Sequence 1 of 5.

Lung Adenocarcinoma.

 This 72 year-old male with a long standing history of heavy
 smoking underwent a screening due to a dysphagia. The
 upper endoscopy was unremarkable.

Sequence 2 of 5.

 Computer Axial Tomography.

Download the video clip by clicking on the CT image.

Sequence 3 of 5.

 Large cell adenocarcinoma of the lung.
 (Microscopic detail).

Sequence 4 of 5.

Pleural retraction due to lung adenocarcinoma.

Sequence 5 of 5.

Pleural retraction due to lung adenocarcinoma.

Sequence 1 of 13.

Gallbladder Adenocarcinoma and litiasis.

 Gallbladder adenocarcinoma is an aggressive tumor and is
 one of the digestive tract malignancies with the poorest
 prognosis. Because of loco-regional extension and delayed
 diagnosis, curative resection is often impossible.

Sequence 2 of 13.

Gross appearance of gallblader carcinoma filling all the cavity and invading the wall.

 Although uncommon, carcinoma of the gallbladder (GB) is
 the most common primary hepatobiliary carcinoma, is the
 fifth most common malignancy of the GI tract, and
 predominantly affects older persons with long-standing
 cholecystolithiasis. GB epithelial tumors tend to behave
 similarly to other GI adenocarcinomas. When the diagnosis
 is made incidentally at the time of cholecystectomy,
 surgical resection can be curative; however, more
 commonly, the tumor is unresectable and rarely diagnosed
 preoperatively despite patients' symptoms. Early diagnosis
 can improve the clinical outcome and cure rate of GB
 carcinoma.

Sequence 3 of 13.

Gross appearance of gallblader carcinoma filling all the cavity and invading the wall.

 The exact etiology of GB carcinoma is unknown; however,
 several associated factors have been identified. One
 hypothesis suggests that irritation of the GB mucosa by
 stones causes chronic inflammation and, followed by
 repetitive epithelial repair, may cause malignant
 transformation. Approximately 15 years is required for
 dysplasia to progress to invasive carcinoma.

Sequence 4 of 13.

Gross appearance of gallblader carcinoma filling all the cavity and invading the wall.

Patients with GB carcinoma have an overall mean survival rate of 6 months, and the 5-year survival rate is 5%.

Sequence 5 of 13.

Associated findings and risk factors for GB carcinoma are as follows:
 

• Cholecystolithiasis, which is present in 70-90% of patients (duration may be a key factor in development of cancer).
• Composition of the bile with cholesterol stones (most commonly implicated).
• Genetic factors.
• Calcification of the GB wall (carcinoma in 25% of patients with "porcelain" GB).
• Infections by Salmonella typhi.
• Environmental carcinogens.

Sequence 6 of 13.

Sequence 7 of 13.

Microscopic pattern of gallblader carcinoma

Sequence 8 of 13.

 Microscopic detail of lymphatic and gallblader wall
 invasion.

Sequence 9 of 13.

Microscopic detail of lymphatic and gallblader wall
 invasion.

Sequence 10 of 13.

Sequence 11 of 13.

Sequence 12 of 13.

Sequence 13 of 13.

Giant Ovarian Serous Cystadenoma.

 This 35 year-old female, presented with voluminous serous
 cystadenoma of the ovary. She was treated surgically with
 good results.

Sequence 1 of 2.

Macronodular Cirrhosis

 Larger nodules separated by wider scars and irregularly
 distributed throughout the liver usually due to an infectious
 agent such as viral hepatitis which does not diffuse
 uniformly throughout the liver.

To enlarge the image click here

 Known causes of cirrhosis account for about 90-95% of
 the cases. Most common etiologies include alcoholism,
 autoimmune chronic hepatitis and chronic viral hepatitis.
 Less common causes include hemochromatosis, primary
 biliary cirrhosis, sclerosing cholangitis, drug-induced liver
 disease and chronic biliary obstruction. Other causes
 include a₁-antitrypsin deficiency, severe steatohepatitis in
 the morbidly obese and Wilson's disease. The remaining
 5-10% of patients with cirrhosis of the liver have no known
 cause, a condition termed cryptogenic cirrhosis. Over the
 last 10 years, the rate of cryptogenic cirrhosis has fallen
 from 30% to current levels. The most likely cause for this
 fall has been the availability of testing for hepatitis C.

 The etiology of the cirrhosis usually cannot be
 determined by the pathologic appearance of the liver
 (with some notable exceptions, including
 hemochromatosis and a₁-antitrypsin deficiency).
 Terms previously used such as portal cirrhosis or
 postnecrotic cirrhosis have been replaced
 by classifications that include three anatomic categories.

Sequence 2 of 2.

Classification of Cirrhosis

• Morphologic: Macronodular Micronodular Mixed
• Histologic: Portal, Post-necrotic, Post Hepatitic, Biliary, Congestive
• ETIOLOGIC AGENTS: Genetic, Toxic, Infectious, Biliary, Vascular, Cryptogenic

 This peculiar transformation of the liver was identified by
 the first anatomic pathologist, Gianbattista Morgagni in his
 500 autopsies published in 1761 but the name of
 "cirrhosis" (greek=orange color) was given by Laennec in
 1826 because of the yellowish-tan color of the cirrhotic liver
 . Only in 1930, one hundred years later, however, the first
 theory as to the pathogenesis of this disorder was
 advanced by Roessle: parenchymal degeneration,
 regeneration and scarring which is now understood
 according to the following sequence:

• Injury
• Degeneration
• Fibrosis
• Formation of fibro-vascular membranes
• Parenchymal dissection into nodules
• Rearrangement of blood
• Cirrhosis
  
  To enlarge the image click here

Zenker´s Diverticula