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Thread: Malignant Polyp Pictures - Atlas of Colon and Ileum

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    Default Malignant Polyp Pictures - Atlas of Colon and Ileum

    What is the function of the breasts?
    Breast consists of the milk nodes and the ducts carrying the milk produced from those nodes to nipple and the fat and connective tissues which is filling interstitial area of those. Each breast is found in front of the pectoral muscles over the ribs. The nipple is the center of the dusky skin area called areola. Also the breast contains lymphatic ducts carrying colorless fluid called lymph. Lymph ducts open out onto the small round lymph nodes. Lymph node groups belonging to breast are found primary near to breast in the armpit, over the collar bone and nearby the sternum (faith bone). Lymph nodes hold bacteria, cancer cells and the other harmful components to be found in the lymph system.

    Why Breast Health Centers of Acibadem?
    1. Multidisciplinary Approach;
    breast-health-mamoIn the branches of Breast Cancer Surgery, Plastic Surgery, Radiotherapy, Chemotherapy, the opportunity of multidisciplinary diagnosis and therapy is being provided to our patients with the specialist and experienced team in one’s field and with the devices of latest technology.

    Apart from these, a multidisciplinary care including supportive services like disease management of breast cancer, nutrition and genetic counseling, psychosocial support programs, physic therapy is being given to breast cancer patients most comprehensively.

    2. High Technology Background;
    In our Breast Health Centers, early diagnosis, therapy and follow-up programs are being implemented with the devices of latest technology (3 dimensional Mammography with Tomosynthesis, 4 dimensional Breast Ultrasonography, Vacuum-assisted Biopsy and Biopsy under the guidance of MR).
    Malignant Polyp Pictures Atlas Colon attachment.php?s=dda5bf997455ff03412538af5c2e4c8f&attachmentid=2072&d=1442183757

    3. Early Detection, Correct Diagnosis;
    In Breast Health Centers of Acibadem, the opportunity of early detection and correct diagnosis is being provided by comprehensive approach.

    We are creating the difference with mammography with tomosynthesis, 4 dimensional ultrasonography, clinical breast examine and by oneself breast examine education and with breast cancer scanning services. Also to learn the breast cancer risk of women who have high risk of contracting breast cancer, the early detection opportunity is being provided by minimizing their chance of contracting cancer in the future via regular examine and special counseling service.

    4. Specialist in One’s Field, Experienced Team;
    breast-health-labOur specialist team consisted of breast surgeons, medical oncologist, plastic surgeon, oncologist of radiation, radiologist, pathologist and medical genetic all specialist in one’s field and experienced provide the comprehensive care of patient in the Acibadem Breast Health Center. Also nutrition counseling, physical therapy and comprehensive psychosocial support program for patients with breast cancer are presented.

    INTRODUCTION
    Adenomatous polyps are tumors of benign neoplastic epithelium with variable potential for malignancy. The adenoma-carcinoma sequence is well known and it is accepted that more than 95% of colorectal cancers arise from adenomas. The World Health Organisation (WHO) classifies adenomas into tubular (less than 20% villous architecture), tubulovillous and villous, with approximately 87% of adenomas being tubular, 8% tubulovillous and 5% villous. Only 5% of adenomas are in danger of becoming malignant. The probability of high grade dysplasia and of carcinomatous transformation increases with polyp size, especially when they are larger than

    1 cm, they have a villous component, there are many polyps or the age at diagnosis is more than 60 years. The neoplasia is considered to be advanced when polyps are 1 cm or more in diameter, there is a villous component or a high degree of dysplasia. More than 25% of advanced polypsand colon cancers are located in the area proximal to the splenic flexure Mixed polyps also have the ability to become malignant, as does hyperplastic polyposis syndrome.
    Malignant Polyp Pictures Atlas Colon attachment.php?s=dda5bf997455ff03412538af5c2e4c8f&attachmentid=2073&d=1442183770

    EPIDEMIOLOGY
    The prevalence of cancerous polyps in series of endoscopically removed polyps is between 0.2% and 11% Nowadays, the number of cases in which malignant polyps are removed is increasing due to screening programmes. In an asymptomatic population of people over 50 years old who underwent direct colonoscopy, there was a 0.8% prevalence of adenocarcinoma of which 50% were carcinoma “in situ” or in stage I[8,9]. During screening programmes, adenocarcinomas have been detected in between 3% and 4.6% of those who undergo colonoscopy following a positive immunological faecal occult blood test result In 2006, Rubio et al reported 10 patients with hyperplastic polyposis coli syndrome and a review of the literature showed that 50% (74/147) of patients with hyperplastic polyposis coli syndrome developed colorectal cancer (CRC).

    HISTOLOGY
    Carcinoma “in situ”, intramucosal carcinoma, high-grade dysplasia or intraepithelial neoplasia is the stage at which there is no involvement of the muscularis mucosa. In general, this tumor stage does not cause metastasis. It is classified as pTis or Stage 0 in the TNM staging system. These terms are defined as non-invasive high grade neoplasia (NHGN) in the Vienna classification. Carcinoma in situ or high-grade dysplasia or intraepithelial neoplasia corresponds to a carcinoma that is restricted to the epithelial layer without invasion into the lamina propria. Intramucosal carcinoma is a carcinoma characterised by invasion into the lamina propria.

    When the carcinoma spreads to the submucosa, the polyp is considered to have become malignant, being able to spread to lymph nodes or distant sites. The tumors that affect the submucosa are classified as T1 and correspond to Stage I of the TNM staging system. This term is defined as submucosal carcinoma in the classification of Vienna or malignant polyp.

    The term pseudoinvasion refers to the presence of glandular epithelium of the mucosa beneath the muscularis mucosa in colonic polyps. These lesions have no malignant potential and should be treated in a similar way to adenomas. However, this phenomenon can be mistaken for invasive carcinoma by an inexperienced pathologist. Pseudoinvasion usually occurs in large polyps (> 1 cm), especially those with long stalks, and is most commonly found in polyps of the sigmoid colon. Islands of adenomatous epithelium are displaced through the muscularis mucosa and are found within the submucosa of the stalk. The displaced glandular tissue usually has rounded, not infiltrative, contours, carries with it a small amount of lamina propria, and is cytologically identical to the overlying adenomatous component. Haemorrhage and haemosiderin deposition are commonly seen and are a clue to diagnosis. In addition, inflammation and granulation tissue can be found. Cystic dilatation of the displaced glands with mucin distention is also not uncommon in pseudoinvasion because mucin produced by the entrapped glands has no means of reaching the lumen. Occasionally, rupture of dilated glands occurs with acellular mucin extravasation and there is a subsequent inflammatory response. Distinction from mucinous (colloid) carcinoma is important and can be difficult. Specifically, in mucinous carcinoma, the mucin pools contain malignant cells, a feature lacking in pseudoinvasion. For these reasons it is highly recommended that level sections and second opinions are obtained in cases of polyps with potential pseudoinvasion.
    Malignant Polyp Pictures Atlas Colon attachment.php?s=dda5bf997455ff03412538af5c2e4c8f&attachmentid=2074&d=1442183784

    All adenomas have some degree of dysplasia, be it high or low. However, low and high grade dysplasias are artificial subdivisions of a spectrum; there is no definition of “high-grade”. Indeed, the WHO book on tumors of the digestive system, does not contain a list of criteria for high-grade dysplasia in adenomas. However, in general, high-grade dysplasia entails more substantial changes and includes carcinoma “in situ”. Among these changes we consider architectural alteration, often resembling the glandular arrangement of adenomas and cytologic abnormalities, principally cellular and nuclear pleomorphism, nuclear hyperchromatism, loss of nuclear polarity, and marked stratification of nuclei. Other authors have considered as features of high grade dysplasia: loss of normal glandular architecture, hyperchromatic cells with multilayered irregular nuclei and loss of mucin, high nuclear/cytoplasmic ratio, marked nuclear atypia with prominent nuclei and focal cribriform patterns. Not all these features are necessarily present to the same degree in all dysplastic epithelia, while low-grade dysplasia manifests these same changes but to a lesser degree.

    References:
    Malignant colorectal polyps
    Breast Health | Acibadem Hospitals Group











    Last edited by Medical Photos; 09-13-2015 at 10:36 PM.

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