7. Malignant and Salivary Gland Neoplasms

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.

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7. Malignant and Salivary Gland Neoplasms