EPULIS

GRANULOMATOUS

EPULIS GRANULOMATOUS
Peripheral giant cell granuloma
Protrudes from the gingiva at some site of
chronic inflammation
lesion covered by intact gingival mucosa, but
it may be ulcerated
Bluish purple
not encapsulated
well delimited and readily excised

EPULIS GRANULOMATOUS cont

Macroscopic:
The tissue sample was 1x0,7x0,5cm in size,
Reddish, rubbery
The surface was smooth

Microscopic:
The tissue was lined by stratified squamous
epithelium.
Beneath the epithelium there were granulation
tissue contain of fibroblast proliferation, with
chronic inflammatory infiltrate.

Fig .: Gross Peripheral giant cell

granuloma

EPULIS GRANULOMATOUS cont

AMELOBLASTOMA

AMELOBLASTOMA

Arise from odontogenic epithelium

commonly cystic
slow growing
locally invasive
a benign course in most cases

AMELOBLASTOMA Cont...
Macroscopic:
There was a cyst at the body of the mandible
contain brown yellow oily fluid.

Microscopic:
The cyst was lined by tall columnar cells, with
nuclei away from the basement membrane.
The central portion of the epithelial island is
composed of a loose network of cells resembling
stellate reticulum.

Fig. : Gross appearance of

ameloblastoma of mandible.

Fig. : Granular cell ameloblastoma.

Fig. : Keratotic ameloblastoma

Fig. : Unicystic ameloblastoma

AMELOBLASTOMA Cont...

RADICULAR CYST

RADICULAR CYST
A lump at mandible
Roentgenographically, it presented as a wellcircumscribed radiolucency at the apex of the
affected tooth.
Macroscopic
3cc fragmented tissue sample,
brownish, rubbery
hard

Microscopic:
The cyst was lined by ulcerated stratified squamous
epithelium.
The wall contained massive chronic inflammatory
infiltrate.

Fig . : Radicular Cyst

RADICULAR CYST Cont ...

SOLID BASAL CELL

CARCINOMA

SOLID BASAL CELL CARCINOMA

The most common skin malignancies

These lessions are rarely metastasize
slow growing
progressively infiltrative over time ( rodent
ulcer)
most occur in the head and neck area of
adults
prolonged sun exposured and in lightly
pigmented people

SOLID BASAL CELL CARCINOMA

Cont ...
Macroscopic :
At the middle there was an ulcerated lesion, reddish
black, circumscribed.

Microscopic :
There were tumor mass arise from the basal layer of
the epithelium.
The tumor cells were oval to spindle,
The nuclei were round to oval, hyperchromatic, and
mitotic figures were rare.
Stroma of the dermis was invaded by the tumor cells,
which were forming island appearance with palisade
nuclei arrangement at the edge of the island.

Fig. : Gross appearance of basal cell

carcinoma of forehead

Fig. : Basal Cell Carcinoma

Fig. : Basal Cell Carcinoma

SOLID BASAL CELL CARCINOMA

Cont ...

Fig. : Clinical appearance of pigmented

basal cell carcinoma

Fig. : Microscopic appearance of

pigmented basal cell carcinoma

Fig. : Multiple basal cell carcinomas in

the skin of the back of an elderly
patient.

Fig. : Highly organoid appearance of

Pinkus fibroepithelioma.

MELANOMA
MALIGNA

MELANOMA MALIGNA
Less common but much more deadly than
basal or squamous cell carcinoma
Sun exposured in light-skinned people
some of melanoma make so little pigment
Amelanotic ( Usually asimptomatic)
Microscopic:
The skin tissue sample was lined by ulcerated
stratified squamous epithelium, which were
hyperkeratosis and parakeratosis.
The tumor cells were hyperplastic in solid
arrangement infiltrating the dermis beneath the
epidermal layer.

MELANOMA MALIGNA Cont..

The tumor cells were round to oval, with
hyperchromatic nuclei.
Some of the tumor cells contain pigment melanin
in their cytoplasm.

Fig. : Gross Melanoma Maligna

32

MELANOMA MALIGNA Cont..

SQUAMOUS CELL
CARCINOMA

SQUAMOUS CELL CARCINOMA

Risk factors are sun exposure,tars,arsenic
poisoning,radiation exposure
Loss of P53
Bowen Disease = Squamous cell Ca insitu
=intraepidermal Ca
Well differentiated
Highly keratinized

SQUAMOUS CELL CARCINOMA

Cont ...
Macroscopic:
had a lesion with ulceration on its surface.
The side of the lesion was firm but brittle when it
was touched.

Microscopic:
The skin tissue sample was lined by stratified
squamous epithelium, which was change to a tumor
mass with ulceration.
The tumor cells were polygonal, hyperplastic in nest
arrangement, contained keratin in their cytoplasm.
The nuclei were polymorph, vesicular with prominent
nucleoli.

Fig. : Appereance Of Squamous cell

carcinoma.

Fig. : Appereance Of Squamous cell

carcinoma

Fig. : Deeply invasive well-differentiated

squamous cell carcinoma.

Source: Rosai: Surgical Pathology 9th edition

Fig. : Squamous cell carcinoma with

spindle metaplastic features

Fig. : Acantholytic squamous cell

carcinoma resulting in a
pseudoglandular appearance.

RETINOBLASTOMA

RETINOBLASTOMA
Most common malignant eye tumor of
childhood
Is unusual in several aspects when compared
with most other solid tumors.
Frequently occurs as a congenital tumor, it can
be multifocal and bilateral, it undergoes
spontaneous regression, and patients have a
high incidence of second primary tumors.
The incidence decreases with age, most cases
being diagnosed before the age of 4 years
46

RETINOBLASTOMA
Macroscopic:
An eyeball with a part of opticus nerve, 2,5cm in
diameter, was cut trough.
The cut surface showed there was white solid
mass within the ocular chamber.

Microscopic:
The tumor was composed of dense masses of
small round cells with hyperchromatic nuclei and
scanty cytoplasm.
There were trabecular and nesting arrangement.
Some of the cells presented a rosette formation,
which was called Flexner-Wintersteiner rosettes.

Fig. : RETINOBLASTOMA Gross

48

RETINOBLASTOMA

49

RETINOBLASTOMA Cont...

CHRONIC
OSTEOMYELITIS

CHRONIC OSTEOMYELITIS
Inflammation of jaw bones usually results
from extension of dental or periodontal
infection.
Divided into acute, subacute and chronic/
sclerosing (Garre) forms

CHRONIC OSTEOMYELITIS
Macroscopic:
Fragmented tissue samples
reddish yellow, and the consistency was
hard.
Microscopic:
The tissue samples consist of bone
sequestrum,
surrounding by granulation tissue with
chronic inflammatory infiltrate and fibrosis.

Fig.: CHRONIC OSTEOMYELITIS,

Gross

54

Osteomyelitis with osteonecrosis, acute

inflammation and fibrosis

CHRONIC OSTEOMYELITIS Cont ...

OSTEOMA

OSTEOMA

Benign
asymptomatic
slow-growing osteogenic lesion
usually affecting the flat bones of the calvaria
and the face
Exophytic growths attached to bone surface
Histologically resemble normal bone
Radioluscent,discrete
Pain cause by PG
58

OSTEOMA
Macroscopic:
A bone tissue sample, 3,5x3x0,5cm in size.
In the middle of the bone there was a nodule,
which was 1cm in diameter, the consistency
as hard as the bone.
Microscopic:
The bone tissue nodule composed of dense,
mature, lamellar bone with haversi canals.

Whole mount section of calvarial

surface osteoma

OSTEOSARCOMA
OSTEOBLASTIC
TYPE

OSTEOSARCOMA
OSTEOBLASTIC TYPE
The most common primary malignant
bone tumor
Men.>women
pleomorfic cell many spindle shape
Multinucleated cell
Nuclear hipercromatism
There are island of reactive of new
woven bone forming as response to
infiltration and dectrusion tumor
64

OSTEOSARCOMA
OSTEOBLASTIC TYPE
Macroscopic:
Bone tissue fragments , with blot clot and necrotic
debris.
Microscopic:
The bone tissue fragments consist of bone
sequestrum, and eosinophilic-staining osteoid with
irregular contour, surrounded by a rim of osteoblasts.
The surrounding area filled with tumor cells. The
tumor cells were round to spindle, with various sizes,
hyperplastic.
The nuclei were polymorph; hyperchromatic and
some osteoclast-like multinucleated giant cells were
found.

Fig. : Gross Osteosarcoma

66

OSTEOSARCOMA OSTEOBLASTIC
TYPE Cont...

LIPOMA

LIPOMA

The most common of soft tissue tumor

Benign Neplasma
Circumscribed
Consist of mature adipose,Slow growing
Resemles the tissue of origin (Fat)
Soft,mobile,localized mass
Subcutaneus masses,easily excised

LIPOMA Cont...
Macroscopic :
The cut surface showed a yellow solid
mass of adiposit origin, with a thin capsel
covered all over the mass.
Microscopic :
The tissue sample was containing of
hyperplastic, solid, mature adiposit cells.
The nuclei were at the periphery of the
cells, with vacuolated cytoplasm.

Fig. : GROSS LIPOMA

71

LIPOMA Cont...

RHABDOMYO
SARCOMA

RHABDOMYOSARCOMA
The most common soft tissue sarcoma of
childhood and adolescence, usually
appearing before age 20.
Interestingly, they occur most commonly in
the head and neck or genitourinary tract,
usually at sites where there is little, if any,
skeletal muscle as a normal constituent.
Often locally infiltrative and difficult to remove
completely

RHABDOMYOSARCOMA Cont...
Macroscopic:
The tissue sample,the color was whitish brown,
and the consistency was soft.
The cut surface showed that the tumor mass was
poorly circumscribed, solid, and whitish.

Microscopic:
The tissue sample consist of small, round to oval
tumor cells which were separated in nest by
connective tissue.
There were some strepshape cells with
crossstriation, tadpole cell with acidophilic
cytoplasm.

RHABDOMYOSARCOMA

76

RHABDOMYOSARCOMA Cont...

PSORIASIS

88

 Psoriasis is a common chronic

inflammatory dermatosis affecting 1%
to 2% of people in the United States.
In rare cases it is associated with
arthritis, myopathy, enteropathy, and
spondylitic ,heart disease.
Thick,silvery,scalling lesinos found at
bony prominence, scalp,genitalia and
hand
89

Fig. : Appeareance Of Chronic

Plaque Psoriasis

90

Microscopic:
Parakeratosis and thinning of stratum
granulosum
Small aggregates of netrophills
Narrow rete ridges
Between rete pegs the epidermis is
thinned over oedematus and expanded
dermal papila
Dilated capilaries is prominence
91

Psoriasis Cont...

92

Alhamdulillah

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