Benign tumors
• Chondroma (gross +
microscopic)
• Osteochondroma(gross
+ microscopic)
Malignant
tumors
• Osteosarcoma(gross +
microscopic)
Locally
malignant
tumors
• Giant cell tumor
(microscopic )
Chondroma of Hand
Tumour mass with
well formed capsule
Left hand (Adult)
Specimen:
Comment :
Cut surface : (mass)
Sum: single
Site: at region of metacarpal bones destroying and replacing them
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Shape: oval- well circumscribed- encapsulated
Size: 8x6 cm
Cut surface: myxomatous degeneration (Honey comb appearance)
Diagnosis :
chondroma
Chondroma
Capsule
Thin vascular
fibrous tissue
septa
Lobules of
mature
cartilage
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Nature: BENIGN MESENCHYMAL
TUMOR of cartilage
Diseases of bone: Chondroma
Mature bland
chondrocyte
Homogenous blue
chondroid matrix
Capsule
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Lacunae (appears as a clear space)
Organ :
Cartlagenous mass
Diagnosis :
Chondroma
Nature of the lesion :
Benign tumor—mesenchymal (cartilagenous )
Important patholgical findings :
1. encapsulated lesion
2. Lobules of mature cartilage
3. Thin vascular fibrous tissue septa
Osteochondroma x-ray/ mushroom
appearance
Osteochondroma
Piece of flat bone
Cancellous bone
Cartilaginous cap
Calcification
Cartilage
exophytic oval bony swelling (mushroom appearance)
Osteochondroma
foci of calcifications
A stalk & head of the
tumour is formed of
woven bone with a
bone marrow cavity
continuous with that
of bone covered by a
cartilagenous cap
Specimen:
Comment :
Irregular bony tumor mass
Cut surface : (mass – focal lesion)
Sum: single
Shape: mushrom shaped covered by cartilagenous cap
Size: 5x4 cm
Consistency: hard
Diagnosis :
Osteochondroma
Cartilagenous exostosis
Osteochondroma microscopic
• Bone trabeculae
covered by linear
hyaline cartilage
NEXT?
Osteosarcoma x ray
• Sun ray
appearance:
perpendical rays of
sclerotic bone to
bone cortex
• Codmanns triangle:
at the angle of
elevated
periosteum from
bone cortex
Osteosarcoma
• Specimen: lower
part of femur
• An ill defined mass
infiltrating medulla
and bone cortex
causing pathological
fracture. Cut section
shows Hemorrhage,
necrosis, cystic
degeneration
Specimen:
Comment :
Lower part of femur
Cut surface : focal lesion (mass)
Sum: single
Site: arising from the Metaphysis
Shape: irregular infiltrating and destroying surrounding tissue,
head,and bone marrow,….
Size:…..x……cm
Colour: greyish white with areas of hemorrhage and necrosis
Consistency: Fleshy
Diagnosis :
Osteosarcoma
Intramedullary
Production
osteoid
of
Malignant
osteoid
Malignant
osteobalasts
Bone and soft tissue pathology.Andrew Horvai
Mitotic activity
Organ :
Diagnosis :
Bone mass
Osteosarcoma
Nature of the lesion :
Metaphyseal malignant tumor (osteoid producing)
Important patholgical findings :
1. Malignant osteoblasts.
2. Malignant osteoid.
3. Hemorrhage and necrosis.
”
Giant Cell Tumor
Clinical keynotes:
•Usually young adults
•Commonly epiphysis of lower
end of femur and radius, upper
end of tibia and humerus
•The mass is
Radiolucent mass
in lower femur traversed
by thin sclerotic lines
giving soap bubble
appearance.
with thinned cortex
Giant Cell Tumor
Nature of this lesion: locally malignant bone tumor of unknown cell of origin
Giant Cell Tumor
Mononuclear stromal cells:
- NEOPLASTIC -Plump, oval cells with scanty cytoplasm and large
vesicular nuclei with prominent nucleoli
Multinucleated large osteoclast-like giant cells:
-DIAGNOSTIC -Evenly distributed -Numerous,contain up to 100
End of muscloskeletal
Skin
Benign
Malignant
• Squamous cell
papilloma
• Squamous cell
carcinoma
• Basal cell carcinoma
• Malignant
melanoma
Squamous cell papilloma
Squamous cell papilloma
Identification:
•Papillary surface with broad
base or papillary structure
•Stratified Squamous epithelium
covering
Squamous cell papilloma
Hyperkeratosis
Papillomatosis
Acanthosis
Squamous cell papilloma
Hyperkeratosis
Acanthosis
acanthosis
Squamous cell papilloma
Papillomatosis
Vascular
onnective tissue
core
Acanthosis
Hyperkeratosis
Organ :
Skin mass
Diagnosis :
Squamous cell papilloma
Nature of the lesion :
Benign tumor—surface epithelial
Important patholgical findings :
1. Papillary growth
2. Stratified squamous epithelial lining showing:
a) Hyperkeratosis (increased keratin)
b) Acanthosis (increased prickle cell layer)
c)Papillomatosis (elongated dermal papillae)
3. Branching fibrovascular connective tissue core
Malignant Tumors
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Squamous cell carcinoma
Ulcer on the face with raised everted edges, necrotic floor
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Nuclear ccc of malignancy
1.
2.
3.
4.
5.
Large nuclei-increased N/C ratio
Pleomorphism(different shapes)
Hyperchromatism (dark)chromatin clumping
Prominent nucleoli.
Mitotic figures
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Squamous cell carcinoma
Stratified
Squamous
epithelium
Ulcer
Hair
follicle
Sebaceous
gland
Groups of
malignant
squamous
epithelial
cells
Epithelial
Pearl
(cell nest)
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Squamous cell carcinoma
Stratified Squamous epithelium
malignant
squamous epithelial
cells
Well differentiated
squamous cell carcinoma
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Cell nest
Squamous cell carcinoma
Stratified Squamous epithelium
Cell nest
Ulcer
Well differentiated
squamous cell carcinoma
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Squamous cell carcinoma
Ulcer
Epithelial
pearl
T
Moderately differentiated
squamous cell carcinoma
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Organ :
Diagnosis :
Skin mass
Squamous cell carcinoma
Nature of the lesion :
MALIGNANT EPITHELIAL TUMOR (surface epithelial)
Important patholgical findings :
1. Surface Ulcer and Infiltration of the wall by a malignant tumor
2. Tumor cells architecture: nests formed of malignant cells+ central keratin
pearls (laminated eosinphillic)+ invade basement membrane to permeate
underlying connective tissue
3. Tumor cells morphology: polygonal with eosinophillic cytoplasm and have
hyperchromatic, irregular, pleomorphic, large nuclei with increased N/C ratio,
prominent nucleoli & atypical mitosis
Basal cell carcinoma
Large rodent ulcer with a rolled , inverted
beaded edge on the medial canthus and right
side of the nose
Ulcer at left side of nose
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Basal cell carcinoma
Identification
skin
Ulcer
Peripheral nuclear
palisading
masses of
malignant
basaloid
epithelial
cells
Peripheral
palisading
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Basal cell carcinoma
T
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Basal cell carcinoma
Skin
Ulcer
masses of
malignant
basaloid
epithelial
cells
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Basal cell carcinoma
Nuclear palisading
Masses of
malignant
basaloid cells
Fibrous stroma with
inflammatory cells
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Basal cell carcinoma
Neoplastic
masses with
palisading
Malignant basaloid
epithelial cells
(darkly stained)
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Basal cell carcinoma
Inner
polygonal
cells
Outer columnar cells arranged in a palisade manner
Cells show scanty cytoplasm & large oval hyper chromatic nuclei
Back to Slide
Organ :
Diagnosis :
Skin mass
Basal cell carcinoma
Nature of the lesion :
MALIGNANT EPITHELIAL TUMOR (surface epithelial)
Important patholgical findings :
1. Surface Ulcer and Infiltration of the wall by a malignant tumor
2. Tumor cells architecture: The dermis is infiltrated by masses and nests of
darkly stained blue malignant basaloid cells.
• Tumor cells morphology:
a. the outer layer of cells is formed of columnar cells arranged in a palisade manner.
b. The inner cells are polygonal.
c. The malignant cells have scanty cytoplasm and large oval hyperchromatic nuclei.
3. The masses are separated by fibrous stroma infiltrated by inflammatory cells .
Malignant Melanoma
Malignant Melanoma
identification
Malignant melanocytes
N.E.
Ulcer
Anorectal junction
Groups of
Malignant
melanocytes
Infiltrating
Single
malignant
melanocytes
Malignant Melanoma
T
Malignant Melanoma
T
Malignant Melanoma
Squamous
epithelium
T
Malignant Melanoma
T
Malignant Melanoma
Malignant
cells with
melanin
pigment
Organ :
(Skin//Anorectal) mass
Diagnosis :
Malignant melanoma
Nature of the lesion :
MALIGNANT EPITHELIAL TUMOR (Melanocytes)
Important patholgical findings :
Subepithelial tissue is infiltrated by masses of malignant cells.
1. These cells are epithelioid or spindle in shape
2. The malignant cells have scanty cytoplasm and large oval hyperchromatic nuclei.
3. Brown melanin pigment is seen both in the cytoplasm of the malignant cells and also
extracellular
4. Stroma is scanty with areas of hemorrhage and necrosis.
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