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Histopathological variants of squamous cell carcinoma

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Histopathological variants of squamous cell carcinoma

  1. 1. Give an overview of the other histopathological variants of SCC
  2. 2. Variants of squamous cell carcinoma There are important variants of squamous cell carcinoma which may present particular diagnostic difficulties; these include: 1. Verrucous carcinoma 2. Spindle cell carcinoma 3. Adenoid squamous cell carcinoma 4. Pseudovascular adenoid squamous cell carcinoma 5. Adenosquamous carcinoma 6. Basaloid squamous cell carcinoma.
  3. 3. Verrucous carcinoma. indolent lesion characterized by an endophytic papillary or verruciform surface, a pushing invasive front and a high degree of differentiation with little cytological atypia.
  4. 4. The photomicrograph shows the invagination of epithelium, the invasive downward growth of the epithelium, and the chronic inflammatory cells just below the invading epithelium. The lesion displays a highly keratinized surface that is papillary, with inflammatory cell infiltrate immediately adjacent to the margins of the invading neoplasm. Verrucous carcinoma-broad bulbous pushing rete ridges with parakeratotic plugging (H&E stain, ×100)
  5. 5. Spindle ceil carcinoma The oral cavity spindle cell carcinomas are usually fungating ulcerative lesions which arise most commonly on the lips, the spindle cell component probably represents anaplastic change in an otherwise conventional squamous cell carcinoma. tongue or gingivae and have a poor prognosis.
  6. 6. A) Oral spindle cell carcinoma. Clinical aspect showing an ulcerated exophytic mass on the upper alveolar ridge. B) (B) Proliferation of dysplastic spindle cells (H&E, original magnification – OM 100×). C) (C) Transition between tumoral spindle cell and dysplastic squamous cell components (H&E, OM 400×). D) (D) Presence of abundant mitosis (H&E, OM 400×; arrows)
  7. 7. Elongated and serpentine spindle cells infiltrate widely into the connective tissues and usually show obvious features of Mlignancy including bizarre pleomorphic nuclei and many abnormal mitoses the diagnosis must be made by the demonstration of an origin from overlying epithelium or by the finding of conventional squamous cell carcinoma elsewhere.
  8. 8. Adenosquamous carcinoma. This carcinoma is a distinct entity which may arise at any site in the upper aerodigestive tract as well as the GI tract and skin. It is relatively rare in the oral cavity but when it does arise it is an aggressive neoplasm with a worse prognosis than squamous cell carcinoma. The lesion is characterized by the presence of areas of squamous cell carcinoma closely associated with, but separated from, areas of adenocarcinoma with glandular differentiation and mucin production. The lesion arises from surface epithelium but simultaneously involves the ducts of minor salivary glands.
  9. 9. (a) Stratified squamous epithelium (indicated by arrow mark) infiltrating into underlying connective tissue stroma (indicated by an asterisk) (H&E stain, ×40). (b) Squamous component (indicated by arrow mark) and glandular component (indicated by asterisk) (H&E stain, ×100)
  10. 10. Adenoid squamous cell carcinoma may resemble adenosquamous carcinoma, but in this case the glandular pattern is due to loss of adhesion and acantholysis of cells in the centre of islands of conventional squamous cell carcinoma. Accordingly this lesion is also referred to as 'pseudoglandular' or 'acantholytic carcinoma’. Mucin is not produced.
  11. 11. Adenoid squamous cell carcinoma -pseudoglandular pattern with acantholytic tumor cells.
  12. 12. Pseudovascular adenoid squamous cell carcinoma (PASCC) is an uncommon histological variant of squamous cell carcinoma that can mimic vascular neoplasms, particularly angiosarcoma, in its morphologic characteristics.
  13. 13. (a, b) Tumor with anastomosing vessel-like channels, lined by a single layer of malignant cells (c, d) showing tumor with dilated and congested blood vessels (H and E, ×100)
  14. 14. Basaloid squamous cell carcinoma variant of squamous cell carcinoma which arises most often in the tongue and is again associated with a worse prognosis and a higher incidence of distant metastases The diagnosis is made on the basis of a conventional squamous cell carcinoma arising from surface epithelium with areas showing solid lobules or islands of small darkly staining and pleomorphic basaloid cells. The basaloid component usually predominates and shows an infiltrative pattern with frequent central comedo necrosis.
  15. 15. Basaloid squamous cell carcinoma biphasic tumor showing basaloid malignant islands with peripheral palisading and comedonecrosis (arrow) (H&E stain, ×100). Inset depicts squamous differentiation with keratin pearl formation (arrowhead) (H&E stain, ×100)

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