DIAGNOSIS OF EPITHELIAL CANCER :
A – Identification of malignancy : once a lesion has been identified as neoplastic , a prime duty of the pathologist is to determine whether the neoplasm is benign or malignant .
1 – The gross appearance of a lesion may suggest its degree of malignancy .
a – benign lesions : tend to grow by expansion , compress surrounding structures , and often produce a well defined capsule .
b – malignant lesions : by contrast , tend to infiltrate the surrounding tissues so that the borders of the lesions are not discrete , and no capsule is formed .
2 – The histological appearance is of major diagnostic importance.
a – the edges of malignant lesions are usually poorly demarcated , and individual neoplastic cells infiltrate the surrounding normal tissue .
b – lesions invade lymphatic channels and blood vessels .
c – Anaplasia , or lack of differentiation , is a major indicator of malignancy .
B – Identification of precancerous lesions :
1 – In many if not all systems ( as cervix , lung and colon ) , clinicopathologic studies have demonstrated that initial neoplastic change can be recognised in a preinvasive stage . Such changes can progress over a prolonged time span .
2 – The morphological alterations of cancer allow the trained pathologist to recognize not only the invasive malignant process , but also the preinvasive lesions ( carcinoma in situ ) .
C – Grading & staging of malignancies : These prognostic measures attempt to express the degree of malignancy & aggressiveness of a tumor , as a guide to its clinical behavior & the probable outcome of therapy .
D – Tumor markers : which can be used to screen the cancer and to monitor cancer patients for recurrences .
CLINICAL MANIFESTATIONS OF EPITHELIAL CANCER :
A – Both benign & malignant neoplasms can produce the following manifestation :
1 – they can be asymptomatic .
2 – they can produce a lump .
3 – they can cause obstruction .
4 – they can cause bleeding .
5 – they can produce abnormal function .
6 – they can interfere with function .
B – Problems more likely to occur with malignancies : includes :
1 – Anemia .
2 – malnutrition .
3 – loss of function .
4 – paraneoplastic syndromes ( a – ectopic hormone production . / b – hypercoagulability . ) .
5 – Infections ( could be obstructive or altered host resistance as serologic factors , cellular factors and cytotoxic chemotherapy or due to malnutrition and associated disorders . ) .
6 – Associated disorders .
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Tags: Aggressiveness, Anaplasia, Benign Lesions, Blood Vessels, Cancer Diagnosis, Cancer Patients, Carcinoma, Cervix, Clinical Behavior, Clinical Manifestations, Gross Appearance, Histological Appearance, Lesion, Lymphatic Channels, Malignancy, Malignant Lesions, Malignant Neoplasms, neoplasm, Neoplastic Cells, Neoplastic Change, Pathologist, Precancerous Lesions, Preinvasive Lesions, Time Span, Tumor Markers