Benign Tumors - Presentation 1 - PDF

 Benign tumours I. Epithelial Tumours 1. Papilloma Definition: benign epithelial tumour of surface epithelium. Grossly: non-capsulated papillary growth, rarely...

 Benign tumours I. Epithelial Tumours 1. Papilloma Definition: benign epithelial tumour of surface epithelium. Grossly: non-capsulated papillary growth, rarely sessile but more commonly pedunculated. Microscopically: branched core of vascular connective tissue covered by hyperplastic [………] epithelium. basement membrane is intact. Types: according to covering epithelium, it is divided into: Squamous cell papilloma: Transitional cell papilloma: Columnar cell papilloma:  2. Adenoma Definition: benign epithelial tumour of glandular epithelium. Sites: all endocrine and exocrine glands + GIT. Grossly: well defined, round or ovoid, capsulated mass. Cut section may be solid, cystic or cystic with papillae. Microscopically: several types are known: Simple adenoma: epithelial cells arranged in solid masses or acini separated by delicate connective tissue stroma. Fibroadenoma: epithelial cells arranged in acini separated by thick connective tissue stroma. It is a mixed adenoma showing proliferation of fibrous tissue between epithelial cells. Best example is fibroadenoma of the breast. Cystadenoma: secretions formed inside acini are retained forming cystic spaces. Best example is cystadenoma of the ovary. Papillary cystadenoma: the epithelium lining cysts continues to proliferate to form papillae. Best example is papillary cystadenoma of the ovary. Effects: may function [endocrine glands] or change into adenocarcinoma.  II. Benign Tumours of Mesenchymal Origin A. Connective Tissue Tumours 1. Fibroma Definition: benign mesenchymal tumour of fibrous tissue. Sites: Subcutaneous and submucous tissues. Intermuscular septa, fascia, ligaments. Fibrous stroma of any tissue as ovary, breast, etc.. Grossly: well defined, round or ovoid, capsulated mass. Cut section is whorly & may be soft & pink [soft fibroma] or hard & gray [hard fibroma]. Microscopically: tumour is made up of fibroblasts [spindle-shaped cells with spindle-shaped nuclei] separated by collagen bundles. In soft fibroma, cells > collagen. In hard fibroma, collagen > cells. Secondary changes: hyaline and myxoid degeneration, calcification, ossification and malignant change into fibrosarcoma. Desmoid Tumour: recurring fibroma of the muscular aponeurosis of the anterior abdominal wall. Commonly seen in females with repeated delivaries. The tumour is noncapsulated, infiltrates the surroundings, recurs after removal, does not show cellular features of malignancy and does not give metastatsis.  2. Lipoma Definition: benign mesenchymal tumour of fatty tissue. Sites: Subcutaneous and submucous tissues. Intermuscular septa, fascia, ligaments. Fatty stroma of any tissue as ovary, breast, etc.. Grossly: well defined, round or ovoid, capsulated mass. Cut section is yellow, greasy & lobulated. Microscopically: tumour is formed of lobules of fat cells separated by delicate fibrous stroma. Fat cells appear as empty spaces with signet ring nuclei. Secondary changes: malignant change into liposarcoma is very rare.  3. Chondroma Definition: benign mesenchymal tumour of hyaline cartilage. Sites: Short bones of hand and feet. Flat bones as ribs, sternum, etc. Ends of long bones. Grossly: well defined, round or ovoid, capsulated mass. Cut section is bluish & lobulated. Microscopically: tumour is formed of lobules of hyaline cartilage separated by delicate fibrous stroma. Cartilage cells appear as empty spaces with central nuclei separated by bluish hyaline matrix Secondary changes: may turn into chondrosarcoma.  B. Muscle Tumours Leiomyoma Definition: benign mesenchymal tumour of smooth muscles. Sites: Uterus, is the most common site. May occur in wall of stomach, intestine & urinary bladder. Grossly: the following is the description of uterine myoma:  Number: single or multiple.  Site: subserous, submucous or intramural.  Size: from few mm to several cm.  Shape: round, ovoid or pedunculated.  Secondary changes: common.  Capsule: absent, there is a false capsule formed of compressed surroundings.  Consistency: firm.  Colour: grayish white.  Cut surface: whorly. Microscopically: tumour is formed of interlacing smooth muscle and fibrous tissue bundles. The muscle fibre is spindle-shaped with rod- shaped nucleus. The fibroblast is spindle-shaped with spindle-shaped nucleus. Secondary changes: common.  C. Vessel Tumours Capillary Haemangioma Cavernous Haemangioma Developmental malformation formed Developmental malformation formed of vascular channels full of blood. of vascular channels full of blood. Skin all over the body. Skin all over the body. Mucous membranes [lips & Mucous membranes [lips & tongue]. tongue]. Liver, kidney, spleen and brain Liver, kidney, spleen and brain Well defined, non-capsulated, Well defined, non-capsulated, slightly raised red area. It is raised and compressible red usually described as birth mark. area. In tongue  macroglossia. In lips  macrocheilia.  Capillary Haemangioma Cavernous Haemangioma Tumour is formed of small capillary Tumour is formed of large cavernous spaces lined by one layer of flat spaces lined by one layer of flat endothelial cells and filled with blood. endothelial cells and filled with blood. Stroma is delicate. Tumour is non- Stroma is delicate. Tumour is non- capsulated capsulated Capillary Lymphangioma Cavernous Lymphangioma Developmental malformation formed Developmental malformation formed of vascular channels full of lymph. of vascular channels full of lymph. Skin all over the body. Skin all over the body. Mucous membranes [lips & tongue]. Mucous membranes [lips & tongue]. Liver, kidney and spleen Liver, kidney and spleen Well defined, non-capsulated, slightly Well defined, non-capsulated, raised raised skin-coloured area. It is usually and non-compressible skin coloured described as birth mark. area. In tongue  macroglossia. In lips  macrocheilia  Capillary Lymphangioma Cavernous Lymphangioma Tumour is formed of small capillary Tumour is formed of large cavernous spaces lined by one layer of flat spaces lined by one layer of flat endothelial cells and filled with endothelial cells and filled with lymph. Stroma is delicate. Tumour is lymph. Stroma is delicate. Tumour is non-capsulated. non-capsulated. Malignant Tumours Carcinoma Sarcoma Malignant tumour of epithelial tissues. Malignant tumour of mesenchymal tissues. More common. Less common. Middle and old age Adolescents and young age