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| {{Top | | <noinclude>{{Top |
| |author1=[[User:Mikael Häggström|Mikael Häggström]] | | |author1=[[User:Mikael Häggström|Mikael Häggström]] |
| |author2= | | |author2= |
| }} | | }}</noinclude> |
| For [[evaluation]] of '''suspected malignancies''' such as '''[[tumors]]''', the most important aspect is whether it is benign or malignant. If malignant, then staging is necessary.<ref name=cancer>{{cite web |url= http://www.cancer.gov/cancertopics/factsheet/detection/staging |title=Cancer staging |date= |publisher=National Cancer Institute |accessdate=4 January 2013}}</ref> There are generally specific criteria for various forms of tumors, which should be used whenever applicable, but following are some generalizations. | | For [[evaluation]] of '''suspected malignancies''' such as '''[[tumors]]''', the most important aspect is whether it is benign or malignant. If malignant, then staging is necessary.<ref name=cancer>{{cite web |url= http://www.cancer.gov/cancertopics/factsheet/detection/staging |title=Cancer staging |date= |publisher=National Cancer Institute |accessdate=4 January 2013}}</ref> There are generally specific criteria for various forms of tumors, which should be used whenever applicable, but following are some generalizations. |
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| File:Nuclear-to-cytoplasm ratios.png|An increased nucleus-cytoplasm ratio is generally an indication of malignancy. | | File:Nuclear-to-cytoplasm ratios.png|An increased nucleus-cytoplasm ratio is generally an indication of malignancy. |
| </gallery> | | </gallery> |
| | | {{Primary tumor versus metastasis}} |
| ==Primary tumor versus metastasis==
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| [[File:Metastasis sites for common cancers.svg|thumb|240px|Main sites of metastases for some common cancer types. Primary cancers are denoted by "''...cancer''" and their main metastasis sites are denoted by "''...metastases''".<ref>List of included entries and references is found on main image page in Commons: [https://commons.wikimedia.org/wiki/File:Metastasis_sites_for_common_cancers.svg Wikimedia Commons: Metastasis sites for common cancers.svg]</ref>]]
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| If a suspected malignancy is present, generally check the patient '''history''' for any history of cancer, especially for tumors in more common metastasis sites, which mainly include lung, bone, liver and/or brain. In case of such history, preferably look at the microscopy slides of the past cancer to help determining whether the current case is of the same origin, versus a primary at the current body location, versus a metastasis of yet another location. If there is no known history of cancer, still consider a metastasis of unknown primary origin, especially for suspected malignancies in lymph nodes, liver, lungs, bones, or skin.<ref>Lymph nodes, liver, lungs, bones, or skin are the main sites of cancer of unknown primary origin (CUP):<br>{{cite web|url=https://www.mskcc.org/cancer-care/types/cancer-unknown-primary-origin|title=Cancer of Unknown Primary Origin|website=Memorial Sloan Kettering Cancer Center|accessdate=20222-10-14</ref>
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| {|class=wikitable align=center
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| |+Metastases of unknown primary origin<ref name="pmid25392080">{{cite journal| author=Collado Martín R, García Palomo A, de la Cruz Merino L, Borrega García P, Barón Duarte FJ, Spanish Society for Medical Oncology| title=Clinical guideline SEOM: cancer of unknown primary site. | journal=Clin Transl Oncol | year= 2014 | volume= 16 | issue= 12 | pages= 1091-7 | pmid=25392080 | doi=10.1007/s12094-014-1244-0 | pmc=4239766 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25392080 }} </ref>
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| | '''Histopathologic type'''<br>- see section below for descriptions<ref name="pmid25392080"/> || '''Relative incidence''' among metastases of unknown primary origin<ref name="pmid25392080"/>
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| | Well and poorly differentiated adenocarcinomas || 50%
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| | Undifferentiated carcinoma || 30%
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| | Squamous cell carcinoma || 15%
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| | Undifferentiated neoplasms || 5%
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| |}
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| *{{Memorization-worthy}} '''Do not diagnose a [[renal cell carcinoma]] metastasis without radiologic evidence of a [[renal tumor]].''' To be a plausible primary tumor for a renal cell carcinoma metastasis, a renal tumor should be visible radiologically. In cases of suspected renal cell carcinoma but no renal imaging is available, it is reasonable to ask the ordering doctor to allow you to wait with signing out the pathology report until renal radiology has been performed.
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| ==Histopathologic type== | | ==Histopathologic type== |
| For specific diagnoses by organ system, see anatomic diagram on Patholines '''[[Main page]]'''. This resource will give the main steps towards reaching a diagnosis, but before making a tumor diagnosis, generally be sure that it fulfills the criteria of the condition according to [https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours The WHO Classification of tumors], and generally consult an experienced pathologist as well until you feel confident. | | For specific diagnoses by organ system, see anatomic diagram on Patholines '''[[Main page]]'''. This resource will give the main steps towards reaching a diagnosis, but before making a tumor diagnosis, generally be sure that it fulfills the criteria of the condition according to [https://publications.iarc.fr/Book-And-Report-Series/Who-Classification-Of-Tumours The WHO Classification of tumors], and generally consult an experienced pathologist as well until you feel confident. |