neoplasia 2011 a.ppt

7/27/2019 NEOPLASIA 2011 A.ppt

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NEOPLASIA

Marlon M. Maramion, MD, DPSP


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Neoplasia

Nomenclature

Characteristics of Benign and malignant neoplasm

EpidemiologyMolecular Basis of Cancer

Molecular Basis of Multistep Carcinogenesis

Carcinogenic agents and their Cellular Interactions

Host Defense against Tumors Tumor Immunity

Clinical Aspects of Neoplasia


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Nomenclature

Neoplasia- new growth

Tumor- swelling caused by

inflammation-non neoplastic usage

Cancer- malignant tumor

Latin for crab because a cancer adhereto any part


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Definition of Neoplasia

A neoplasm is an abnormal mass of tissue, the

growth of which exceeds and is uncoordinated

with that of the normal tissues and persists in

the same excessive manner after cessation ofthe stimuli which evoked the change- Willis

Genetic changes

Autonomous

Clonal


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Neoplasia

All tumors have two basic components

1. Parenchyma

2. Stroma- blood supply

- framework

- growth influenceDesmoplasia

Scirrhous


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Nomenclature Benign Tumors

-oma = benign neoplasm

Mesenchymal tumors

chrondroma: cartilaginous tumor

fibroma: fibrous tumor

osteoma: bone tumor


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Nomenclature Benign Tumors

Epithelial tumor

adenoma: tumor forming glands

papilloma: tumor with finger likeprojections

papillary cystadenoma: papillary and cystic

tumor forming glands polyp: a tumor that projects above a

mucosal surface


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Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 28 July 2005 03:41 PM)

2005 Elsevier


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Colonic Polyp: Tubular Adenoma

Stalk

Tumor


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Nomenclature Malignant Tumors

Sarcomas: mesenchymal tumor chrondrosarcoma: cartilaginous tumor

fibrosarcoma: fibrous tumor

osteosarcoma: bone tumor


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Nomenclature Malignant

Tumors

Carcinomas: epithelial tumors

adenocarcinoma: gland forming tumor

squamous cell carcinoma: squamous

differentiation

undifferentiated carcinoma: nodifferentiation


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Nomenclature Tumors with mixed differentiation

derived from one germ cell layer thatdifferentiates into more than oneparenchymal cell type

mixed tumors: e.g. pleomorphic adenoma

of salivary gland carcinosarcoma

Teratoma

tumor comprised of cells from more thanone germ layer

arise from totipotent cells (usually gonads)

benign cystic teratoma of ovary is the most

common teratoma


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Downloaded from: Robbins & Cotran Pathologic Basis of Disease (on 28 July 2005 03:41 PM)

2005 Elsevier


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Nomenclature Aberrant differentiation (not true neoplasms)

Hamartoma: disorganized mass of tissuewhose cell types are indiginous to the siteof the lesion

Choristoma: ectopic focus of normal tissue(heterotopia)

Misnomers

hepatoma: malignant liver tumor

melanoma: malignant skin tumor

seminoma: malignant testicular tumor

lymphoma: malignant tumor of

lymphocytes


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Characteristics of Benign andMalignant Neoplasms

The distinction between benign and malignant

tumors is based on

1. appearance (morphology)

2. behavior (clinical course)


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If cells LOOK BAD, they are probably going to BEHAVEBAD


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If cells LOOK GOOD, they are probably going to BEHAVE GOOD


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Characteristics of Benign andMalignant Neoplasms

Basis for distinction

1. Differentiation and anaplasia

2. Rate of growth3. Local invasion

4. Metastases


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Differentiation and Anaplasia

Differentiation- resemblance to the normal

Anaplasia- lack of differentiation

1. pleomorphism2. abnormal nuclear morphology

3. mitosis

4. loss of polarity5. tumor giant cells, necrosis

dysplasia (disordered growth)

- loss of uniformity & architecture


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Dysplasia


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Carcinoma in situ


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Rate of Growth

Factors affecting tumor growth

1. Doubling time of tumor cells

2. Fraction of tumor cells that are in replicativepool

3. Rate at which cells are shed or die


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Schematic Representation Of Tumor

Growth


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Factors affecting growth of benign

& malignant neoplasms

Hormonal stimulation

Adequacy of blood supply

Other unknown influences


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Fast Growing Tumors

High cell turnover

Susceptible to chemotherapy

GROWTH RATE correlates with level of

DIFFERENTIATION


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LocalInvasion


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Metastasis

-single most important feature

distinguishing malignant from benign

neoplasm.

Three routes

1. Seeding of body cavities

2. Lymphatics

3. Hematogenous


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Comparison between Benign and Malignant Tumors


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Characteristics Benign MalignantDifferentiation/anapla

sia

-well differentiated,

structure maybe typical of

tissue origin

-some lack of

differentiation with

anaplasia, structure isoften atypical

Rate of growth -usually progressive and

slow, mitotic figures are

rare and normal

-erratic and maybe slow to

rapid, mitotic figures

maybe numerous and

abnormalLocal Invasion Usually cohesive and

expansile, well

demarcated masses that

do not invade or infiltrate

surrounding normal

tissue

-locally invasive, infiltrating

the surrounding normal

tissues, sometimes

seemingly cohesive and

expansile

Metastasis absent -frequetly present, the

larger and more

undifferentiated the

primary the more likely are

metastases

p g g


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EPIDEMIOLOGY

G hi & E i l


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Geographic & Environmental

Factors


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Genetic Predisposition to Cancer

3 categories

1. Autosomal dominant inherited cancer

syndromes

2. Defective DNA-repair syndrome

3. Familial cancers

characterized by familial clustering but thetransmission pattern is not clear

-e.g CA breast, colon, brain and ovary

neoplasia 2011 a.ppt

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