Epithelial skin tumors
Hair matrix carcinoma (ʙazalioma)
Hair matrix carcinoma (ʙazalioma) It is the most common epithelial tumors of the skin (found in 50 % cases). It develops from the cells of the basal layer of the epidermis, characterized destruirujushchego growth, recurs, It provides almost no metastases. It occurs with equal frequency in men and women, mainly in the elderly and middle-aged. In 82-97 % cases is localized on the face (eyelid, the inner corner of the eye, forehead, angle of the mouth, nostrils and others.), It grows slowly, often ulcerate. Grossly distinguish surface (in the form of plaques), papillomatoznyh (borodavchatuyu) and tumor (gnarled and ulcerative) ʙazaliomu.
Cytologically basal cell carcinoma characterized by the presence among the squamous cells of small monomorphic hyperchromatic cells of cylindrical shape, similar to basal cells. layer. They are located in dense groups, tyazhami, as well as trabecular, solid structures, complexes and fields with scalloped edges. Nuclei of cells of relatively large sizes, round, oval and elongated, painted in dark blue-purple color. The structure of chromatin and nucleoli are usually not visible. The cytoplasm is small, basophilic, intensely colored, often with indistinct contours, no intercellular bridges. Often there are cells in the correct state of mitosis.
On the periphery of the clusters observed radial grouping of cells, who presented a high prismatic epithelium with basal nuclei located. In the interior of complexes and strands loose cells are disordered Location, sometimes grouped in parallel or concentric. Sometimes, in the interior of large complexes cells, which are located at a considerable distance, acquire spindle or star shape, and between processes is lipoic homogeneous mass oxyphilic. Often occur in the central portions degeneration and necrosis of the cells, followed by lysis and forming detritus, may form a cyst (kistoznaja ʙazalioma). The preparations are many elements of inflammation - leukocyte, gistiocitov.
Depending on the nature of the growth and differentiation of tumor cells secrete several types of basal cell carcinoma.
Superficial basal cell carcinoma multicentric located mostly on the trunk. It is characterized by the presence of multiple solid dense strands of small hyperchromatic cells with narrow cytoplasm, germinating at different depths from the basal layer of the epidermis into the dermis.
Bazalioma morfea ( giadinizirovannaya, sklerodermopodobnaya bazalioma) accompanied by sclerosis and hyalinosis stroma and the presence of branching strands of small tumor cells against a background of mass oxyphilic. These tumors usually do not ulcerate.
Fibroepithelial bazalioma It has blyashkoobraznuyu form, It consists of dark tumor cells, spaced strands, fields and complexes. Bands may be alveolar, solid trabecular structure. Under the plaque develops in the dermis sclerosis and basophilic degeneration of collagen.
Adenoidnaя bazalioma It consists of lighter tumor cells, arranged in zhelezistopodobnyh, tubular and cystic formations. There are cells with signs of secretion (increased, with cytoplasmic vacuolization).
Oslizlennaya bazalioma It arises mucosal degeneration of tumor cells and stroma.
Pigment (pigmented) ʙazalioma presented by tumor cells, in the cytoplasm which has a melanin uneven brown or gray-brown pigmentation in a small amount in the form of clusters. Meets pigment and extracellular. Unlike melanoma, for pigmented basal cell carcinoma characterized by the presence of tumor in the peripheral portion of the complex high-prismatic cells, and the absence of pronounced polymorphism.
Squamous (spinotsellyulyarny, epidermoid) cancer
Squamous (spinotsellyulyarny, epidermoid) cancer occurs most often in older men in vulnerable areas of the body (underlip, nasal bridge, skulovaâ debt, auricles), in the transition areas of squamous epithelium mucosally, sometimes against actinic keratosis, leukoplakia scar tissue, etc.. Tumor early ulcerate. Its growth may be exophytic. There are three degrees of squamous cell differentiation.
Vыsokodifferentsirovannыy ploskokletochnыy cancer characterized by the presence of cancer in native preparations "pearls" and rods, consisting of cells, similar in their morphological features of normal squamous epithelium, but having a larger core. Around the core formations and concentrically stratified cells - cancer "pearls" (bulbs) often found lying separately cancerous squamous cells with large hyperchromatic atypical nuclei and cytoplasm cornified.
Often found fatty degeneration of atypical cells. In stained preparations core education and cancer "pearls" are losing their structure and appear dark spots. In this form of cancer is usually purulent discharge and therefore cytological examination should be carried out on the material from the deeper layers of affected tissue.
Moderately differentiated squamous cell carcinoma cytologically presented sharply polymorphic, malignantly altered cells (round, polygonal, outstretched, serpentine, bizarre as a tadpole, Racket, sickle) large, rough, hyperchromatic, polymorphic nuclei bumpy structure. The nucleoli are seen only in the light nuclei. The cytoplasm is more or less abundant, Homogeneous, sometimes vitreous, Pearl, indicating cornification. Perhaps the presence of degenerative changes in the cytoplasm, vakuolizacii, zernistosti.
Initial signs of keratinization are grain keratohyalin, detected around the nucleus. When stained by Pappenheim it looks clear cytoplasm, soft blue or intensely blue. As a result, uneven keratinization cells appear like "bird's-eye" with the cytoplasm, lighter and darker around the nucleus at the periphery. The nuclear-cytoplasmic ratio is shifted to the core, cells are located separately, less in the form of complexes. With increasing anaplasia lost resemblance of tumor cells with the cells of the epidermis, Spindle forms appear (veretenokletochnыy cancer) or bright cells (svetlokletochnыy cancer).
Poorly differentiated squamous cell carcinoma of the skin without keratinization rare. In cytological preparations cancer cells medium and large sizes, arranged in groups of various sizes. Kernels large, with delicate chromatin structure, viewed hypertrophied nucleoli. The cytoplasm of various widths, painted in pastel blue color, Homogeneous, Unlike glandular cells, It contains secretory inclusions.
The above options can be combined with squamous cell carcinoma.
Metatipichnыy cancer (Mixed cancer, Intermediate cancer)
Cytologically often presented layers of squamous cell cancer and portions of cells, characteristic of basal cell carcinoma with atypia cellular elements. By metatipichnomu cancer they include basal, which cells after irradiation increased, acquire a polygonal shape of the nucleus, the tumor becomes larger and sharply Ying- vazivnoj, metastaziruet.
Undifferentiated carcinoma of the skin
Undifferentiated carcinoma is characterized by the absence of signs of squamous cell carcinoma or adenocarcinoma. Cytologically abnormal cells are found dramatically different form, reminiscent of melanoma cells, or sarcoma, but arranged in groups, clusters, layers not containing melanin pigment.
