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M1 Histopathology Labs with Virtual Slides
The University of Michigan Medical School
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Histopath Lab 7:
Neoplasia I

INSTRUCTORS: First click here to
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Robbins and Cotran Pathologic Basis of Disease 9th Ed.

Suggested Reading:
Pages 265-275 – General Aspects
Pages 1101-1103 – Parathyroid Hyperfunction
Pages 1123-1127 – Adrenal Hyperfunction
Pages 807-810 – Colonic Adenoma
Pages 810-815 – Colonic Adenocarcinoma
Pages 1004-1006 – Cervical Cancer
Pages 1019-1021, 1223 – Leiomyoma, Leiomyosarcoma
Pages 1220-1221 – Lipoma, Liposarcoma


NEOPLASIA I


Slide 28 [WebScope][ImageScope]

Parathyroid Gland: This section is dominated by a circumscribed nodule of epithelial cells, which are pushing aside the normal gland tissue. Just outside of this nodule is a thin rim of normal parathyroid tissue, seemingly stretched or compressed by the nodule. Although not evident in the picture, the nodule is much larger than a normal parathyroid gland, which we know by its weight.

  • This nodule is composed of parathyroid cells similar to those seen in the normal tissue, but differs from the adjacent, more normal gland. In what respects does it differ?
  • Is this a parathyroid neoplasm or simply parathyroid hyperplasia? Why?
  • Is this neoplasm benign or malignant? What features support your answer?
  • What do you think is the diagnosis for this parathyroid lesion? How would this present clinically?
  • What laboratory tests could help establish the presence of this parathyroid lesion?

 

Slide 29 [WebScope][ImageScope]

Adrenal Gland: As you inspect this slide using low magnification, you'll see that the section includes part of a nodule attached to a segment of normal adrenal gland.

  • Review the architecture of the normal adrenal gland. You’ll be able to see the cortex and the medulla.
  • How does the architecture of the nodule differ from that of the normal adrenal cortex?
  • Is this an adrenocortical neoplasm or simply adrenocortical hyperplasia? Why?
  • Is this benign or malignant? What features would support a malignant adrenocortical carcinoma?
  • What do you think is the diagnosis for this adrenal lesion? How would this present clinically?
  • How might an adrenal lesion of this sort present clinically?
  • What is the proper name of a benign neoplasm of the adrenal medulla? What hormone would it produce?

 

Slide 30 [WebScope][ImageScope]

Colon: Inspect this slide under scanning power, noting two sections of the lesion. On one section, the lesion is a thickened plaque, while on the other it projects into the lumen of the colon as a broad-based polypoid mass.

  • Using scanning power, orient yourself to the various layers of the colonic wall, noting that the lesion is entirely confined to the mucosa (meaning that there is no invasion into the underlying structures of the colonic wall).
  • Now look specifically at the epithelium. Contrast the arrangement and low-power appearance of the epithelium in the mass itself with the more normal mucosa. Then compare the high-power features of this epithelium with the adjacent normal epithelium. How do they differ? What descriptor would you use for the abnormal epithelium?
  • Is it sufficient to call this polyp simply a “polyp”? Why or why not?
  • Is this benign or malignant? What would be the best way to support whether this is malignant rather than benign?
  • What is the chief clinical importance of this process?

 

Slide 31 [WebScope][ImageScope]

Colon: As you inspect this slide under scanning power, you'll note a sessile mass projecting from the surface.

  • Compare the epithelium in this mass with that of the normal colonic mucosa.
  • What feature of this neoplasm identifies it as malignant and distinguishes it from the lesion in Slide 30?
  • Why is the designation "adenocarcinoma" appropriate?
  • How do lesions like this present clinically?
  • What is the chief clinical importance of this process?

 

Slide 32 [WebScope][ImageScope]

Uterine Cervix:

  • How can you identify tissue as the uterine cervix? (Hint: inspect the normal epithelium on either side of the section.) Identify the ectocervical squamous mucosa and endocervical glandular mucosa.
  • Under low magnification, note the masses of epithelium extending deep into the substance of the cervix. Normally, the stratified squamous epithelium makes a fairly thin layer over the fibromuscular tissue of the cervix. These deeper masses of epithelial cells are invading the underlying tissues.
  • Compare the epithelium in the invading masses with that of the immediately adjacent mucosa and that of the more distant ectocervical squamous mucosa. Immediately adjacent to the neoplasm, the squamous epithelium is dysplastic.
  • What features of the invasive epithelium enable you to identify it as squamous cell carcinoma?
  • How would such a lesion present clinically? What virus typically causes squamous cell carcinoma in the uterine cervix?
  • What would be the biggest clinical concern in a patient with this disease?

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