Nonepithelial tumors actuality of the topic
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NONEPITHELIAL TUMORS Actuality of the topic. The nonnepithelial tumors often take place, the immature tumors of this group are characterized by a complicated development and can cause death. The immature nonepithelial tumors often have the distinct cellular peculiarities that they lose the signs of tissue, they originated from, so there is a need to use histochemical, immunohistochemical and ultramicroscopic methods for establishing the correct diagnosis. It is necessary to be able to distinguish these tumors on the microscopic base, have the idea about the peculiarities of their hystogenesis, clinical development, complications, meaning for an organism. These knowledge and skills, gained at the lessons, are necessary for the doctors of every specialization, they also help at mastering the appropriate sections at the departments of radial diagnostics, therapy, surgery, oncology. Aim: to be able to distinguish morphological peculiarities of mature and immature nonepithelial tumors. Concrete aims Aims of the primary level To be able to
For you to know whether your primary level of knowledge corresponds to the necessary one, propose to complete several tasks. Tasks for the self-control of primary level of skills-knowledge Task № 1. During studying a skin tumor was stated that it has nonepithelial genesis, consists of prolonged cells fascicles, expressed desmins. Chose the possible source of its development:
Task № 2. During an operation a surgeon removed a tumor growing like a node. During the microscopic examination it was stated that its origin came from smooth tissue cells. In which of enumerated organs this node could localize?
Task № 3. In the region of talocrural joint at a child was removed a node of dense, semitransparent, shining on the section surface homogeneous tissue. Which tissue this node can come from?
Task № 4. Removed enlarged mesenteric lymphatic ganglia had the foci of black color, there was diagnosed the metastatic tumor from melanin forming cells during the histological examination. Point out an organ in which there are melanin producing cells as the most possible source of a tumor.
The keys for right answers for the self-control of the primary level of skills-knowledge: 1-5; 2-3; 3-3; 4-2. The information necessary for completing of skills-knowledge can be found in the following literary sources:
The main theoretical questions on the base of which the aiming tasks are possible to complete:
Literature for mastering skills-knowledge:
Additional literature
After studying the previous tasks for mastering skills-knowledge, the following aiming tasks are proposed to complete: Task № 1. At a man, aged 45, there was removed a tumor of the front lobe of the brain. During the histological examination there was stated that a tumor is metastatic, consisting of polymorphic spindle-shaped cells. For stating the histogenesis there was made immonuhistochemical examination according medial filaments. There was found only vimentin in the tumor cells. What tumor metastasized in the brain?
Task № 2. At a woman, aged 53, there was found a tumor in the hip muscle, growing like a nod. The tumor was removed, during the operation it was stated to be connected with aponeurosis. During the microscopic examination it was stated that the tumor consists of moderate polymorphic fibroblastic cells with big nuclei and collagenic fibers, the cells and fibers fascicles are of different thickness and go in different directions. There are a great quantity of mitosises, pathological at the same time. Your diagnosis:
Task № 3. At a woman, aged 50, during USE of uterus there were found two ganglia, situated subserously, about 6 sm in diameter each. The tumors were removed, during the microscopic examination there was diagnosed a fibromyoma of the uterus. What complication could develop at such localization of the tumor? 1. uterine bleeding; 2. parametritis; 3. pyelonephritis; 4. peritonitis; 5. metrovesical fistula. Task № 4. During the post-mortal examination of a woman, aged 65, a pathologist discovered a neoplasm looking like a sharply separated ganglia of purple-blue color in the liver. The tissue resembles a sponge on the incision. During the microscopic examination it was stated that a tumor consists of thin-walled cavities of different sizes and shapes, filled with blood; the cavities are covered with one layer of mature endothelial cells. Your prognosis:
Task № 5. There was found a tumor, 5 sm in diameter, at a man, aged 35 in the retroperitoneal space. The tumor was growing like a nod of dense consistency, sharply separated from surrounded tissues, of lobe structure on the incision. During the microscopic examination it was stated that the tumor is made of different in size groups of large, gigantic, round, processed cells with large light nucleus, great amount of cytoplasm, situated among the fascicles of podgy fibrillar connective tissue and neurotic fibers. Your diagnosis:
Task № 6. During the post-mortal examination of a man, aged 52, a pathologist discovered a neoplasm on the skin of the back 3 sm in diameter, brown-black in color. Microscopic the tumor consists of polymorphic cells with large hyperchromic nuclei, there is a large quantity of mytosises, often – pathological. There are a lot of granules of brown pigment in the cytoplasm. There is a dense lymphocytic infiltrate on the tumor border. Your diagnosis:
Methodical instructions for students’ work at the practical lesson on the topic: “Nonepithelial tumors” At the beginning you should check the correct answers of home assignment according to the keys. Your preparation for the lesson will be checked by the means of test-control. You must study the macro- and micropreparations, solve the situational tasks by yourself. The macroscopic forms of nonepithelial tumors are studied on the preparations “Fibromyoma of uterus”, “Melanoma metastasis into liver”, using the standard of the macroscopic diagnosis. On the microphoto- and micropreparations the morphology of “Fibromyoma of uterus” “Cavernous hemangioma of liver”, “Melanoblastoma of an eye”, “Ganglioneuroma” are studied and described, with the help of the standard of microscopic diagnosis of the tumors. ^
Addition № 1 Key of logical structure on the topic: “Nonepithelial tumors”
Of fibrillar connective tissue Of lipid tissue Of cartilaginous tissue ↓ ↓ ↓ ↓ ↓ ↓ ↓ Mature Immature Mature Mature Immature Mature Immature ↓ ↓ ↓ ↓ ↓ ↓ ↓ Fibroma Fibrosarcoma Lipoma Hypernoma Liposarcoma Chondroma Chondrosarcoma Of bony tissue ↓ ↓ Mature Immature ↓ ↓ Osteoma Osteosarcoma
Of smooth musculature Of skeletal musculature Mature → leiomyoma Mature→ rhabdomyoma Immature→ leiomysarcoma Immature→ rhabdomyosarcoma
Of bloody vessels Of lymphatic vessels Mature Immature Mature Immature ↓ ↓ ↓ ↓ Hemangioma Hemangioendothelioma Lymphogioma Lymphogioendothelioma Arterial Venous Capillary Cavernous
Nevus ← tumoral state Immature → Melanoma Addition № 1(continuation) Key of logical structure on the topic: “Nonepithelial tumors”
Mature - Meningioma
of vascular plexus of ventricle Immature- Malignant plexus ependyma meningioma ↓ ↓ ↓ Mature- Medulloblastoma Mature Immature Mature- Ependimoma Glioblastoma ↓ ↓ Immature- Ependimoblastoma Astroblastoma choroidpapilloma choroidcarcinoma Immature- Astrocytoma Oligodendroglioma
Mature Immature ↓ ↓ Neurofibroma Malignant neurinoma Neurinoma
Mature- Ganglioneuroma Immature- Ganglioneuroblastoma |
