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Neoplasia

Neoplasia. Dr. Raid Jastania. Neoplasia: Terminology. Cancer is the 2 nd cause of death in the US Neoplasia is “new growth”

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Neoplasia

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  1. Neoplasia Dr. Raid Jastania

  2. Neoplasia: Terminology • Cancer is the 2nd cause of death in the US • Neoplasia is “new growth” • Neoplasm is an abnormal mass of tissue the growth of which exceeds and is uncoordinated with that of the normal tissues and persists after cessation of stimuli (By Willis)

  3. Neoplasia: Terminology • Loss of normal growth (growth autonomy) • Loss of normal differentiation • Transformation • Tumor: swelling, mass of tissue • Oncology: Study of tumors • Benign vs Malignant • Benign: localized, not fatal • Malignant: cancer, invasive, metastasize, fatal

  4. Neoplasia: concept of origin • Zygote – cells – tissues – organs – human • DNA, genetic material, genes are the present in all the cells of the body • Cells differ in gene expression • Type of cells (based on genes expressed) • Control of growth • Differentiation • Monoclonality is the basis of neoplasia • Tumor progression, divergent differentiation

  5. Nomenclature • Benign tumors • Suffix “–oma” is added to the cell type • Fibrous: fibroma • Cartilage: chondroma • Bone: osteoma • Adipose tissue: lipoma • Smooth muscle: leiomyoma • Skeletal muscle: rhabdomyoma • Blood vessels: hemangioma • Epithelial: adenoma (cystadenoma, papilloma)

  6. Nomenclature • Malignant tumors • Mesenchymal: sarcoma • Fibrous: fibrosarcoma • Cartilage: chondrosarcoma • Bone: osteosarcoma • Adipose: liposarcoma • Smooth muscle: leiomyosarcoma • Skeletal muscle: rhabdomyosarcoma • Blood vessels: angiosarcoma • Epithelial: carcinoma • Gland forming: adenocarcinoma • Squamous: Squamous cell carcinoma • Transitional cell: Transitional cell carcinoma (urothelial carcinoma)

  7. Nomenclature • Mixed tumors: • Pleomorphic adenoma of salivary gland • Fibroadenoma of breast • Teratoma: more than one germ-cell layer • Teratoma contains: bone, epithelium, muscle, fat, nerve….

  8. Nomenclature • Exceptions: • Malignant tumors • Lymphoma, melanoma, mesothelioma, seminoma • Hamartoma: not neoplastic, it is rather a malformation. Hamartoma contain mixture of mature (adult-type) tissue in abnormal distribution and arrangement • Choristoma: Hetrotopic rest. It is normal tissue in abnormal place.

  9. Benign and Malignant • How do we know benign from malignant tumor? • Features: • Differentiation and Anaplasia • Rate of Growth • Local Invasion • Metastasis

  10. Differentiation and Anaplasia • Differentiation is the extent to which tumor cells resemble their normal cells morphologically and functionally • Generally: • Benign tumors are well differntiated • Malignant tumors can be well differentiated, moderately differentiated or poorly differentiated. They can be “undifferentiated” • Anaplasia is lack of differentiation

  11. Differentiation and Anaplasia • Anaplasia is lack of differentiation • Peomorphism • Hyperchromatic nuclei • High nuclear to cytoplsmic ratio (N/C ratio) • Giant cells • Mitosis • Loss of polarity and normal arrangement • Loss of sturcture

  12. Differentiation and Anaplasia • Function: • Benign tumors: have normal function eg. Adrenal cortical adenoma • Malignant tumors: have variable function according to the degree of differentiation eg. Hepatocellular carcinoma produces bile

  13. Differentiation and Anaplasia • Dysplasia: • Not neoplstic growth • Disordered growth and differentiation • Show mild anaplastic features eg. Nuclear pleomophism, hyperchromasia, mitosis….

  14. Rate of Growth • Benign: slow growing • Malignant: fast growing

  15. Relation between Growth and Differentiation

  16. Local Invasion • Benign tumors: localized, may be surrounded by pseudocapsule “capsule” • Malignant: invasive, infiltrating, destructiv, penetrating

  17. Metastasis • Secondary implants discontinuous from the primary tumor • 30% of newly diagnosed cancer has metastasis • 20% has occult metastasis • Modes of metastasis: • 1. Seeding in body cavity • 2. Lymphtics: lymph nodes • 3. Hematogenous: liver, lung, brain….

  18. Benign and Malignant • In summary, Features of malignancy are • Less Differentiation and More Anaplasia • Rate of Growth - high • Local Invasion • Metastasis

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