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Summary Lecture 1 + 2 - Primary skin tumors

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Lecture 1 2 - Primary skin tumors

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  • August 14, 2019
  • 6
  • 2017/2018
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By: Dzeneta • 3 year ago

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Principles and practice of Human Pathology – Lecture 1 + 2 (19-4-2018):
Pathology of primary skin tumors

Primary tumor: tumors that derive from the skin
Secondary tumor: tumors derived from another organ.

In both primary and secondary tumors you can have benign or malignant tumors.

Primary skin tumor:
Benign:
- No invasion of other tissue: limited to compartment of origin
- Name: tissue of origin + suffix ‘oma’, e.g. lipoma, angioma

Malignant:
- Local invasion
- Distant metastases can develop
- Name: tissue of origin + suffix ‘carcinoma’ or ‘sarcoma’

Mesenchymal = soft tissue, not epithelial derived.

Differences between benign and malignant tumors:
Benign:
- Normal chromosomal numbers/diploid
- Often slowly growing
- Cells without atypia

Malignant:
- Often rapid growth: mitoses
- Cells atypical
- Chromosomal abnormalities/aneuploidy

Histological diagnosis of tumors:
- Often simple with only microscope and simple H&E staining

If a tumor is malignant: the tumor will be excised.

Bread loaf technique: the way of processing a skin excision.

*The pathological assessment of a skin excision happens by means of microscopy.

Diagnosis of a tumor:
- Routine histology is sufficient in most cases (HE staining)

Sometimes additional techniques:
- Immunohistochemistry
- Molecular pathology

Immunohistochemistry:
- Usage of an antibody directed against an antigen on a tumor cell. The binding
is visualized with a chromogen.

, Cause of rising incident of melanoma:
- Aging
- Sun exposure (holidays)
- Tanning bed

*The most important thing you can do is prevention.

Most frequent primary malignant skin tumors:
1. Basal cell carcinoma
2. Squamous cell carcinoma
3. Melanoma

Melanoma is less frequent but much more aggressive than basal cell carcinoma and
squamous cell carcinoma.

Basal cell carcinoma (BCC):
- Really frequent
- Probably derived from hair follicle cells
o Therefore, not found on mucosa, palms and soles, because there is no
hair there.
- Frequent around eyes and nose.
- Only occurs in skin, not in other organs!!

Biological behavior:
- Locally aggressive
- Hardly ever metastasizes
o You will almost never die from a BCC.

Squamous cell carcinoma (SCC):
- Derived from keratinocytes
- Not really frequent
- Especially in areas with sun-exposition of long duration
- Can give rise to metastases: mostly nodal
- SCC can also develop in other organs with squamous epithelium (can be
primary or secondary)
o Therefore it is always important to think whether it is a primary tumor or
if it is derived from metastasis.

Cause 1: UVB;
- UV-specific mutations CC to TT mutations are found in tumor suppressor
genes (TP53, p16)

Cause 2: HPV
Cause 3: Immunesuppression
- E.g. with renal transplant recipients.

Cancer and genes:
1. Disease involving genes controlling cell growth and cell death
2. Clonal process: a tumor originates from a single progenitor cell that suffered
from genetic damage.

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