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Introduction to Neoplasia

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Presentation on theme: "Introduction to Neoplasia"— Presentation transcript:

1 Introduction to Neoplasia
Major Topics for Discussion Definition of neoplasia Benign neoplasms Malignant neoplasms Spread of neoplastic cells (metastasis) Clinical evaluation: grading and staging Epidemiology Oncogenes and tumor suppressor genes

2 Neoplasia Clonal proliferation of cells
Autonomous growth - uncoordinated Derived from cells with proliferative capacity (active cell cycle) Results from alterations in DNA Some resemblance to cell of origin

3 Classification Benign vs Malignant

4 Benign Neoplasms Grow slowly
Do not invade adjacent tissues or metastasize (spread to distant sites) Often are encapsulated Closely resemble cell of origin (differentiated) Uncommonly cause patient death

5 Uterine Leiomyoma (benign smooth muscle cell tumor)

6 Benign Gastrointestinal Polyp

7 Benign Brain Tumor (Meningioma)

8 Malignant Neoplasms Grow more rapidly
Invade adjacent tissues and have potential to metastasize Not encapsulated Less-closely resemble cell of origin More-likely to cause patient death

9 Adenocarcinoma of Colon

10 Adenocarcinoma of Uterus

11 Squamous Cell Carcinoma

12 Nomenclature General rules cell type + “oma” = benign neoplasm
cell type + “carcinoma” = malignant neoplasm of epithelial origin cell type + “sarcoma” = malignant neoplasm of mesenchymal origin

13 Examples (Benign & Malignant)
Chondroma & condrosarcoma Lipoma & liposarcoma Adenoma & adenocarcinoma (of breast) Papilloma & squamous cell carcinoma

14 These neoplasms have an “oma” suffix, but they are malignant.
Exceptions to Rules Malignant tumors include: Teratoma Seminoma Lymphoma Melanoma These neoplasms have an “oma” suffix, but they are malignant.

15 Morphology of Neoplasms
Differentiation – degree of resemblance to normal cell of origin Anaplasia – lack of differentiation Pleomorphism – variation in cell size and nuclear appearance Mitotic rate – reflects proliferative rate Necrosis – outgrow blood supply

16 Gross & Microscopic Features
Benign Meningioma Malignant Melanoma

17 Benign Neoplasm of cartilage
Normal Cartilage Benign Neoplasm of cartilage

18 Malignant Chondrosacrcoma

19 Squamous Cell Carcinoma (note the keratin “pearls”)

20 Spread of Neoplasms Carcinoma in situ Local invasion
(no invasion of the basement membrane) Local invasion Seeding of body cavities (carcinomatosis) Distant metastasis Lymphatic spread Hematogenous spread

21 cervical biopsy shows carcinoma in-situ - CIS

22 Invasive Cervical Squamous Cell Carcinoma

23 Malignant Melanoma (radial growth phase)

24 Bone Metastases of Malignant Melanoma

25 Metastatic Liver Cancer

26 Peritoneal Carcinomatosis - Widely Disseminated Cancer

27 Hematogenous Spread

28 Lymphatic Spread

29 Mechanisms of Metastatis
Altered Cell Adhesion Altered Cell Motility Hydrolytic enzymes Invasion

30 Grading and Staging Used to predict the behavior of neoplasms (prognosis) and determine appropriate therapy Grading – assessment of degree of differentiation and proliferative capacity Staging – assessment of tumor size and extent of spread locally and distantly

31 Epidemiology 20% of total mortality in the US
Epithelial cancers (lung, colon, breast, prostate) are most common in adults Leukemia, lymphoma, CNS neoplasms are most common in children Geographic differences in incidence Environmental associations (carcinogens)

32 Cancer Incidence in US Males

33 Cancer Incidence US Females

34 Neoplasia is a Genetic Disease
Oncogenes Tumor suppressor genes

35 Chromosomal Translocation and Neoplasia

36 Retinoblastoma and Rb Tumor Suppressor Gene Mutations


38 Path Key Words Adenocarcinoma Adenoma Carcinoma in situ Chondroma
Chondrosarcoma Grading Hepatoma Leukemia Lipoma Melanoma Metastasis Peritoneal carcinomatosis Squamous cell carcinoma Staging Teratoma Transitional cell carcinoma

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