Reversible Dysplasia

Normal cervical squamous epithelium at the left, dysplastic squamous epithelium at the right.

Dysplasia: disorderly growth of epithelium but still confined to the epithelium; the next step toward neoplasia but still reversible.

Dysplastic cervical epithelium

At high magnification, the normal cervical squamous epithelium at the left merges into the dysplastic squamous epithelium at the right which has more disorderly cells.

Neoplasm

There's a mass of abnormal tissue on the surface of the cervix.

Neoplasm: uncontrolled new growth; often used synonymously with "tumor" but a tumor can mean any mass effect(inflammatory, hemodynamic, or neoplastic); not reversible once started.

Squamous Cell Carcinoma

Disorderly growth of the squamous epithelial cells in these large nests with pink keratin in the centers.

Adenomatous polyps of the cecum

A case of familial polyposis.

Dysplastic tubular adenoma

Left side is normal, right side is dysplastic.

Fibroadenoma of the breast

A benign neoplasm more commonly found in younger women of reproductive age. The blue dye was injected during a radiographic procedure to mark the location of the neoplasm so the surgeon could find it.

Breast fibroadenoma

This fibroadenoma has compressed ducts surrounded by a fibrous stroma. These lesions are most likely to be found as a breast lump on examination of young women: discreet, firm, rubbery masses that are freely movable.

Multiple benign neooplasms in uterus

Benign neoplasms can be multiple, as is shown in this uterus with leiomyomas of varying size but all benign and well-circumscribed firm white masses. The most common neoplasm is a benign nevus (pigmented mole) of the skin. Benign neoplasms do not give rise to malignant neoplasms.

Hepatic Adenoma

The cut surface of the liver reveals them. Very well circumscribed with the remaining liver a pale  yellow brown b/c of fatty change from chronic alcoholism.

Hepatic Adenoma

Normal liver tissue with a portal tract on the left hepatic adenoma on the right composed of cells that resemble normal hepatocytes, but the neoplastic liver tissue is disorganized hepatocyte cords and doesn't contain a normal lobular architecture.

Infiltrating ductal carcinoma of the breast

Center is very firm(scirrhous) and white because of the desmoplasia. There's areas of yellowish necrosis in the portions of neoplasm infiltrating into the surrounding breast. These tumors appear very firm and non-mobile on physical exam.

Malignancy of the breast

Associated with a faster rate of growth and a fibrotic process called desmoplasia, which hardens the tumor and makes it immobile.

Infiltrating ductal carcinoma of the breast-low magnification

Appears to radiate from a central area of desmoplasia, the collagenous component gives the neoplasm a hard "scirrhous" consistency that's palpable. Such an invasive carcinoma may be fixed to underlying chest wall, making it non-mobile.

Hepatocellular Carcinoma

Such liver cancers arise in the setting of cirrhosis.

Viral hepatitis is the most common cause worldwide, but in the US chronic alcoholism is the most common cause. 

The neoplasm is large and bulky and has a greenish cast b/c it contains bile. To the right of the main mass are smaller satellite nodules.

Hepatocellular Carcinoma

Malignant cells (seen mostly on the right) are well differentiated and interdigitate with normal, larger hepatocytes (seen mostly on the left).

Renal Cell Carcinoma

Arises in the lower pole of the kidney, fairly circumscribed. Cut surface demonstrates a variegated appearance w/ yellowish areas, white areas, brown areas, and hemorrhagic red areas. These neoplasms are usually slow-growing, they can often reach a considerable size before detection b/c there's a lot of room to engage i the retroperitoneum and there's another kidney to provide renal function. Presenting signs and symptoms: flank pain, mass effect, and hematuria.

Renal Cell Carcinoma

Classic histologic appearance: neoplastic cells have clear cytoplasm and are arranged in nests w/ intervening blood vessels->why they're often called "clear cell carcinomas".

Nodular melanoma from the back

This lesion should have been excised long ago, but metastases are present when the lesion's allowed to reach this size.

Malignant Melanoma

Large polygonal cells(or spindle cells in some cases) have very pleomorphic nuclei that contain prominent nucleoli. Neoplasm is making brown melanin pigment. A Fontana-Masson stain for melanin may help to detect small amounts of cytoplasm melanin.

Cross section through the mesentery

Reveals multiple enlarged lymph nodes that abut each other. Unlike metastases, nodes w/ lymphoma tend to have little necrosis and maintain a solid, fleshy tan appearance. High grade non-Hodgkin's lymphoma tends to involve a signal node , localized group of nodes or extranodal site. Low grade NHL tends to involve multiple lymph nodes.

Large cell NHL

About half of the NHL cases in adults are large cell, can be associated with immunosuppressed states like AIDS, can be B or T cell origin. Cells are large, w/ prominent nucleoli and abundant cytoplasm. This disease tends to be localized at low stage, but with more rapid enlargement, and a greater propensity to be extranodal than the low grade lymphomas.

Squamous cell carcinoma

Extends from hilum to pleura, the black areas represent anthracotic pigment trapped in the tumor.

Squamous cell carcinoma-microscopic

Nests of polygonal cells with pink cytoplasm and distinct cell borders. The nuclei are hyperchromatic and angular.

Femur with a large eccentric tumor mass

Arises in the metaphysel region, this is an osteosarcoma (a varient known as parosteal osteogenic sarcoma) of bone. Tumors most often occur in  young persons(epiphysis at the right is still present).

Osteosarcoma

Neoplastic spindle cells are seen to be making pink osteoid here. Osteoid production by a sarcoma is diagnostic of osteosarcoma.

Metastases to the liver

Tan-white masses are multiple and irregularly sized. Like many large metastatic lesions, there's a central necrosis. A primary neoplasm is more likely to be a solitary mass, the presence of metastases are the best indication that a neoplasm is malignant

Metastatic adenoarcinoma in a lymph node

It's common for carcinomas to metastasize to lymph nodes. The first nodes invovled are thoe draining the site of the primary neoplasm.