Prostate Nodular hyperplasia

It is a benign lesion of prostate.   All men are affected after 50 years.
This is a patient with prostate hyperplasia,, 80 years old. Is performed prostatectomy radicale.
Clinical symptoms: periurethral  nodules  compress urethra and cause obstructive  of urinary tract.  Then can apear  infection, obstruction,  bladder hypertrophy.
I atached a microscopic picture of pacient prostate. We see  Hyperplasia of glandular and stromal tissue.
 Basal cell layer of glands  is continuous  that means isn 't a malign process.
 Stromal changes is  presence of  smooth muscle and inflamation cronic.
Treatment chirurgical and medicamentous.
 Transurethral resection of prostate is frecvent operation of these patience.
 Androgen antagonists.

Colonic adenoma

Adenoma-general of colon
Known case of colonic carcinoma operated 2 years back.
Colonoscopy shows small polyp 2 mm close to anastemosis site.
Colonic adenom is a a premalignant lesion. Are present  polypoid areas of epithelial dysplasia.
In photo we see in left part of image normal glands of colon.  In right is the lesion.  Cytological and architectural changes  are in favour of  dysplasia;
Nuclei are enlarged, hyperchromatic .Nuclei are stratified.  architectural changes  and loss of polarity are minimal.
 Reduced mucin of cells.
Conclusion is: low  grade dysplasia present in colonic  adenoma.
Treatment is chirurgicaly excision of adenoma and  monitorize the pacient.

Papillary urothelial neoplasm of low malignant potential

Papillary urothelial neoplasm of low malignant potential
It is a case from 45 years old , sex masculin with hematuria. Lesion was 1 cm , polypoid formation in lateral wall of bladder.
This lesion preferred  the lateral posterior wallsof bladder  and ureteric orifices. Rareis  associated with invasion or metastases.

Micro description: papillae with minimal architectural abnormalities. Minimal nuclear atypia, and  cell thickness of bladder

Reduced cytoplasmic clearing compared to normal urothelium bladder. The  epithelium  is thicker than papilloma.

Excellent prognosis when totally tumor is excised.

Gastric signet ring cell carcinoma

It is a case from a patient with  ulcer in the prepyloric area of stomach of male patient 49 years old.
 Gastric cancer is in the majority cases  asymptomatic.
 Symptoms present: weight loss, abdominal pain, nausea, vomiting.
Mycroscopic- This is a signet ring cell pattern of adenocarcinoma in which the cells are filled with mucin.  vacuoles  push the nucleus  to one side.
Cells infiltrate as individual cells or small clusters. This malignant cells  can infiltrate  entire stomach.
In photo you can see these malignant cells.
Treatment: gastrectomy, chemotherapy.

Hepatocellular carcinoma-Fibrolamellar variant

Hepatocellular carcinoma-Fibrolamellar variant
Common variant in young adults 20-40 years.  Is  characterized by  oncocytic cells in dense acellular collagen bundles.
Not association  with hepatitis B virus or  cirrhosis  of liver.
Treatment is aggresive surgery.
Macroscopic is a lesion singl, large  hard, white-brown tumor.  Are present  fibrous bands  in liver parenchimat and central stellate scar.
This tumor at is more common in left lobe of liver. Present  bile staining, hemorrhage and necrosis.
Microscopic diagnosis:
Are present  nests, sheets of  oncocytic cells in  collagen bundles. This bundle are  arranged in parallel lamellae way.
Cells are large and polygonal, abundant, eosinophilic cytoplasm.
Can be present  pale bodies : are PAS+ hyaline globules.
Vascular invasion and necrosis  in carcinoma fibrolamelar is frecvent
Radiologic calcification corresponds to necrosis  reaction.
For diagnosis i used imunochemistry like: HepPar and CK7 which help me in diagnosis.
Thanks
+liver
+fibrolamelar  hepatic carcinoma

Skin-melanocytic tumor Spitz nevus

Benign tumor of spindled and epithelioid melanocytes
.Epidemiology
Usually occurs before puberty, but 2/3 were age 20+ years.

• Sites
• Trunk most common; also lower extremities, head and neck
• Tongue lesions may have pseudoepithelio matous hyperplasia and resemble malignancy.
  
  

Small, symmetrical, pink-tan lesion

Micro description

• Symmetric with sharp lateral borders, usually compound nevus with prominent intraepidermal component
• 5% are junctional, 20% are dermal
• Composed of spindled and epithelioid cells
• Spindle cells may be arranged in fascicles in dermal papillae, are perpendicular to epidermis, cigar-shaped with large nuclei, have prominent nucleoli
• Epithelioid cells are dispersed individually, polygonal with abundant eosinophilic cytoplasm, distinct cell borders, large nuclei and prominent nucleoli, have variable mitotic figures, occasional multinucleation and often marked atypia, although most cells appear benign
• Cell maturation occurs in deep portion of tumor

Skin - Actinic keratosis

Also called solar keratosis or senile keratosis
Exposure to sunlight. On sun-exposed sites (face, arms, dorsum of hands)
● Called actinic cheilitis in lips
● May become invasive with only a single layer of atypical keratinocytes
Risk factors:● Fair skin, ionizing radiation, hydrocarbon or arsenic exposure, renal transplant

                                                                                                                                                               

Actinic keratosis  (a) One of the first clues to the diagnosis  is the discontinuity of the parakeratosis as the dysplastic process spares adnexal structures. Note the lack of parakeratosis over the sebaceous gland. This specimen also demonstrates dense dermal elastosis (b)  keratinocyte dysplasia confined to the lower third of the epidermis (200x). (c) A more established lesion of AK demonstrating nearly full thickness keratinocyte dysplasia and prominent budding of the basal layer into the superficial dermis

Treatment:

● Curettage, cryotherapy, topical chemotherapeutic agents (Imiquimod, 5-FU)