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Carcinoma

In medicine, carcinoma is any cancer that arises from epithelial cells, as opposed to a sarcoma which arises from connective or supportive tissue. It is malignant by definition: carcinomas invade surrounding tissues and organs, and may spread to lymph nodes and distal sites (metastasis). A tumor which appears malignant but does exhibit invasive properties is termed carcinoma in situ (CIS).

Contents

Types of carcinoma

By histology

By location

Histology

Carcinomas are recognised on light microscropy by their atypia (cells losing their peculial characteristics), appearance of the nucleus, and various other characteristics. It is deemed malignant when it can be seen invading other structures, e.g. crossing the basal lamina. Very atypical lesions that do not appear to be invasive are termed carcinoma in situ.

Most carcinomas stain positive for cytokeratin. Additionally, specific immunohistochemical markers may reveal the nature of the malignancy, especially when its origin is uncertain. Breast cancer lesions often express the estrogen receptor and the progesterone receptor (although negative staining does note rule it out).

Unknown primary is a malignancy of which the origin cannot be determined. It can occur in any organ, but frequently affects the liver and brain, as well as the lungs.

Staging

Carcinomas, like all cancers, are "staged" according to the extent of disease. This is different for every histological type of cancer, but generally:

  • T reflects the tumor size (usually 0-3).
  • N reflects the number of local lymph nodes affected.
  • M reflects the presence of distal metastasis (0: not, 1: yes).

If any of these determinants are unknown, a question mark is used. Therefore, if metastasis has not been confirmed nor rules out, T1N1M? would be acceptable notation (although the presence of lymph node spread should prompt the search for secondaries).

Staging is an essential step in oncological care, because the stage of the tumor is the main determinant of prognosis and may inform the decision to pursue chemotherapy, radiation therapy or immunotherapy.

See also



Last updated: 02-08-2005 11:48:09
Last updated: 04-25-2005 03:06:01