Squamous cell carcinoma of the skin laboratory findings: Difference between revisions

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Latest revision as of 17:29, 30 May 2019

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2], Raviteja Guddeti, M.B.B.S. [3]

Overview

Squamous cell carcinoma of the skin is most often caused by long term exposure to the sun, and other certain risk factors. No specific laboratory tests are indicated for the diagnosis, as physical exam and biopsy are the primary means of diagnosis. Histopathological evaluation of the biopsy specimen stands out to be the most important diagnostic test.

Laboratory Findings

No specific laboratory tests are required for the diagnosis of squamous cell carcinoma. Routine blood tests are performed as part of the complete evaluation, including a complete blood count and serum electrolytes.

Liver function tests will help to determine if there is metastatic spread to the liver.
Blood gas analysis and pulmonary function testing may be helpful in cases of Squamous cell carcinoma of lungs, in addition to other imaging studies.
Another important test to assess for paraneoplastic syndrome is a serum calcium, (as Squamos cell carcinoma of the lungs can cause hypercalcemia) and serum parathyroid hormones level.

Sputum Cytology

SCC of the lung which is centrally located and exfoliates, will secrete cells that can be visualized on sputum cytology.

Although sputum cytology is fast, easy, and economical it has a high false negative rate, and accuracy is highly dependent on storage, collection, number of samples, and the location of the tumor

Further analysis may be needed by obtaining biopsy samples during bronchoscopy.

References

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+__NOTOC__
- {{Squamous cell carcinoma}}
+{{Squamous cell carcinoma}}
+{{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:Aditya Govindavarjhulla|Aditya Govindavarjhulla, M.B.B.S.]] [mailto:agovi@wikidoc.org], [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S.]] [mailto:ravitheja.g@gmail.com]
-{{CMG}}; '''Associate Editor(s)-in-Chief:''' [[User:Aditya Govindavarjhulla|Aditya Govindavarjhulla, M.B.B.S.]] [mailto:agovi@perfuse.org], [[User:Raviteja Reddy Guddeti|Raviteja Guddeti, M.B.B.S.]] [mailto:rgudetti@perfuse.org]
 == Overview ==
-Squamous cell carcinoma of the skin is often caused by long term exposure to the sun and certain other risk factors. No specific laboratory test is indicated for the diagnosis. As history and physical exam will reveal it. A [[biopsy]] is done where a sample is taken and examined under a microscope by a [[Pathologist]] to support the diagnosis.
+[[Squamous cell carcinoma of the skin]] is most often caused by long term exposure to the sun, and other certain [[risk factors]]. No specific laboratory tests are indicated for the [[diagnosis]], as [[physical exam]] and [[biopsy]] are the primary means of [[diagnosis]]. [[Histopathological|Histopathological evaluation]] of the [[biopsy]] specimen stands out to be the most important [[diagnostic]] [[Test|test.]]
-== Laboratory tests ==
-As mentioned no specific laboratory tests are required. Routine blood tests are performed. Complete blood count and platelet counts are performed to rule out associated pathologies.
-Histopathological examination is done to confirm it and to aid in staging of the disease.
-Important points to be noted during histopathological examination include
-*Invasion
-*Differentiation
-*Depth
-Couple of techniques are used for biopsy like shave, punch , excisional. For biopsy sample can be taken in physician's office under local anesthesia. But kind of biopsy method is chosen basing upon the size of lesion.
-*For smaller lesions in easy accessible regions excisional biopsy is preferred. It provides even therapeutic benefit to the patient.
-*For lesions which are large and of cosmetic concern we cannot offer excisional type instead suggesting punch biopsy is advisable. Depending upon the results of Histopathological examination further treatment is based.
-*Shave biopsy is seldom recommended in cases of malignancy.
-Few principles are important when taking a sample for biopsy.
-* Full thickness biopsy is advocated to ensure the depth of tumor invasion, which is the most important part of tumor prognosis.<ref>Brantsch KD, Meisner C, Schönfisch B, Trilling B, Wehner-Caroli J, Röcken M, et al. Analysis of risk factors determining prognosis of cutaneous squamous-cell carcinoma: a prospective study. Lancet Oncol. Aug 2008;9(8):713-20</ref>
-*biopsy should include normal tissue , its useful comparison with the pathology of the lesion.
-*For large lesions is advised to have a large sample to look for evidence of any invasion to surrounding tissue.
-Toluidine Blue can be used for early detection of oral lesion of squamous cell carcinoma as an adjunant. It has got high sensitivity, specificity and accuracy in detecting premalignant lesions. <ref>name="pmid22259809">{{cite journal |author=Rahman F, Tippu SR, Khandelwal S, Girish KL, Manjunath BC, Bhargava A |title=A study to evaluate the efficacy of toluidine blue and cytology in detecting oral cancer and dysplastic lesions |journal=Quintessence Int |volume=43 |issue=1 |pages=51–9 |year=2012 |month=January |pmid=22259809 |doi= |url=}}</ref>Basic principle of toluidine blue staining is that it doesn't stain mucosa, dye is being easily absorbed by the nuclei of malignant cells and they are clearly seen.
+== Laboratory Findings ==
+* No specific [[laboratory]] [[Test|tests]] are required for the [[diagnosis]] of [[Squamous cell carcinoma of skin|squamous cell carcinoma]]. Routine [[blood tests]] are performed as part of the complete evaluation, including a [[Complete blood counts|complete blood count]] and [[Electrolyte|serum electrolytes]].
-Patients who were found to have regional lymphadeonpathy identified during physical examination or during imaging studies should undergo lymph node biopsy or fine needle aspiration biopsy.
+* [[Liver function tests]] will help to determine if there is [[metastatic]] spread to the [[liver]].
+* [[Blood gas analysis]] and [[pulmonary function testing]] may be helpful in cases of [[Squamous cell carcinoma of lung|Squamous cell carcinoma of lungs]], in addition to other [[imaging studies]].
+* Another important test to assess for [[paraneoplastic syndrome]] is a [[Calcium|serum calcium]], (as [[Squamous cell carcinoma of the lung|Squamos cell carcinoma of the lungs]] can cause [[hypercalcemia]]) and [[Parathyroid hormone|serum parathyroid hormones leve]]<nowiki/>l.
+'''<u>Sputum Cytology</u>'''
+* [[Squamous cell carcinoma of lung|SCC of the lung w]]<nowiki/>hich is centrally located and exfoliates, will secrete [[Cells (biology)|cells]] that can be visualized on [[sputum]] [[cytology]].
-'''<u>Histological Findings</u>'''
+* Although sputum cytology is fast, easy, and economical it has a high false negative rate, and accuracy is highly dependent on storage, collection, number of samples, and the location of the [[tumor]]
-The findings are very important to the physician as it well help him in guiding the next step. The neoplastic cells may demonstrate varying degrees of squamous differentiation and atypia.
-*The most conspicuous finding is keratin pearls( well formed desmosome attachments and intracytoplasmic bundles of keratin tonofilaments)
-*Depending on the histology it can be graded into three
-**Well differentiated : nuclei which are more normal, abundant cytoplasm & extracellular keratin pearls
-**Poorly differentiated : High degree of nuclear atypia,greater nuclear cytoplasmic ration and  very less keratinization. It at times due to poor differentiation mimics mesenchymal tumors.Poorly differentiated carcinoma has higher rates of metastasis and high rates of invasion into surrounding tissues.
-**Moderately differentiated : This type of hsiolgy had a look in between these two types.
-**Squamous cell carcinoma in situ - it has full thick atypia of squamous cells(including surfaces) without invading the basement membranes.
-*Invasive carcinomas have most of the times inflammation when it invades the surrounding tissues.
-Apart from biopsy and other imaging studies we may need to couple of specific blood tests for squamous cell carcinoma of lung which presents with [[paraneoplastic syndromes]] causing hypercalcemia.
+* Further analysis may be needed by obtaining [[biopsy]] samples during [[bronchoscopy]].
 ==References==
 {{reflist|2}}
+[[Category:Disease]]
 [[Category:Dermatology]]
 [[Category:Types of cancer]]
-[[Category:Oncology]]
 [[Category:Otolaryngology]]
-[[Category:Mature chapter]]
-[[Category:Grammar]]
-[[de:Plattenepithelkarzinom]]
-[[he:קרצינומת תאי קשקש]]
-[[nl:Plaveiselcelcarcinoom]]
-[[pl:Rak kolczystokomórkowy skóry]]
-[[tr:Skuamöz hücreli karsinoma]]
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Squamous cell carcinoma of the skin laboratory findings: Difference between revisions

Latest revision as of 17:29, 30 May 2019

Overview

Laboratory Findings

References

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