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 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.
+[[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 ==
+== 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]].
-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 SCC of lungs, in addition to other imaging studies. Another important test to assess for [[paraneoplastic syndrome]] is a serum calcium, as SCC of the lungs can cause [[hypercalcemia]]. For this reason, blood levels of [[parathormone]] should also be obtained if SCC of the lung is suspected.
+* [[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]].
-Histopathological examination confirms diagnosis and aids in the staging of the disease. Histopathological evaluates in detail the following characteristics of the specimen;
+* 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]]
-*Invasion
-*Differentiation
-*Depth
-The various types of biopsy that may be obtained includes shave, punch, and excisional biopsies. The sample may be obtained at a physician's office under local anesthesia. The type of biopsy method chosen is based upon the size of lesion.
+* Further analysis may be needed by obtaining [[biopsy]] samples during [[bronchoscopy]].
-*For smaller lesions in easy accessible region of the body, an excisional biopsy is preferred. This may be therapeutic as well as diagnostic.
-*For lesions which are large and for which the cosmetic appearance may be of concern, a punch biopsy is advisable. Further treatment is based upon the results of histopathological evaluation.
-*A shave biopsy is seldom recommended in cases where the lesion is suspected to be malignant.
-Important principles to consider when taking a sample for biopsy.
-* A full thickness biopsy should be taken to best evaluate the true depth of the lesion and extent of invasion. Depth of the lesion is an important determinant in the prognosis and staging of cancer.<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>
-* The biopsy specimen should also include samples of normal tissue as a comparison.
-* Large lesions require a thorough sample that will adequately assess the entirity of the lesion.
-Toluidine Blue can be used for the early detection of the oral lesions of squamous cell carcinoma. It has 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> The basic principle surrounding the use of toluidine blue staining is that it doesn't stain the normal mucosa, however the dye is easily absorbed by the nuclei of malignant cells.
-Patients found to have regional lymphadenopathy on physical exam, or in imaging studies, should undergo lymph node biopsy or fine needle aspiration biopsy.
-'''<u>Histological Findings</u>'''
-Histopathological evaluation is important in determining the next step in the grade and treatment of the cancer. The neoplastic cells may demonstrate varying degrees of squamous differentiation and atypia uncder the microscope.
-*The most conspicuous finding under a microscope are keratin pearls(well formed desmosome attachments and intracytoplasmic bundles of keratin tonofilaments).
-*SCC can be graded up to grade 3.
-**Well differentiated: nuclei which are more normal, abundant cytoplasm & extracellular keratin pearls
-**Poorly differentiated: High degree of nuclear atypia, greater nuclear:cytoplasmic ratio and less keratinization. Due to poor differentiation it may mimic mesenchymal tumors. Poorly differentiated carcinoma has a higher rate of metastasis and high rates of invasion into surrounding tissues.
-**Moderately differentiated: Has an appearance that is midway between poorly differentiated and well differentiated.
-**Squamous cell carcinoma in situ - has full thick atypia of squamous cells (including surfaces) without invasion through the basement membrane.
-*Invasive carcinomas cause the most inflammation upon invasion of the surrounding tissues.
-'''<u>Sputum Cytology</u>'''
-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.It is easy,quick and economical. 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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