病理学第17章肿瘤.ppt

平滑肌肉瘤（leiomyosarcoma） 横纹肌肉瘤 ( Rhabdomyosarcoma ) Remember that the most common neoplasm is a benign nevus (pigmented mole) of the skin, and most people have several. As a general rule, benign neoplasms do not give rise to malignant neoplasms. This excision of skin demonstrates a malignant melanoma, which is much larger and more irregular than a benign nevus. There is a large unilateral mature cystic teratoma seen here at the right (in left ovary--the uterus is opened anteriorly). The uterus has an intramural and a subserosal leiomyoma. The other ovary is replaced by a fibroma. The cystic nature of a mature teratoma of ovary is seen here. The most common tissue element of these teratomas is skin, so large amounts of hair and sebum are produced, leading to a challenging cleanup problem in surgical pathology following dissection of these tumors. If these tumors are mostly solid, then they are often immature teratomas with less differentiated tissue and are more aggressive. Rarely, there are frankly carcinomatous areas. Here are bilateral mature cystic teratomas of the ovaries. These are a form of ovarian germ cell tumor. Histologically, a variety of mature tissue elements may be found. These tumors are often called dermoid cysts because they are mostly cystic. Microscopically, invading adenocarcinoma can be seen here. Normal gastric epithelium at the left merges into the carcinoma at the right, and irregular neoplastic glands infiltrate downward into the submucosa. （1）管状腺癌：多见于胃肠、胆囊、子宫体等。癌细胞形成大小不等，形状不一、排列不规则的腺样结构，癌细胞异型性明显，常不规则地排列成多层，核大小不一，核分裂像多见。 （2）乳头状腺癌： （3）黏液癌：又称为胶样癌，常见于胃肠。镜下，初时黏液聚积在癌细胞内，将核挤向一侧，使该细胞成印戒状，又称印戒细胞。 （4）实性癌：或称单纯癌。 属低分化的腺癌，恶性程度较高，多发生于乳腺，少数可发生于胃及甲状腺。 癌巢为实体性，无腺腔样结构，癌细胞异型性高，核分裂像多见。 有的癌巢小而少，间质结缔组织多，质地硬，称为硬癌。 有的则癌巢较大较多，间质结缔组织相对较少，质地如脑髓，称为髓样癌。 stroma parenchyma 硬癌 软癌 实性癌 三、间叶组织良性肿瘤 纤维瘤 脂肪瘤 Of course, neoplasms can be benign as well as malignant, though it is not always easy to tell how a neoplasm will act. Here is a benign lipoma on the serosal surface of th