Squamous cell carcinoma

Introduction Squamous cell carcinoma, also known as skin-like carcinoma, begins with skin covered with squamous epithelium. The rim of the skin and the junction of the conjunctiva is its multiple sites. The severity of this type of cancer is higher than that of basal cell carcinoma. The development is faster and the damage is greater. It can destroy the eye tissue, invade the paranasal sinus or the brain, and can be transferred to the anterior or submandibular lymph nodes through the lymphatic vessels, and even cause systemic metastasis. Squamous cell carcinoma is a malignant tumor of the epidermal cells of the skin. The incidence rate is about 8% of orbital malignancies. More common in the elderly at the age of 50. More men than women. It occurs in the layer of skin and spine cells at the junction of the orbital conjunctiva. It begins to be nodular, similar to basal cell carcinoma, but rich in keratin. As the tumor progresses, pain can occur, especially when the tumor invades the superior and inferior phrenic nerves. Squamous cell carcinoma can be divided into two types: ulcer type: the bottom of the ulcer is hard, congested, the ulcer is deep, the height is uneven, the edge is high, and even the valgus is sometimes crater-like. Cauliflower-like or papillary: The tumor develops to the surface and can be very large. The surface is cauliflower-like or papillary, and there is a stench on the surface. Squamous cell carcinoma is more malignant than basal cell carcinoma, with fast growth and extensive destruction, which can destroy eyelids, eyeballs, eyelids, sinuses and face. It is generally easy to transfer along lymphatic tissue to nearby tissues, such as the anterior and submandibular lymph nodes or even the whole body. This is the difference between it and basal cell carcinoma.

Cause

1. Ultraviolet radiation, radiation or thermal radiation damage.

2. Chemical carcinogens: such as arsenic, polycyclic aromatic hydrocarbons, coal tar, creosote, paraffin, and the like.

3. Viral infections: In particular, human papillomavirus type 16, 18, 30 and 33 infections.

4. Some precancerous skin diseases: such as sun keratosis, leukoplakia, arsenic keratosis.

5. Some chronic skin diseases: such as chronic ulcers, chronic myelitis, etc.

6. Genetic factors: Some hereditary skin diseases such as xeroderma pigmentosum and albinism have a higher incidence of this disease.

an examination

Related inspection

Effusion carcinoembryonic antigen leucine aminopeptidase serous effusion cytology examination serous effusion CT scan

Epidermal keratinization, the tumor consists of squamous epithelial cell mass, irregularly infiltrated into the dermis, the spine cells are neoplastic, with a cord-like or nested cell mass, with a basal cell layer at the edge and a horn at the center. The cancerous beads have many schizophrenia in the cancer cell mass, and the surrounding lymphocytes and plasma cells are infiltrated.

an examination

1. Pay attention to the age of onset, the location of cancer, and occupation. Whether there is long-term wind and sun or sea life history, whether there is smoking habits and chronic heat stimulation, whether there is unstable scar, chronic osteomyelitis, chronic ulcer history.

2. Pay attention to whether the lesion is rough, desquamation, ulceration, etc., and the adjacent lymph nodes and regional lymph nodes are swollen and fixed.

3. Chest X-ray examination, bone X-ray film should be taken when bone destruction is suspected.

4. Adjacent lymph node resection for pathological examination.

Sign

Rough lesions, desquamation, ulceration, etc., adjacent lymph nodes and regional lymph nodes are enlarged and fixed. Most lung squamous cell carcinomas originate from the central main bronchus, leaf bronchus or segmental bronchus.

Differential diagnosis

(1) The diagnosis of other tumors derived from the lining epithelium in the breast organs must be excluded. Mammary gland primary squamous cell pain must first exclude tumors of the nipple, skin and its appendages, especially tumors of epidermoid cyst origin. Therefore, the diagnosis should be fully taken, multi-slice, carefully examined under the microscope, and strictly grasp the diagnostic criteria.

(B) It is necessary to exclude other parts of the squamous cell carcinoma from metastasis to the breast. Most breast cancers are primary and rarely metastatic. Although malignant tumors that are transferred from other sites to the breast are rare, there are many types, such as various malignant lymphomas, leukemias, malignant melanoma, squamous cell carcinoma, carcinoid tumors, and lung cancer. Therefore, the diagnosis of primary squamous cell carcinoma of the breast should be more cautious. The oral cavity, lung and bronchus, esophagus, and other parts should be thoroughly examined.

(C) Different from other types of breast cancer with squamous metaplasia, all or most of the primary breast squamous cell carcinoma is a typical highly differentiated squamous cell carcinoma structure, which may be accompanied by a small amount of intraductal cancer components. The latter is only a squamous metaplasia with different degrees of visible breast cancer. It is worth mentioning that squamous metaplasia often shows undifferentiation, that is, squamous epithelial cells show malignant characteristics, and should be alert to not diagnosed as squamous cell carcinoma.

(D) Differentiation from medullary carcinoma The medullary carcinoma is usually flat and polygonal, and often accompanied by squamous metaplasia, which looks very similar to squamous cell carcinoma. But careful observation, squamous cell carcinoma has intercellular bridge and keratinization, while medullary carcinoma does not.

(V) Identification of primary mucinous epidermoid tumors Primary mucinous epidermoid carcinoma of the breast is rare, both tumor squamous epithelial cells and neoplastic secretory glandular structures, and the two components are mixed in different proportions. The latter's special pathological changes as well as positive PAS staining and squamous cell carcinoma can be identified.

(VI) Identification of fusiform gallbladder cancer In the new histological classification of WHO breast tumors, both belong to metaplastic cancer. The spindle cell carcinoma is mainly composed of spindle cells, which appear to be bipolar. The nuclear polymorphism is not obvious. There are few mitotic figures, and the cells are arranged in bundles or braided, wavy and spiral. There is a non-specific breast cancer morphology around the spindle cell area. This type is often diagnosed as pseudosarcoma, carcinosarcoma, sarcomatoid carcinoma, etc., and is also misdiagnosed as a spindle cell metaplasia of breast squamous cell carcinoma.

Epidermal keratinization, the tumor consists of squamous epithelial cell mass, irregularly infiltrated into the dermis, the spine cells are neoplastic, with a cord-like or nested cell mass, with a basal cell layer at the edge and a horn at the center. The cancerous beads have many schizophrenia in the cancer cell mass, and the surrounding lymphocytes and plasma cells are infiltrated.

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