5 tumor sistem pernafasan
DESCRIPTION
Tumor Sistem PernafasanTRANSCRIPT
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TUMOR SISTEM PERNAFASAN
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Nasal Polyp
Low power High power
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Neoplasm
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Inverted Papilloma
The tumor mass is growing inward (inverted)
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Squamous Cell Ca, non-keratinizing
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leukoplakia
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Verrucous leukoplakia
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oral hairy leukoplakia
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Nasopharynx
Inflammation• Acute
• Chronic
Neoplasm• Juvenile angiofibroma
• Undifferentiated carcinoma
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a McIvor mouth gag is applied and a left nasopharyngeal mass is visible behind the soft palate and left posterior
pillar. The final diagnosis was lymphoepithelioma
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Nasopharingeal Ca, non-keratinizing, undiff.
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Nasopharingeal Ca, non-keratinizing, undiff.
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EBV(IH; LMP-1) x 600
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Anaplastic (undifferentiated) Carcinoma
Metastasic tumor
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LARYNX: benign vs malignant
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Laryngeal papillomatosis
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Laryngeal Carcinoma
Gross: fungating/papillar Microscopical: well.diff. SCC
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PATHOLOGY OF THE RESPIRATORY TRACT
Lower Respiratory Tract
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Pathology
of the LUNGI. Congenital Anomalies
II. Atelectasis
III. Hyaline membrane disease (RDS Type I)
IV. Circulation disorders
V. Inflammatory disorders / infection
VI. Chronic Obstructive Pulmonary Diseases (COPD)
VII. Restrictive Pulmonary Diseases (RPD)
VIII. Neoplasms
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Lung unit
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TUMORS OF THE LUNG
Histological classification
Primary tumors• Bronchogenic tumors• Non-bronchogenic tumorSecondary tumors (metastasis)
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Carcinoma in situ: bronchus
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Carcinoma in situ: bronchus
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Carcinoma in situ: bronchus
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The incidence of the bronchogenic tumors
1. Non-small cell lung Ca (NSCLC): 70-75%
a. SCC: 25 – 30 %
b. AdenoCa, including bronchioloalveolar
carcinoma: 30 – 35 %
c. Large cell Ca: 10 – 15 %
2. Small Cell Lung Ca (SCLC) : 20 – 25 %
3. Combined : 5 – 1 0 %
- SCC + adenoCa
- SCC + SCLC
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lung carcinoma
central lung carcinoma Peripheral lung carcinoma
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Bronchogenic Carcinoma
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a b
c d
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a. Squamous cell ca.: men >> women, smoking history central bronchus
squamous metaplasia-displasia-Ca
b. Adenocarcinoma : bronchial/ bronchioloalveolar type Women >> men, non smokers pheripherally location
grow more slowly than SCC
c. Small cell ca : Highly malignant tumor smokers, Hilar/ central
EM: neurosecretory granules high response to chemotherapy
d. Large cell ca : Undifferentiated ca
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Cytologic diagnoses of lung cancer
a. Sputum specimenb. FNA of Lnn : small cell ca
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Bronchioloalveolar carcinoma
Terminal bronchoalveolar regionPeripheral portion of the lungMales = females, all ages( 3rd decade- advanced years)
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BRONCHIAL CARCINOID
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S C Carcinoma in situ
No gross mucosal abnormalities
Bronchial washing
Bronchial brushing
SCC in situ
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Early invasive SCC
SCC in situ with foci of early invasion (nodular thickening)
Early invasive scc
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SCC
Endobronchial SCC
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Well differentiated SCC
Keratin mass
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SCC moderately differentiated
Individual cell keratinization
Pearl formation
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SCC moderately differentiated
Pearl formation
Central squamous differentiation
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SCC poorly differentiatedDense eosinophilic cytoplasm
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Adenocarcinoma
This lobectomy specimen shows a lobulated, somewhat glistening mass
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AdenocarcinomaWell differentiated
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Adenocarcinoma Moderately differentiated
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Adenocarcinoma Poorly differentiated
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AdenocarcinomaCytology
3 dimension cell group, vacuolization
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Bronchioloalveolar Carcinoma (BAC)Nonmucinous type
Upper lobe is almost entirely consolidated by mucinous BAC, architecture is maintained, and there is an absence of necrosis and hemorrhage
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Bronchioloalveolar Carcinoma (BAC)
Nonmucinous type
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Bronchioloalveolar Carcinoma (BAC)
Nonmucinous type
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Bronchioloalveolar Carcinoma (BAC)
Nonmucinous type
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Bronchioloalveolar Carcinoma (BAC)Mucinous type
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Bronchioloalveolar Carcinoma (BAC)Mucinous type
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Small cell (lung) carcinoma(HE) x 50
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Pleural tumors
Mesothelioma
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Pleural mesothelioma
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Epithelial mesothelioma
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Sarcomatous mesothelioma
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Lymphnode stations
Lymphnode stations are shown projected onto a chest-roentgenogram
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Pattern of Spread
1. Direct extention to adjecent structure
2. Aerogenous spread
3. Lymphatic spread
4. Hematogenous dissemination
5. Pleural seeding
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The Border of the Metastasis Tumor Mass
Alveolar soft part sarcoma, well circumscribedwith pushing border. Metastases often have this appearance.
Irregular border: a nodule of metastatic leio-myosarcoma extends into the interstitium of the surrounding lung
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Pattern of MetastasisPattern of Metastasis
Multinodular metastasisMultinodular metastasis
Yellow appearance to the metastatic nodules:abundant fat content of primary tumor: renal- cell carcinoma
Black appearance in some nodules: primaryTumor is malignant melanoma
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Pattern of MetastasisPattern of Metastasis
“Cannonball” metastasis“Cannonball” metastasis
Primary tumor: osteogenic sarcoma. A variety of tumors: sarcoma, renal cell Ca, malignant melanoma, colorectal Ca, may produce this appearance
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SECONDARY TUMORS ( METASTASIS)