2.0 Using the Pathologist

Question 1

Note some of the differences, both gross and microscopic, between benign and malignant tumors.

Answer 1

Question 2

Review tumor nomenclature

Answer 2

Question 3

what are the types of metastases and which tumors are common for each?

Answer 3

(1) lymphatic

• typical of carcinoma
• if epithelial cells are present in the LNs, this is highly indicative
• usually ends up in the liver or lungs

(2) vascular

• typical of sarcoma
• tumor seeds widely to internal organs
• to see if a sarcoma has spread, sampling the LNs is ineffective; the liver and lungs are typically the first to be affected

(3) trans-cavity

• typical of mesothelioma (99.9% malignant)
• tumor spteads across serosal surfaces

(4) local

• typical of fibrosarcomas, but may occur in multiple tumor types
• spread along facial planes

Question 4

What does a pathologist require to perform an appropriate review of the sample?

Answer 4

(1) a representative sample

• include a margin of normal tissue
• avoid necrotic/cavitated areas (except for bone tumors)
• mark areas of interest (ink or suture)

(2) a correctly submitted sample

• fix properly: neutral buffered formalin
• no greater than 2cm in longest dimension

(3) a full clinical history

• signalment, history, special considerations, etc.