

Lymphatic dissemination: lymph node

metastases
From: Stevens A. J Lowe J. Pathology. Mosby 1995

Fig.9.22.

Fig.9.23.

Fig.9.23. Lymph node metastasis of adenocarcinoma: The tumoral cells invade

lymph node and form tumoral glands limited by an atypical epithelium.
From cases of the Pathology Department - U.M.F. Gr. T. Popa Iasi

Fig.9.24.
Blood dissemination

Visceral metastases

Fig.9.25.