病理学第5章肿瘤.ppt

Tumors of nervous system 1. The central nervous tumors (1) Glioma ① Astrocytoma ② Oligodendroglioma ③ Ependymoma (2) Medulloblastoma (3) Meningioma 成人脑瘤以胶质细胞瘤多，多位于大脑； 儿童脑瘤以胶质细胞瘤和髓母细胞瘤多，多位于小脑； 2. Peripheral nervous tumors (1) Neurofibroma (2) Neurilemmoma 3. Retinoblastoma Neurilemmoma Retinoblastoma Others Nevus (Nevi)：先天性畸形，非真性肿瘤 来源：皮内黑色素母细胞及皮神经鞘膜细胞 a. Dermal Nevi (表皮内痣) b. Junctional Nevi (交界痣)：恶变多 c. Compound Nevi (复合痣) Others (1) Pigmented nevus Most authorities agree that the melanocytes are derived from neuro-ectoderm, and migrate to the basal layer of the skin in early intrauterine life A nevus or more implies a benign pigmented tumor containing nevus cells. melanoma（黑色素瘤） High grade malignant tumor. Most from junctional nevi 大体：边不规则，棕黑色 镜下：核仁明显 诊断：ＤＯＰＡ反应阳性，ＨＭＢ－４５染色 预后：极差．早期淋巴道转移．放射线不敏感 易转移到肝，肺和脑 Adenocarcinoma：单纯﹏，囊﹏ 乳头状囊﹏ ，黏液﹏ ， Signet-ring cell carcinoma Adenocarcinoma of breast (carcinoma simplex) Types: a. Sclerous carcinoma: dense stroma b. Medullary carcinoma encephaloid carcinoma: Little stroma, and large masses of tumor cells. c. Carcinoma simplex: Poor defferentiation adenocarcinoma with equal quantities of tumor cells and stroma. Undifferentiated carcinoma：分化差，组织来源难鉴别的恶性肿瘤 特点：多见于肺，可见于胃，食道，鼻咽等． 　　　　网状纤维染色用于鉴别诊断． 　　　　恶性程度高，常发生血道转移． 　　　　对放射线和化疗药较敏感． Carcinoid （类癌）－－argentaffin carcinoma 来源：神经嵴的嗜银细胞 好发部位：胃肠道与支气管，阑尾多 生长慢，＜２cm很少转移． 组织学特点：细胞小，大小和形态较一致．核圆分裂少； 　　　　　　细胞质少，嗜银染色 　　　　　　 younger person, B. M. tumors relativity, change of tissue (more forms, complicated elements) fibro - , lipo - , leiomyo - , rhabdomyo - , hemagio - , lymphangio - , osteo - , chondro – 二. Mesenchymal tissue (non lymphohematopoietic) 2. Tumors of soft tissues (1) tumors of fibro-tissue a. fibroma b. fibrosarcoma (2) tumors of fat tissue a. lipoma (2) tumors of fat tissue b. liposarcoma (３) Tumors of muscle Leiomyo