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General Pathology Basic Principles
of Cellular and Organ Pathology
Oncology - II
Jaroslava Dušková
Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague
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General Oncology - I
Disorders of the cell proliferation and growth (hypertrophy, hyperplasia,
metaplasia) Neoplasms – disorders of cell proliferation and differentiation Molecular biology of neoplasia - oncogenesis Host - neoplasm interactions
General Oncology - II
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
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General Oncology - II
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
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NEOPLASIA – classification
BEHAVIORAL
benign borderline malignant
histological vs. clinical behaviour
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NEOPLASIA – growth
benign expansive
borderline - locally destructive
malignant infiltrative
METASTASES
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Clinical manifestation of neoplasms Benign
nomass (palpable or visible on
imaging) compression obstruction
pressurebleedinghormonal production
Malignantnomasspressurebleeding hormonal production
destructioninflammatory
responsedistant metastases
Borderline
combined…!
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Metastasis
Def.: development of secondary tumour foci in the distant places
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Metastases - pathways
seeding (body cavities) lymphatic spread hematogenous spread
cellular embolism!!!
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Invasion & Metastasis - steps Invasion into the extracellular matrix - ECM
– dyscohesion of cells – loss of – E-cadherine– ECM degradation – proteolytic enzymes– migration
epithelio-mesenchymal conversion ameboid migration or groups
Angioinvasion – esp. into newly formed vessels Extravasation – local factors promoting or
inhibiting the subsequent growth tropism late metastases
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NEOPLASIA – macroscopy whittish/grayish mass yellow nodule lipoma, clear cell kidney carcinoma,
adrenocortical adenoma red nodule hemangioma brown nodule nevocellular nevus, melanoma, pigm.
basalioma organ enlargement leukemia organ consolidation (& superficial ulceration)
tongue carcinoma organ softening – necrosis glioblastoma branched outgrowth papilloma, villous adenoma cystic (cystopapillary) cystadenoma, ca
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NEOPLASIA – histological architecture
solidglandularpapillary
cystopapillarydissociated
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NEOPLASIA – cytology
Benign similar to nonneoplastic
Malignant cellular pleomorphismNUCLEAR FEATURES:
hyperchromasia (polyploidy, aneuploidy)
rough chromatine structureirregular nuclear outlinelarge and/or multiple nucleoli
!or undifferentiated monotonous cellularity!
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General Oncology - 2
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
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Pseudotumors
Definition:
- pathological lesions of different etiology masquerading real neoplasms
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Pseudotumors cysts pseudocysts deposits of pathol. material
(gout, ganglion, amyloid) inflammatory pseudotumors
(tuberculoma) hyperplasia (esp. nodular) embryonal development disturbance
(choristia, hamarcia)
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Precanceroses (preblastomatoses)
most pseudotumorous processes with dysplasia features
dysplastic lesions looking not like tumours (SIL, intest. metaplasia
with dysplasia)
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Nonneoplastic Growth Disturbances – II
repair hypertrophy / atrophy hyperplasia metaplasia dysplasia anaplasia – undifferentiation
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Dysplasia
Definition:
- disturbance of cell growth, maturation, architecture
(frequently, but not always preneoplastic condition)
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PSEUDOTUMORS and PRECANCEROSES (preblastomatoses)
pseudotumors
precanceroses
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Diagnosis early less complicated therapy
pseudotumors – clinical– morphological
precanceroses– screening
– morphological
precanceroses– screening
– morphological
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General Oncology - II
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
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NEOPLASIA – classification
HISTOGENETIC mesenchymal epithelial neuroectodermal mixed germ cell, teratoma, choriocarcinoma mesothelioma
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General Oncology - I
Disorders of the cell proliferation and growth (hypertrophy, hyperplasia,
metaplasia) Neoplasms – disorders of cell proliferation and differentiation Molecular biology of neoplasia - oncogenesis Host - neoplasm interactionsGeneral Oncology - II
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms
General Oncology - III Methods of tumour diagnostics Neoplasm prognostification Prediction of the response to the therapy