An Analysis of Clinical and Histopathological Correlation of Skin Tumours.

Srigayathri, S (2008) An Analysis of Clinical and Histopathological Correlation of Skin Tumours. Masters thesis, Kilpauk Medical College, Chennai.


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Skin Is A Heterogenous Organ In Which Precisely Regulated, Cellular And Molecular Interaction Govern Many Crucial Responses To Our Environment(44). It Is Composed Of Varied Elements Having Ectodermal And Mesodermal Origin. Most Of These Individual Elements Are Capable Of Producing Tumours And Thus The Number Of Different Skin Tumours Exceeds That Of Any Other Organ(9). Cutaneous Neoplasm Comprises An Extremely Diverse And Sizable Collection Of Pathologic Entities. They May Be Divided Into Number Of Categories, Reflecting Their Different Biologic Behaviors. These Include Hamartoma, Reactive Hyperplasia And Benign Tumours. Virtually Every Individual Will Serve To A Number Of Tumours In Lifetime But Majority Of These Are Of Little Consequence And May Never Attract Attention Of The Patient Or His Physician. In Contrast To Vast Majority Of Inconsequential Skin Tumours, Which May Be Passed Off As Birthmarks Or Blemishes, One May Also Encounter Small Group Of Serious Malignant Tumor Originating In Skin And Capable Of Causing Death(9). Common Experience Suggests That Most People Suffer From One Or More Benign Tumours Such As Melanocytic Nevi, Skin Tags And Seborrhoeic Keratosis. The Exact Prevalence Of Benign Tumours Is Unknown. But Their Frequency Is Much Greater Than Hospital Or Private Statistics Would Suggest. Most Of The Sources Of Information On Tumours Are Based On Selected Series Of Cases Seen In The Clinic Or By Pathologists And Cannot Be Related To The Population From Which They Were Drawn. The Best Epidemiological Approach Should Be To Examine The Medical Histories Of All Patients Treated In Geographically And Demographically Defined Areas During A Known Period. Because Skin Lesions Are Visible And Easily Accessible, Skin Cancers Provide Us With An Excellent In Vivo Model To Study The Development Of Cancers. Malignant Tumours Of Skin Constitute An Important Public Health Problem Despite Their Low Mortality Rate. In Most Instances The Histopathologic Diagnosis Is Straightforward, Very Occasionally, Tumours Encountered Are Difficult To Classify Because Of Apparent Morphological Overlap With Various Appendageal Tumours Or The Tumor Exhibits Both Basaloid And Squamous Differentiation. In Addition To Malignant Tumours, One Finds In The Surface Epidermis, So Called Premalignant Conditions Better Regarded As Tumours Largely In Situ. Although Cytologically Malignant, They Are Biologically Still Benign. Multiple Factors Are Involved In Etiology Of Skin Tumours. Genetic, Environmental, Racial, Enzyme Defects, Radiations, Geographic Factors, Exposure To Sun Rays Are Some Of The Factors Implicated As Etiology (47,24). Genetic Factors Some Of The Skin Tumours Are Dominantly Inherited. These May Be Symmetrically Distributed And Most Profuse On Head And Trunk. They May Not Manifest Until Puberty. Examples Are Trichoepithelioma, Cylindroma, Steatocystoma Multiplex, Basal Cell Nevus And Neurofibroma.(9,16) Environmental Factors Sir Percivial Pott Described The Classic Example Of Environmental Causes In His Work On Cancer Of Scrotum In Chimneysweepers. A Number Of Other Environmental Causes Have Been Attributed Subsequently Like Coal Tar, Cresolite Oil, Mineral Oil, Crude Paraffin, Arsenic, And Sunlight, X Rays. UVB Rays (290 – 320 Nm) Are The Most Damaging Part Of Sunrays (5). The Effect Of Sunlight Is Cumulative And Produces Other Changes Before Malignancy Occurs. Exposure To Ionizing Radiations May Occur As An Accidental Occupational Hazard. Longer Wavelength Radiant Energy And Grey Rays May Be Carcinogenic. Basal Cell Carcinoma Is The Most Common Cancer By Ionizing Radiation(17). Xeroderma Pigmentosum Is A Genetically Determined Defect Where The Ability To Repair The DNA After UV Exposure Is Compromised. In These Patients There Is A High Risk Of Light Induced Malignant Skin Tumours Developing At An Early Age. Cutaneous Pigmentation Confers A High Degree Of Protection Against Light Induced Degenerative Changes Like Solar Keratosis, Squamous Cell Carcinoma And Basal Cell Carcinoma. The Malignant Transformation May Be Attributed To The Acquisition Of Additional Genetic Events Or To Immunosuppression Due To An Underlying Neoplastic Disease. Therefore Patients With Systemic Diseases Or Malignancy Should Be Carefully Examined And Followed For Sudden Changes In Preexisting Benign Cutaneous Tumours. Neoplasms Of Skin Comprise A Wide Spectrum Of Benign And Malignant Tumours That Exhibit Morphological Differentiation Towards One Or More Of Structures Found In Normal Skin. Cutaneous Adnexal Tumours Are A Large And Diverse Group Of Tumours That Are Commonly Classified According To Their State Of Appendageal Differentiation: Eccrine, Apocrine, Follicular And Sebaceous . These Tumours Generally Behave In A Benign Manner, But Malignant Types Exist. Most Tumours Are Relatively Uncommonly Encountered In Routine Practice, And Pathologists Can Recognize A Limited Number Of Frequently Encountered Tumours. In This Study The Histological Features Of Selected But Important Benign And Malignant Tumours And Tumor Like Lesions Are Discussed With Emphasis On Diagnostic Approach And Pitfalls In Histological Diagnosis.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Clinical; Histopathological ; Correlation ; Skin Tumours.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 27 Jun 2017 13:25
Last Modified: 27 Jun 2017 13:27

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