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7/29/2019 7. Malignant and Salivary Gland Neoplasms
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MALIGNANT LESIONS
Prepared by: Gustavo A. Reyes
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Bronchial Carcinoma- any epithelial carcinoma occuring
in the bronchopulmonary tree.
Neuroendocrine Tumors
-Typical Carcinoid
-Atypical Carcinoid
-Large cell neuroendocrinecarcinoma.
-Small Cell Carcinoma
BRONCHIAL
CARCINOMA
Non- Small Cell Lung
Carcinomas
-Squamous Cell
Carcinoma
-Large Cell Carcinoma
-Adenocarcinoma
- Bronchoalveolar
carcinoma
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Currently, the pathologic diagnosis of lung
cancer is based on light microscopic criteria.
Immuno-histochemical staining & electron
microscopy are used as adjuncts in diagnosis,
particularly in the assessment of
neuroendocrine tumors.
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Non- Small Cell Lung Carcinoma
Encompasses many tumor cell types, including
adenocarcinoma, squamous cell carcinoma &
large cell carcinoma.
Although they differ in appearance
histologically, their clinical behavior &
treatment options are similar.
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Squamous Cell Carcinoma
30-40% of lung cancers. Males> Females; highly associated with
cigarrete smoking.
Histologically: cells develop a pattern ofclusters with intracellular bridges & keratin
pearls.
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Primarily located centrally & arises in the major
bronchi.
- Hemoptysis
- bronchial obstruction- Atelectasis
* Central Necrosis is frequent with resultantabscess formation.
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Adenocarcinoma
25-40% of all lung cancers.
Females> Males.
Peripherally based tumor.
Histologically: composed of glands with or without
mucin production, combined with destruction ofcontiguous lung architecture.
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Bronchoalveolar Carcinoma
5% of all lung cancers.
Its a subtype of adenocarcinoma.
Differs from adenocarcinoma in that, rather than
invading & destroying lung parenchyma, its tumor
cells multiply and fill the alveolar spaces.
It grows within alveoli/alveolar spaces: tumor cellscan seed aerogenously to other parts of the same
lobe, lung or contralateral lung.
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Bronchoalveolar carcinoma
Columnar Cells that proliferate along the framework of
alveolar septae.
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Large Cell Carcinoma
10-20% of lung cancers. Maybe located centrally or peripherally.
30-50 m. They are often admixed with other
cell types such as squamous cells oradenocarcinoma.
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Neuroendocrine Neoplasms
Essential Neuroendocrine Markers for Dx:
-Chromogranins
-Synapthophysin
- CD57
-Neuron-specific Enolase
Grade I NEC(neuroendocrine carcinoma)
Grade II NEC
Grade III
Classical or Typical Carcinoid
Atypical Carcinoid
Large Cell Type/Small Cell type
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GRADE I NEC
Classical/Typical
Low grade epithelial tumor.
Arises primarily in centralairways but can occur
peripherally.
Tumor cells are arranged in the
cords and clusters with a rich
vascular stroma.
Regional lymph node
metastases are seen in 15% ofpatients but rarely spread
systematically of cause death.
- Classicaly presents with;-
Hemoptysis
Airway obstruction
Pneumonia
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GRADE II NEC
Histologic findings may
include necrosis, nuclear
polymorphism & highermitotic rates.
Lymph node metastases
are found 30-50% of thepatients
- Aggressive clinical behavior.
- Etiologically linked to
cigarrete smoking
- Peripherally located
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GRADE III NEC
Tumor consists of smaller
cells (10-20um) that have
very little cytoplasm & verydark nuclei.
Tumors have mitotic rate &
areas of extensive necrosis. Multiple mitoses are easily
seen.
-Most malignant.
-Small Cell Lung Carcinoma.
- 25% of all lung cancers.
- Leading producers ofparaneoplastic syndromes.
-Tumors are centrally located.
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Salivary gland-type neoplasm
Histologically identical to those seen in the
salivary glands.
The 2 most common are adenoid cystic
carcinoma & mucoepidermoid carcinoma.
Both occurs centrally. Its a slow-growing
tumor that is locally and sytemically invasive..
It tends to grow submucosally and infiltrate
along perineural sheaths.