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What Is Poorly Differentiated Carcinoma

Poorly Differentiated Neuroendocrine Carcinoma Of The Colon

Imaging of a poorly differentiated adenocarcinoma of the stomach with signet ring cells
What is poorly differentiated neuroendocrine carcinoma?

Poorly differentiated neuroendocrine carcinoma is a type of colon cancer. It starts from the neuroendocrine cells normally found in the colon. Poorly differentiated neuroendocrine carcinoma can develop anywhere along the length of the colon from the cecum to the rectum. It is an aggressive type of cancer that often present at a late stage . Pathologists divide poorly differentiated neuroendocrine carcinoma of the colon into two types: small cell carcinoma and large cell carcinoma.

The colon

The colon is a part of the gastrointestinal tract which also includes the mouth, esophagus, stomach, small bowel, and anus. The colon is a long hollow tube that starts at the small bowel and ends at the anal canal. The colon is divided into sections which include the cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. The functions of the colon are to absorb water from the food that we eat and to move waste out of the body.

The colon is made up of six layers of tissue:

  • Mucosa The mucosa is the tissue that covers the inside surface of the colon. The mucosa is lined by specialized cells that connect together to form structures called glands. When examined under the microscope, the normal, healthy glands look like long, straight test tubes with the opening at the mucosal surface and the base normally sitting on the submucosa . In the colon, these long, straight glands are called crypts.
  • Tumour size

    The Clinical Study Of The Poorly Differentiated Head And Neck Squamous Cell Carcinoma

    The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details.
    Verified September 2016 by Zhigang Huang, Beijing Tongren Hospital. Recruitment status was: Not yet recruitingFirst Posted : September 27, 2016Last Update Posted : September 28, 2016
    • Study Details
    Condition or disease
    Carcinoma, Squamous Cell

    Head and neck Squamous Cell Carcinoma is one of the most common head and neck malignant tumors. Investigators found that several patients with early TNM stage and poor differentiated HNSCC had poor prognosis, yet someone with advanced TNM stage and well differentiated HNSCC had good prognosis. Hence, Investigators suggested that prognosis factors and survival rates probably related to the differentiation of HNSCC, and prognosis factor of poorly differentiated HNSCC were rare discussed and controversy. Investigating the prognostic factors of poorly differentiated HNSCC is undoubtedly crucial.

    About this study ,inclusion criteria were the following parts:

    AND the exclusion criteria were:

    What Is Poorly Differentiated Adenocarcinoma

    Poorly differentiated adenocarcinoma is a serious condition that can threaten the life of a patient. Patients with this type of cancer may have a quickly growing tumor that is difficult to completely remove. Adenocarcinoma can attack many different systems, including the internal organs, the breasts, the lymph nodes and the skin. The prognosis for this type of cancer depends a great deal on the system in which the cancer is first found, as well as how differentiated the cancerous cells are.

    Doctors will take a biopsy of a patients tumor to determine how differentiated the cancer cells are. Looking at the cells under a microscope will reveal whether they seem similar to healthy cells or have many mutations and poorly developed organelles. Cells that develop with many mutations and those that do not mature properly are often said to be poorly differentiated adenocarcinoma cells, because the various parts of these cells are not clearly defined.

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    Diagnosis And Treatment Of Well

    Adenocarcinoma is a type of malignant tumours arising from glandular tissue organs, i.e. from glandular epithelium. There are several different types of tumours, depending on their degree of differentiation . One such species is the high-grade adenocarcinoma. These tumours minimally differ from the tissue of normal cells in the shape and structure. Therefore, they are less aggressive.

    Furthermore, adenocarcinoma can be classified depending on the place of its formation. Thus, it can distinguish well-differentiated carcinoma of the uterus body, cervix, colon, stomach, lung, and any other body which has a glandular epithelium.

    What Are Some Of The Cancer Type

    File:Poorly differentiated gastric adenocarcinoma, high ...

    Breast and prostate cancers are the most common types of cancer that have their own grading systems.

    Breast cancer. Doctors most often use the Nottingham grading system for breast cancer . This system grades breast tumors based on the following features:

    • Tubule formation: how much of the tumor tissue has normal breast duct structures
    • Nuclear grade: an evaluation of the size and shape of the nucleus in the tumor cells
    • Mitotic rate: how many dividing cells are present, which is a measure of how fast the tumor cells are growing and dividing

    Each of the categories gets a score between 1 and 3 a score of 1 means the cells and tumor tissue look the most like normal cells and tissue, and a score of 3 means the cells and tissue look the most abnormal. The scores for the three categories are then added, yielding a total score of 3 to 9. Three grades are possible:

    • Total score = 35: G1
    • Total score = 67: G2
    • Total score = 89: G3
    • Gleason X: Gleason score cannot be determined
    • Gleason 26: The tumor tissue is well differentiated
    • Gleason 7: The tumor tissue is moderately differentiated
    • Gleason 810: The tumor tissue is poorly differentiated or undifferentiated

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    What Are The Signs And Symptoms Of Carcinoma Of Unknown Primary

    There are no unique symptoms to carcinoma of unknown primary . If you notice any of these general signs and symptoms of cancer, see your healthcare provider:

    • Lump or thickening in any part of your body.
    • Pain in your chest or abdomen.
    • Swollen, firm, non-tender lymph nodes particularly noticeable on the sides of your neck, collarbone, under your arms or groin area.
    • A cough that doesnt go away or hoarseness in your voice.
    • Change in bowel or bladder habits, such as constipation, diarrhea, or frequent urination.
    • Feeling of fullness or bloating in your abdomen.
    • Unusual bleeding or discharge.
    • Unexpected weight loss or loss of appetite.

    How Is It Treated

    Your treatment depends on the type of adenocarcinoma you have and how far along your disease has moved. This is called the stage of your cancer.

    • Surgery. Your first treatment will probably be to remove the tumor and tissue around it. Your doctor can then look at the tissue to see if you’re cured or if there still may be cancer cells in your body. You may need to combine other treatments with surgery to make sure your cancer is gone.
    • Chemotherapy. Drugs can kill adenocarcinoma cells, slow their growth, or even cure your disease.
    • Radiation. Doctors use high-energy X-rays or other types of rays to kill your cancer cells.

    You may need chemo along with surgery and radiation to treat your cancer. Some chemo drugs may kill both cancer and healthy cells. Other, newer drugs may target just your cancer cells.

    Your cancer treatment can have side effects. You might get very tired or feel like you need to throw up. Your doctor can suggest ways to manage these problems. Theyà may prescribe drugs that fight nausea.

    Talk to your family and friends about how you’re feeling, and don’t hesitate to ask them for help while you’re getting treatment. Also tell them about your worries and fears. They can be a huge source of support.

    Check the web site of the American Cancer Society. You can find out about local support groups, where you’ll meet people who have the same type of cancer as you and can share their experience.

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    What If My Report Mentions Margins Or Ink

    When an entire tumor is removed, the outside edges of the specimen are coated with ink, sometimes even with different colors of ink on different sides of the specimen. The pathologist looks at slides of the tumor under the microscope to see how close the cancer cells get to the ink . If cancer cells are touching the ink , it can mean that some cancer was left behind, and more surgery or other treatments may be needed. Sometimes, though, the surgeon has already removed more tissue to help make sure that this isnt needed.

    Sometimes, all of the invasive cancer is removed, but there may be pre-cancer or another serious condition at or near the margin, such as ductal carcinoma in situ or lobular carcinoma in situ .

    If your pathology report shows positive margins, your doctor will talk to you about what treatment is best.

    Poorly Differentiated Thyroid Cancers

    Well differentiated hepatocellular carcinoma vs benign hepatic proliferation

    Poorly differentiated refers to cancer cells that have more abnormalities and look less like normal cancer cells. Poorly differentiated thyroid cancer is uncommon, accounting for fewer than 5% of thyroid cancers. Poorly differentiated thyroid cancer is more clinically aggressive and can be challenging to treat. These cancers can spread to the neck lymph nodes, lungs, and bones. Poorly differentiated and well-differentiated thyroid cancers can be present at the same time.

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    What Is A Cancer Stage

    While a grade describes the appearance of cancer cells and tissue, a cancers stage explains how large the primary tumor is and how far the cancer has spread in the patients body.

    There are several different staging systems. Many of these have been created for specific kinds of cancers. Others can be used to describe several types of cancer.

    What Does It Mean If My Carcinoma Has Tubular Mucinous Cribriform Or Micropapillary Features

    These are different types of invasive ductal carcinoma that can be identified under the microscope.

    • Tubular, mucinous, and cribriform carcinomas are “special types” of well-differentiated cancers that often have a better prognosis than the more common type of invasive ductal carcinoma .
    • Micropapillary carcinoma is a type of invasive breast carcinoma that often has a worse prognosis.

    If your doctor knows that your tumor is made up of one of these special types of breast cancer, he or she may recommend different treatment.

    Since some tumors are made up of more than one type, the entire tumor must be removed in order to know what types your tumor contains. A needle biopsy doesnt give enough information to guide treatment.

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    What Is A Cancer Of Unknown Primary

    Cancer starts when cells begin to grow out of control. Cells in nearly any part of the body can become cancer, and can spread to other areas. Cancers often spread from their primary site to one or more metastatic sites . Cancers are named based on their primary site, regardless of where in the body they spread. For example, a lung cancer that spreads to the liver is still classified as lung cancer and not as liver cancer.

    Sometimes its not clear where a cancer may have started. When cancer is found in one or more metastatic sites but the primary site cannot be determined, it is called a cancer of unknown primary or an occult primary cancer. This happens in a small portion of cancers.

    Further tests may eventually find the primary site of some of these cancers. When this happens, they are no longer considered a cancer of unknown primary and are renamed and treated according to where they started.

    In many cases, the source of the cancer is never determined. The most thorough search still might not find the primary site. Even when doctors do autopsies on people who have died of cancer of unknown primary, they are often still unable to find the site where the cancer started.

    But even if the primary site is not known, treatment can still be successful. How the cancer cells look under the microscope, the results of lab tests, and information about which organs it has already affected can help doctors predict what kinds of treatment might be helpful.

    What If My Report Mentions Sentinel Lymph Node

    Poorly differentiated gastric adenocarcinoma.

    In a sentinel lymph node biopsy, the surgeon finds and removes the first lymph node to which a tumor drains. This lymph node, known as the sentinel node, is the one most likely to contain cancer cells if they have started to spread. This procedure may be done during surgery to remove a breast cancer. It is a way to check for the spread of cancer to underarm lymph nodes without removing as many of them.

    The sentinel lymph node is then checked to see if it contains cancer cells. If there is no cancer in the sentinel node, it’s very unlikely that the cancer has spread to other lymph nodes, so no further lymph node surgery is needed.

    If a sentinel lymph node does contain cancer, your report will say that cancer was present in the lymph node. It may also say how large the deposit of cancer cells is. In some cases, if cancer is found in a sentinel lymph node, you may then also need additional treatment such as surgery to remove more underarm lymph nodes or radiation therapy to the underarm region. You should discuss this with your doctor.

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    How Does Tumor Grade Affect A Patients Treatment Options

    Doctors use tumor grade and other factors, such as cancer stage and a patients age and general health, to develop a treatment plan and to determine a patients prognosis . Generally, a lower grade indicates a better prognosis. A higher-grade cancer may grow and spread more quickly and may require immediate or more aggressive treatment.

    The importance of tumor grade in planning treatment and determining a patients prognosis is greater for certain types of cancer, such as soft tissue sarcoma, primary brain tumors, and breast and prostate cancer.

    Patients should talk with their doctor for more information about tumor grade and how it relates to their treatment and prognosis.

    Selected Reference
  • American Joint Committee on Cancer. AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer 2010.

  • Related Resources

    Is A Biopsy Always Performed If Theres A Suspicion Of Cancer

    If your healthcare provider finds a lump or your symptoms and initial round of tests indicate that you may have cancer, they will take a biopsy. During a biopsy, some cells or tissue are removed from your body so they can be looked at under a microscope.

    A pathologist uses different kinds of high-powered microscopes and dyes, stains or chemicals to make cell details easier to see and to look for changes in the DNA of cells. Certain cell changes or details are linked to certain types of cancers.

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    Hurthle Cell Thyroid Cancer

    Hurthle cell thyroid cancer is a rare sub-type of follicular thyroid cancer. Approximately 3% of thyroid cancer cases are Hurthle cell. Hurthle thyroid cells can be benign or cancerous. Benign Hurthle cells usually do not recur once they are removed.

    Hurthle cells are larger than follicular cells and have a pink-staining quality. Hurthle cell thyroid cancer tends to affect older adults and has a slightly poorer prognosis than follicular and papillary types. It spreads to the lymph nodes about 20% of the time.

    What Is Poorly Differentiated Squamous Cell Cancer

    Ancillary studies for the diagnosis of hepatocellular carcinoma

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    What If My Report Mentions The Cecum Ascending Colon Transverse Colon Descending Colon Sigmoid Colon Or Rectum

    These are all parts of the large intestine. The cecum is the beginning of the colon, where the small intestine empties into the large intestine. The ascending colon, transverse colon, descending colon, and sigmoid colon are other parts of the colon after the cecum. The colon ends at the rectum, where waste is stored until it exits through the anus.

    Diagnosis Of Hurtle Cell Thyroid Cancer

    Hurtle cell thyroid cancer cannot be diagnosed by fine needle aspiration biopsy . The only way to diagnose cancerous Hurthle cells is by surgically removing the whole tumor.

    The following tests may be ordered:

    Blood tests

    Blood tests help show if your thyroid is functioning normally. Tests commonly ordered check levels of thyroid-stimulating hormone and T3 and T4 hormones. Blood tests are also used to monitor thyroid cancers.

    Imaging tests

    Advanced imaging scans of your neck help your physician see the precise location and extent of the suspected cancer including: Ultrasound scan , Computed tomography and scan Magnetic resonance imaging .

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    Mrna Analysis Of The Dicer1 Germline Variant

    RNA was reverse transcribed into cDNA using SuperScriptIII first-strand cDNA synthesis . DICER1 transcript NM_177438 was used to design cDNA-specific PCR primers for the exons 67 boundaries as well as for the c.G5437A p.E1813K mutation. Presence of a modified transcript and zygosity at the cDNA level in tumor-derived cDNA was tested using PCR followed by Sanger sequencing. Primers are available upon request.


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