Pr.

Pathology Slides
(Lab 5: Tumors)
Prepared by:
Omer Abdullah

Information by:
Karbeen bestwn
Benign epithelial tumors
Squamous papilloma (epithelial)

Microscopically:
Central fibro-vascular core, covered
by stratified squamous epithelium

Grossly:
1. Finger-like projection
2. It is a benign tumor, arises from
the stratified squamous
epithelium (e.g. skin, oral cavity,
pharynx and vagina)
Squamous papilloma (epithelial)
Stratified Squamous epithelium

Microscopically:
Central fibro-vascular core,
covered by stratified squamous
epithelium

Fibrovascular core Grossly:

1. Finger-like projection
2. It is a benign tumor, arises
from the stratified squamous
epithelium (e.g. skin, oral
cavity, pharynx and vagina)
Squamous papilloma (epithelial)

Stratified sqamous epithelium Microscopically:

Central fibro-vascular
core, covered by
stratified squamous
epithelium

Grossly:
1. Finger-like projection
2. It is a benign tumor,
arises from the
stratified squamous
epithelium (e.g. skin,
Fibrovascular core oral cavity, pharynx
and vagina)
Adenomatous
polyp
Adenomatous colonic polyp (pedinculated)
Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular
core, covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
Pedinculated adenoma
polyp 3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Multiple sessile adenomatous polyposis coli

Adenomatous polyposis coli

Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular
core, covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated

More than 100 polyp

Large adenomatous colonic polyp (pedinculated)
Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is (tubular,
villous or tubule-villous) adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Multiple sessile colonic polyp

Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Sessile polyp, villous adenoma
Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated

Villous polyp (may become malignant)

Tubular adenoma
Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Multiple tubular adenoma
Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Tubular adenoma
Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Tubular adenoma

Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Dysplastic adenoma

dysplasia
 Villous polyp
Villous adenoma
Saw tooth appearance

Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular core,
covered by intestinal mucosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Normal dysplastic

The dysplastic changes in adenoma

Villous adenoma
Arise from: Mucosal layer

Microscopically:
1. Consist of central fibro-muscular
core, covered by intestinal muscosa
2. The architecture of the gland is
(tubular, villous or tubule-villous)
adenoma
3. Shows various degree of dysplasia
4. The architecture will change, due to
lack of goblet cells

Grossly:
1. Small or large
2. Single or multiple
3. Sessile or pedunculated
Villous adenoma
Follicular thyroid adenoma (adenomatous polyp)

Microscopically:
Consist of closely packed thyroid
follicles, lined by a single layer of
follicular epithelium, containing central
colloid material

Grossly:
Capsulated, solitary, benign, well
defined epithelial tumor of thyroid gland
Follicular thyroid adenoma (adenomatous polyp)

Microscopically:
Consist of closely packed thyroid
follicles, lined by a single layer of
follicular epithelium, containing central
colloid material

Grossly:
Capsulated, solitary, benign, well
defined epithelial tumor of thyroid
gland
BENIGN STROMAL
TUMORS
Lipoma

Microscopically:
Consist of benign, mature, adipose
tissue

Grossly:
1. Single or multiple, soft yellow to
gray, lobulated, well defined mass
2. Asymptomatic, that is slow in
growth
3. It is the most common benign
tumor
Lipoma

Microscopically:
Consist of benign, mature, adipose
tissue

Grossly:
1. Single or multiple, soft yellow to
gray, lobulated, well defined
mass
2. Asymptomatic, that is slow in
growth
3. It is the most common benign
tumor
Lipoma
lipoma lipoma Microscopically:
Consist of benign,
mature, adipose tissue

Grossly:
1. Single or multiple,
soft yellow to gray,
lobulated, well
defined mass
2. Asymptomatic, that
is slow in growth
3. It is the most
common benign
tumor
Lipoma

Microscopically:
Consist of benign, mature,
adipose tissue

Grossly:
1. Single or multiple, soft yellow
to gray, lobulated, well defined
mass
2. Asymptomatic, that is slow in
growth
3. It is the most common benign
tumor
Lipoma

Microscopically:
Consist of benign, mature, adipose
tissue

Grossly:
1. Single or multiple, soft yellow to gray,
lobulated, well defined mass
2. Asymptomatic, that is slow in growth
3. It is the most common benign tumor
Outside part of colon (lipoma)

Microscopically:
Consist of benign, mature,
adipose tissue

Grossly:
1. Single or multiple, soft yellow
to gray, lobulated, well
defined mass
2. Asymptomatic, that is slow in
growth
3. It is the most common
lipoma benign tumor
Lipoma

Microscopically:
Consist of benign, mature,
adipose tissue

Grossly:
1. Single or multiple, soft
yellow to gray, lobulated,
well defined mass
2. Asymptomatic, that is slow
in growth
3. It is the most common
benign tumor
Lipoma

Microscopically:
Consist of benign, mature,
adipose tissue

Grossly:
1. Single or multiple, soft yellow
to gray, lobulated, well defined
mass
2. Asymptomatic, that is slow in
growth
3. It is the most common benign
tumor
LEIOMYOMA
(smooth muscle tumor)
Uterine leiomyoma (stromal) = Fibroid tumor

Microscopically:
Consist of interlacing bundles of smooth
muscle, with connective tissue in
between them

Grossly:
1. Sharply defined mass
2. Gray to white in color
3. Firm in consistency
4. If it is calcified, it can be cut, so it
must be decalcified
5. May be single or multiple
6. The cut surface or cut section has a
“whorl white” or “stormy form”
Uterine leiomyoma (stromal) = Fibroid tumor

Microscopically:
Consist of interlacing bundles of
smooth muscle, with connective tissue
in between them

Grossly:
1. Sharply defined mass
2. Gray to white in color
3. Firm in consistency
4. If it is calcified, it can be cut, so it
must be decalcified
5. May be single or multiple
6. The cut surface or cut section has
a “whorl white” or “stormy form”

Multiple uterine leiomyoma

Uterine leiomyoma (stromal) = Fibroid tumor

Microscopically:
Consist of interlacing bundles of smooth
muscle, with connective tissue in
between them

Grossly:
1. Sharply defined mass
2. Gray to white in color
3. Firm in consistency
4. If it is calcified, it can be cut, so it
must be decalcified
5. May be single or multiple
6. The cut surface or cut section has a
“whorl white” or “stormy form”

A single well-defined leiomyoma

Uterine leiomyoma (stromal) = Fibroid tumor

myometrium
Microscopically:
Consist of interlacing bundles of smooth
muscle, with connective tissue in between
them

Grossly:
1. Sharply defined mass
leiomyoma
2. Gray to white in color
3. Firm in consistency
4. If it is calcified, it can be cut, so it must be
decalcified
5. May be single or multiple
6. The cut surface or cut section has a
“whorl white” or “stormy form”
Uterine leiomyoma (stromal) = Fibroid tumor

Microscopically:
Consist of interlacing bundles of
smooth muscle, with connective
myometrium
leiomyoma tissue in between them

Grossly:
1. Sharply defined mass
2. Gray to white in color
3. Firm in consistency
4. If it is calcified, it can be cut, so it
must be decalcified
5. May be single or multiple
6. The cut surface or cut section
has a “whorl white” or “stormy
form”
Uterine leiomyoma (stromal) = Fibroid tumor

Microscopically:
Consist of interlacing bundles of
smooth muscle, with connective tissue
in between them

Grossly:
1. Sharply defined mass
2. Gray to white in color
3. Firm in consistency
4. If it is calcified, it can be cut, so it
must be decalcified
5. May be single or multiple
6. The cut surface or cut section has
a “whorl white” or “stormy form”
Uterine leiomyoma (stromal) = Fibroid tumor

Microscopically:
Consist of interlacing bundles of smooth
muscle, with connective tissue in
between them

Grossly:
1. Sharply defined mass
2. Gray to white in color
3. Firm in consistency
4. If it is calcified, it can be cut, so it
must be decalcified
5. May be single or multiple
6. The cut surface or cut section has a
“whorl white” or “stormy form”
BENIGN VASCULAR TUMORS
Capillary hemangioma

Cause:
Birth mark (Abnormal overgrowth of
blood vessels)

Microscopically:
1. Composed of closely packed small
capillary sized blood vessels, that are
lined by endothelial cells
2. Contain RBC’s with connective tissue
between them

Grossly:
Bright red or blue in color, elevated or
Hemangioma flat, on touch it doesn’t have any special
sensations, it may disappear with aging
Capillary hemangioma

Cause:
Birth mark (Abnormal overgrowth of
blood vessels)

Microscopically:
1. Composed of closely packed small
capillary sized blood vessels, that are
lined by endothelial cells
2. Contain RBC’s with connective tissue
between them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it doesn’t have any special
sensations, it may disappear with aging
Capillary hemangioma

Cause:
Birth mark (Abnormal overgrowth of
blood vessels)

Microscopically:
1. Composed of closely packed small
capillary sized blood vessels, that are
lined by endothelial cells
2. Contain RBC’s with connective tissue
between them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it doesn’t have any special
sensations, it may disappear with aging
Capillary hemangioma

Cause:
Birth mark (Abnormal overgrowth of
blood vessels)

Microscopically:
1. Composed of closely packed small
capillary sized blood vessels, that are
lined by endothelial cells
2. Contain RBC’s with connective tissue
between them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it doesn’t have any special
sensations, it may disappear with aging
Capillary hemangioma

Cause:
Birth mark (Abnormal overgrowth of
blood vessels)

Microscopically:
1. Composed of closely packed small
capillary sized blood vessels, that are
lined by endothelial cells
2. Contain RBC’s with connective tissue
between them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it doesn’t have any special
sensations, it may disappear with aging
Capillary hemangioma

Cause:
Birth mark (Abnormal overgrowth of
blood vessels)

Microscopically:
1. Composed of closely packed small
capillary sized blood vessels, that are
lined by endothelial cells
2. Contain RBC’s with connective tissue
between them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it doesn’t have any special
sensations, it may disappear with aging
Cavernous hemangioma

Microscopically:
Large dilated blood vessels,lined by
endothelial cells, containing RBCs and
connective (fibrous) tissue in between
them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it has a spongy sensation,
consist of large space
Cavernous hemangioma

Microscopically:
Large dilated blood vessels,lined by
endothelial cells, containing RBCs and
connective (fibrous) tissue in between
them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it has a spongy sensation,
consist of large space
Cavernous hemangioma (benign vascular tumor)

Microscopically:
Large dilated blood vessels, lined by
endothelial cells, containing RBCs and
connective (fibrous) tissue in between
them

Grossly:
Bright red or blue in color, elevated or
flat, on touch it has a spongy sensation,
consist of large space
Pyogenic granuloma

Microscopically:
composed of closely packed
small capillary sized blood
vessels, lined by endothelial
cells, containing RBCs and
connective tissue between them
(the connective tissue contains
inflammatory cells)

Grossly:
Rapidly growing mass in the skin
or oral mucosa, it has exophytic
growth, they may have stalk and
it easily bleeds
Pyogenic granuloma

Microscopically:
composed of closely packed small capillary
sized blood vessels, lined by endothelial cells,
containing RBCs and connective tissue
between them (the connective tissue contains
inflammatory cells)

Grossly:
Rapidly growing mass in the skin or oral
mucosa, it has exophetic growth, they may
have stulk and it easily bleeds
Pyogenic granuloma

Microscopically:
composed of closely packed small
capillary sized blood vessels, lined
by endothelial cells, containing
RBCs and connective tissue
between them (the connective
tissue contains inflammatory cells)

Grossly:
Rapidly growing mass in the skin or
oral mucosa, it has exophetic
growth, they may have stulk and it
easily bleeds
Pyogenic granuloma

Microscopically:
composed of closely packed small
capillary sized blood vessels, lined by
endothelial cells, containing RBCs
and connective tissue between them
(the connective tissue contains
inflammatory cells)

Grossly:
Rapidly growing mass in the skin or
oral mucosa, it has exophetic growth,
they may have stulk and it easily
bleeds
Pyogenic granuloma

Microscopically:
composed of closely packed small
capillary sized blood vessels, lined
by endothelial cells, containing
RBCs and connective tissue
between them (the connective
tissue contains inflammatory cells)

Grossly:
Rapidly growing mass in the skin or
oral mucosa, it has exophetic
growth, they may have stulk and it
easily bleeds

Inflammatory cells
Pyogenic granuloma

Microscopically:
composed of closely packed small
Inflammatory capillary sized blood vessels, lined
cells by endothelial cells, containing
RBCs and connective tissue
between them (the connective
tissue contains inflammatory cells)

Grossly:
Rapidly growing mass in the skin or
oral mucosa, it has exophetic
growth, they may have stulk and it
easily bleeds
MALIGNANT
EPITHELIAL
TUMORS
 SQUAMOUS
CELL CARCINOMA
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia, which
are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of keratin
due to invading of squamous cell carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as “leukoplakia”
Ulcerative squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia, which
are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of keratin
due to invading of squamous cell carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as “leukoplakia”
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia, which
are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of keratin
due to invading of squamous cell carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as “leukoplakia”
Squamous cell carcinoma of ear
Cause:
Sun exposure and cigarette smoking
Squamous cell carcinoma, exophytic mass of ear
Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia, which
are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of keratin
due to invading of squamous cell carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as “leukoplakia”
Ulcerative squamous cell carcinoma
Ulcerative squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking
Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia, which
are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of keratin
due to invading of squamous cell carcinoma
Grossly:
1. Nodule like ulcerative lesion with crusting on it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as “leukoplakia”
Ulcerative squamous cell carcinoma
Cause:
Ulcerative SCC Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia, which
are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of keratin
due to invading of squamous cell carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as “leukoplakia”
Well differentiated squamous cell carcinoma
keratin pearl Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
Well differentiated squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
Keratin pearl
3. In oral cavity it may be present as
“leukoplakia”
Well differentiated squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking
Keratin pearl
Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
Squamous cell carcinoma
Cause:
Sun exposure and cigarette smoking

Microscopically:
1. composed of sheets and nest of invasive
malignant stratified squamous cell epithelia,
which are eosiophilic with increase in N/C ratio,
hyperchromatic, mitotic, pleomorphism and
surrounded by inflammatory cells (in form of
lymphocyte-lymphocyte infiltration)
2. We can see keratin pearl when it is well
differentiated, which is an accumulation of
keratin due to invading of squamous cell
carcinoma

Grossly:
1. Nodule like ulcerative lesion with crusting on
SCC
it
2. Yellow in color with erythematous around
3. In oral cavity it may be present as
“leukoplakia”
 BASAL
CELL
CARCINOMA
Basal cell carcinoma
Cause:
Sun exposure

Microscopically:
1. The malignant cells composed of basophilic cells, they
grow in “nest”, they show various degrees of
(hyperchromasia, pleomorphism, mitosis, increase in
N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are parallel to
each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red elevated
papule over the skin, eosinophilic, with prominent
dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
metastasize, but deep and severe in certain location
Basal cell carcinoma
Cause:
Sun exposure

Microscopically:
1. The malignant cells composed of basophilic cells, they
grow in “nest”, they show various degrees of
(hyperchromasia, pleomorphism, mitosis, increase in
N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are parallel to
each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red elevated
papule over the skin, eosinophilic, with prominent
dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
metastasize, but deep and severe in certain location
Basal cell carcinoma
Cause:
Sun exposure

Microscopically:
1. The malignant cells composed of basophilic cells, they
grow in “nest”, they show various degrees of
(hyperchromasia, pleomorphism, mitosis, increase in
N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are parallel to
each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red elevated
papule over the skin, eosinophilic, with prominent
dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
metastasize, but deep and severe in certain location
Basal cell carcinoma
Cause:
Sun exposure

Microscopically:
1. The malignant cells composed of basophilic cells, they
grow in “nest”, they show various degrees of
(hyperchromasia, pleomorphism, mitosis, increase in
N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are parallel to
each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red elevated
papule over the skin, eosinophilic, with prominent
dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
metastasize, but deep and severe in certain location
Basal cell carcinoma
Cause:
cleft Sun exposure

Microscopically:
1. The malignant cells composed of basophilic
cells, they grow in “nest”, they show various
Peripheral pallisading degrees of (hyperchromasia, pleomorphism,
mitosis, increase in N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are
parallel to each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red
elevated papule over the skin, eosinophilic, with
prominent dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
metastasize, but deep and severe in certain
location
Basal cell carcinoma
Cause:
Sun exposure

Microscopically:
1. The malignant cells composed of basophilic
cells, they grow in “nest”, they show various
degrees of (hyperchromasia, pleomorphism,
mitosis, increase in N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are
parallel to each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red
elevated papule over the skin, eosinophilic, with
prominent dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
metastasize, but deep and severe in certain
location
Basal cell carcinoma
Cause:
Sun exposure
Squamous epithelium cleft
Microscopically:
1. The malignant cells composed of basophilic
cells, they grow in “nest”, they show various
degrees of (hyperchromasia, pleomorphism,
mitosis, increase in N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are
parallel to each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red
elevated papule over the skin, eosinophilic, with
prominent dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
Peripheral pallisading metastasize, but deep and severe in certain
location
Basal cell carcinoma
Cause:
Sun exposure

Microscopically:
1. The malignant cells composed of basophilic
cells, they grow in “nest”, they show various
degrees of (hyperchromasia, pleomorphism,
mitosis, increase in N/C ratio)
2. They also have 2 important characteristics:
a. Peripheral palisading: long axis of cells are
parallel to each other (only seen in periphery)
b. Presence of cleft: due to shrinkage of stroma

Grossly: they may be:

1. Nodule lesion that has telangiectasia: red
elevated papule over the skin, eosinophilic, with
prominent dilated blood vessel
2. Ulcerative lesion: it is destructive, appears as it is
pouched out, the edge of ulcer is rolled clinically
(called rodent ulcer)
3. Pigmented lesion: if it contains melanin, rarely
metastasize, but deep and severe in certain
location
Question:
Melanin arise
from what ?

Answer:
Melanocytes
ADENOCARCINOMA
Adenocarcinoma of esophagus
Cause:
Barrette’s esophagus

Microscopically:
Composed of malignant cells invading the
stroma, shows pleomorphism,
hyperchromasia, mitosis, increase in N/C
ratio and sometimes focal necrosis

Grossly: they may be:

1. Polypoid lesion: sessile or pedinculated,
large or small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls

Note: In this slide, the esophagus is lined by

squamous epithelia superficially, and there is
(malignant granular tissue)
Colonic adenocarcinoma
Cause:
High fat diet
It can be: mass, intestinal obstruction,
ulcerative, pain and bleeding

Microscopically:
Composed of malignant cells invading the
stroma, show pleomorphism, mitosis,
increase in N/C ratio, hyperchromasia and
sometimes focal necrosis

Grossly: they may be:

1. Polypoid: sessile or pedunculated, large
or small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls
Colonic adenocarcinoma
Malignant gland invading stroma
Cause:
High fat diet
It can be: mass, intestinal obstruction,
ulcerative, pain and bleeding
Microscopically:
Composed of malignant cells invading the
stroma, show pleomorphism, mitosis,
increase in N/C ratio, hyperchromasia and
sometimes focal necrosis
Grossly: they may be:
1. Polypoid: sessile or pedinculated, large or
small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls
Colonic adenocarcinoma
Cause:
High fat diet
It can be: mass, intestinal obstruction,
ulcerative, pain and bleeding

Microscopically:
Composed of malignant cells invading the
stroma, show pleomorphism, mitosis,
increase in N/C ratio, hyperchromasia and
sometimes focal necrosis

Grossly: they may be:

1. Polypoid: sessile or pedinculated, large or
small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls
Colonic adenocarcinoma
Cause:
High fat diet
It can be: mass, intestinal obstruction,
ulcerative, pain and bleeding

Microscopically:
Composed of malignant cells invading the
stroma, show pleomorphism, mitosis,
increase in N/C ratio, hyperchromasia and
sometimes focal necrosis

Grossly: they may be:

1. Polypoid: sessile or pedinculated, large or
small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls
Colonic adenocarcinoma
Cause:
High fat diet
It can be: mass, intestinal obstruction,
ulcerative, pain and bleeding

Microscopically:
Composed of malignant cells invading the
stroma, show pleomorphism, mitosis,
increase in N/C ratio, hyperchromasia and
sometimes focal necrosis

Grossly: they may be:

1. Polypoid: sessile or pedinculated, large or
small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls
Colonic adenocarcinoma
Cause:
High fat diet
It can be: mass, intestinal obstruction,
ulcerative, pain and bleeding

Microscopically:
Composed of malignant cells invading the
stroma, show pleomorphism, mitosis,
increase in N/C ratio, hyperchromasia and
sometimes focal necrosis

Grossly: they may be:

1. Polypoid: sessile or pedinculated, large or
small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls
Colonic adenocarcinoma
Cause:
High fat diet
It can be: mass, intestinal obstruction,
ulcerative, pain and bleeding

Microscopically:
Composed of malignant cells invading the
stroma, show pleomorphism, mitosis,
increase in N/C ratio, hyperchromasia and
sometimes focal necrosis

Grossly: they may be:

1. Polypoid: sessile or pedinculated, large or
small
2. Fungating mass
3. Ulcerative lesion
4. Or there may be no change, only
thickening of the walls
MALIGNANT
STROMAL
TUMOR
Leiomyosarcoma (Malignant tumor of smooth muscle)

Microscopically:
Characterized by presence of:
1. Necrosis
2. Pleomorphism
3. Frequent mitosis

Grossly:
1. Bulky tumor, fleshy
2. Invades the myometrium
3. Characterized by presence of
“foci of hemorrhage and
necrosis”
 leiomyosarcoma
Leiomyosarcoma

Microscopically:
Characterized by presence of:
1. Necrosis
2. Pleomorphism
3. Frequent mitosis

Grossly:
1. Bulky tumor, fleshy
2. Invades the myometrium
3. Characterized by presence of
“foci of hemorrhage and
necrosis”
 leiomyosarcoma
Leiomyosarcoma

Microscopically:
Characterized by presence of:
1. Necrosis
2. Pleomorphism
3. Frequent mitosis

Grossly:
1. Bulky tumor, fleshy
2. Invades the myometrium
3. Characterized by presence of
“foci of hemorrhage and
necrosis”
Leiomyosarcoma

Microscopically:
Characterized by presence of:
1. Necrosis
2. Pleomorphism
3. Frequent mitosis

Grossly:
1. Bulky tumor, fleshy
2. Invades the myometrium
3. Characterized by presence of
“foci of hemorrhage and
necrosis”
Leiomyosarcoma

Microscopically:
Characterized by presence of:
1. Necrosis
2. Pleomorphism
3. Frequent mitosis

Grossly:
1. Bulky tumor, fleshy
2. Invades the myometrium
3. Characterized by presence of
“foci of hemorrhage and
necrosis”