Chapter 5 Neoplasia.

Slides:



Advertisements
Similar presentations
Neoplasia II: Tumor Characteristics
Advertisements

Leicester Warwick Medical School Neoplasia 1 What is a Tumour? Professor Rosemary A Walker Department of Pathology.
Module 6: Clinical Stage and Grade. Introduction Stage and grade determine prognosis Staging reflects the clinical extent of the tumor Grading a tumor.
Neoplasia Nomenclature
ONCOLOGY Dr. Walid Daoud Assistant Professor. Oncology Oncology is the study of tumors (neoplasms) - Benign neoplasm:. Growth of the same cells as the.
Neoplasia 1: Introduction. terminology oncology: the study of tumors neoplasia: new growth (indicates autonomy with a loss of response to growth controls)
Neoplasia.
Dr. Bruce F. Burns Anatomical Pathology Ottawa Hospital
Neoplasia I Introduction Husni Maqboul, M.D. Terminology Tumor : Pathologic disturbance of growth, characterized by excessive and unnecessary proliferation.
Introduction to Neoplasia
Evolution of Neoplasia The Uterine Cervix As a Model Raj C. Dash, MD Duke University Medical Center Durham, North Carolina.
Abdulmalik Alsheikh, M.D, FRCPC Dr. Maha Arafah, MBBS, KSFP
Neoplasia Lecture 1 Definition and Nomenculature Dr. Maha Arafah
Neoplasia Dr. Raid Jastania. Neoplasia: Terminology Cancer is the 2 nd cause of death in the US Neoplasia is “new growth” Neoplasm is an abnormal mass.
Weeks 6 and 7 Neoplasia Dr.İ.Taci Cangül Bursa-2008.
Neoplasia Lecture 2 Dr. Maha Arafah.
Genomics Lecture 7 By Ms. Shumaila Azam. Tumor Tumor – abnormal proliferation of cells that results from uncontrolled, abnormal cell division A tumor.
NEOPLASIA (Malignant Tumors)
Pathology of Neoplasia. Neoplasia Shashi-Aug-15 Introduction:  Inflammatory, Degenerative & Neoplastic  Growth – Increase in size due to synthesis of.
Tumor 2 Pathology and Histology.
Neoplasia I Walter C. Bell, M.D..
Abdulmalik Alsheikh, MD, FRCPC
Terminology of Neoplasms and Tumors  Neoplasm - new growth  Tumor - swelling or neoplasm  Leukemia - malignant disease of bone marrow  Hematoma -
Tumor Cells and the Onset of Cancer
Neoplasia. 3- Rate of growth  Most benign tumours grow slowly over a period of years, whereas most cancers grow rapidly, spread locally and to distant.
NEOPLASIA Nadia Ismiil, MD, FRCPC.
Introduction to Cancer
Systemic Pathology. Neoplasia -Abnormal cell growth.
Notes by Dr Sanjay A Pai. Neoplasm An abnormal proliferation of cells, resulting in a mass called a neoplasm.
Abdulmalik Alsheikh, MD, FRCPC
Neoplasia Lecture 1 Dr. Maha Arafah. Neoplasia Upon completion of these lectures, the student should: Define a neoplasm. Contrast neoplastic growth with.
Abdulmalik Alsheikh, MD, FRCPC Maha Arafah, MBBS, KSFP
Principles of Surgical Oncology Done by : 428 surgery team surgery team.
General Pathology Basic Principles of Cellular and Organ Pathology Oncology - II Jaroslava Dušková Inst. Pathol.,1st Med. Faculty, Charles Univ. Prague.
Path 822: Experimental Cancer Diagnostics & Therapeutics: PATHOLOGY OF TUMOURS Sandip SenGupta, M.D. Professor of Pathology September 2005.
Neoplasia Lecture 1 Maha Arafa,MD,KSFP Abdulmalik Alsheikh, MD, FRCPC.
Cancer 101: A Cancer Education and Training Program for American Indians & Alaska Natives Cancer 101: A Cancer Education and Training Program for American.
TUMORS and NEOPLASM.
Dr. Saleem Shaikh NEOPLASIA - II. Majority of the neoplasms are categorised clinically and morphologically into benign and malignant on basis of certain.
CANCER HCT !. OBJECTIVES  Define and understand the difference between benign and malignant tumors  Students will be able to identify the classifications.
Cytopathology. 7 Dr. Maha Al-Sedik 2015 CLS Neoplasm. 2- Stages of carcinoma. 3- Differences between benign and malignant neoplasm. 4- Dysplasia.
Neoplasia 1. a) Definition b) Terminologies Neoplasia “new growth” Definition: “an abnormal growth of tissue, the growth of which exceed and is uncoordinated.
Neoplasia Lecture 2 Maha Arafah,MD,KSFP Abdulmalik Alsheikh, MD, FRCPC CHARACTERISTICS OF BENIGN AND MALIGNANT NEOPLASMS EPIDEMIOLOGY CHARACTERISTICS OF.
Copyright (c) by W. H. Freeman and Company
Neoplasia Lecture 1 Maha Arafa,MD,KSFP Abdulmalik Alsheikh, MD, FRCPC.
Neoplasia Lecture 2 Abdulmalik Alsheikh, MD, FRCPC Maha Arafah, MBBS, KSFP Abdulmalik Alsheikh, MD, FRCPC Maha Arafah, MBBS, KSFP CHARACTERISTICS OF BENIGN.
Chapter 5 Hyperplasias and Neoplasms. Review of Structure and Function All cells develop from the fertilized ovum.
Lecture # 42 NEOPLASIA - 3 Dr
Dr. Osama I Nassif. MD, FRCPC. Associate professor & consultant pathologist. Pathology Dept. King Abdulaziz University. NEOPLASIA بسم الله الرحمن الرحيم.
N EOPLASIA 1 D R. HIBA AL ZOU ’ BI. - Neoplasia literally means "new growth“ - In medicine it is referred to as a tumor, - The study of tumors is called.
Malignant Epithelial Tumors
Neoplasia Lecture 1 Abdulmalik Alsheikh, M.D, FRCPC Dr. Maha Arafah, MBBS, KSFP Foundation block 2013 Pathology Foundation block 2013 Pathology Definition.
Neoplasia References: Pathologic Basis of Disease by Robbins and Cotran, 8th Ed. (2010)
Chapter 13: Reducing Your Risk of Cancer Cancer is a group of diseases characterized by uncontrolled, disorderly cell growth Cancer is the second-leading.
Neoplasia. Fig. 2 Hanahan and Weinberg Cell 100:57 Signaling Networks in Cancer.
NEOPLASIA Dr. Manal Maher Hussein.
Neoplasia Basics, Grading and Staging Kimiko Suzue MD, Ph.D. Department of Pathology Mt. Sinai Hospital.
Benign v. Malignant Vocabulary Neoplasm – a new and abnormal growth of tissue in some part of the body Benign – refers to a condition, tumor, or growth.
Neoplasia By Prof.Dr. Ahmed Mohy El Din Intended Learning Outcomes (ILOs): Define neoplasia: Differentiate neoplastic from non neoplastic lesions. Classify.
Unit 7 Neoplasia Neoplasm is an abnormal mass of tissue as a result of neoplasia Neoplasia (new growth in Greek) is the abnormal proliferation of cells.
Nomenclature & Characteristics of Tumours Neoplasia 1
CHARACTERISTICS OF BENIGN AND MALIGNANT TUMORS
Chapter 5 Tumor , neoplasm Department of pathology.
CLASSIFICATION OF TUMORS
Chapter 3 Neoplasms 1.
NEOPLASIA (Malignant Tumors)
Cytopathology-8 DR. MAHA AL-SEDIK.
Neoplasia means literally “new growth”
SINUSES A sinus is a blind tract usually lined with granulation tissue that leads from an epithelial surface into the surrounding tissue. e.g. pilonidal.
Presentation transcript:

Chapter 5 Neoplasia

Background The tumor is a common disease all over the world. In many countries especially developed countries, malignant tumor has become the first or second leading cause of death. Although many research works focused on oncology and great progress has been made in understanding tumors in the past decades, the morbidity and mortality rate of malignant tumor is increasing. The underlying causes include air pollution, pressure, excess weight, unhealthy lifestyle, ageing population and so on.

Contents Definition Structure Characteristics of Tumors Nomenclature Differentiation and Anaplasia Growth, Local Invasion and Metastasis Difference Between Benign and Malignant tumors Effects of Tumors on the Hosts Precancerous Lesions, Dysplasia, and Carcinoma in situ Brief Introduction of Common Neoplasms

Definition of Neoplasm A neoplasm is an abnormal mass of tissue, it’s growth exceeds and is uncoordinated with that of the normal tissue and persist in the same excessive manner after cessation of the stimuli which evoke the change. (Dr. RA Willis)

Definition of Neoplasm At molecular level, neoplasm is disorder of growth regulatory genes ( the activation of proto- oncogenes and the inactivation of tumor suppressor genes ). It develops in a multistep fashion, such that different neoplasms, even of the same histological type, may show different genetic changes.

Features of Neoplasm Excessive cellular proliferation; Lack of responsiveness to control mechanisms; Lack of dependence on the continued presence of the stimulus.

Structure Characteristics of Tumors The gross appearance of tumor is varied. It is usually related to histogenesis, site and biologic behavior.

Structure Characteristics of Tumors Gross appearance of tumor-shape: polypoid papillary nodular lobulated cystic fungating ulcerated

Structure Characteristics of Tumors Color of tumor: lipoma Hepatocellular carcinoma

Structure Characteristics of Tumors Two basic components of all the tumors: Parenchyma – the parenchyma is made up of proliferating neoplastic cells and largely determines the biologic behavior of the tumor. In addition, the classification, nomenclature and histological diagnosis are also made according to the parenchymal cells. Supporting stroma – the supporting stroma is made up of connective tissue, blood vessels, and possibly lymphatics.

parenchyma supporting stroma

Nomenclature Basic principle: Neoplasms are named according to binomial system denoting their histogenic origin of the parenchymal component and the biologic behavior.

Nomenclature Benign tumors: “ ~ oma”, e.g., fibroma; lipoma Malignant tumors: “ ~ carcinoma, ~ sarcoma”

fibroadenoma of breast thyroid adenoma colonic adenoma leiomyoma of uterus fibroadenoma of breast

osteosarcoma of bone heptocellular carcinoma Squamous cell carcinoma adenocarcinoma of colon osteosarcoma of bone

Differentiation and Anaplasia What is neoplasm differentiation? Neoplasm differentiation denotes the degree to which a neoplasm cell resembles the normal mature cells of the tissue both morphologically and functionally.

Differentiation and Anaplasia Benign tumors are usually well differentiated. They resemble closely their normal counterpart. Malignant tumors, on the other hand, show variable degree of differentiation. Malignant tumors that are composed of undifferentiated cells are said to be “anaplastic”,that means no morphological resemblance to normal tissue.

Differentiation and Anaplasia What is anaplasia? lack of differentiation; literally means ‘to form backward,’ implying a ‘reverse differentiation’ of mature normal cells. For cancers, it does not represent reverse differentiation. It means lack of differentiation .

Growth, Local Invasion and Metastasis Rate of growth and malignancy: The growth rate of neoplastic cells varies greatly and is one of its chief factors that serves to distinguish benign from malignant. In a general rule, the degree of malignancy of a neoplasm is correlated with its growth rate: the more rapid the growth, the more malignant the neoplasm.

Growth, Local Invasion and Metastasis Invasion ( Infiltration) Nearly all benign tumors grow as cohesive expansile masses that remain localized to their site of origin. Benign tumors grow slowly and usually develop a fibrous capsule keeping the tumor as a discrete, readily palpable and easily movable mass that can be excised. When a benign tumor arises in a epithelial or mucosal surface, the tumor grow away from the surface, often forming a polypoid.

Lipoma Here is a benign lipoma on the serosal [si'rəusəl] surface of the small intestine. It has the characteristics of a benign neoplasm: it is well circumscribed, slow growing, and resembles the tissue of origin (fat).

Growth, Local Invasion and Metastasis Invasion ( Infiltration) The growth of cancers, in contrast, is accompanied by infiltration, invasion, and destruction of the surrounding tissue. In general, malignant tumors are lack of a well defined cleavage plane and usually exhibit local invasiveness or infiltration that make it difficult to be excised. Malignant tumors on epithelial or mucosa surface may form a protrusion in the early stages, but eventually invade the underlying normal tissue.

Squamous cell carcinoma of lung Malignant neoplasms are also characterized by the tendency to invade surrounding tissues. Here, a lung cancer is seen to be spreading along the bronchi into the surrounding lung.

hepatocellular carcinoma hepatic adenoma hepatocellular carcinoma Here is a small hepatic adenoma that shows how well-demarcated an benign neoplasm is. In contrast, this hepatocellular carcinoma is not as well circumscribed (note the infiltration of tumor off to the lower right) nor as uniform in consistency. It is also arising in a cirrhotic (nodular) liver. cirrhotic[si‘rɔtik] 肝硬化

Metastasis What is metastasis of neoplasms? Metastasis is to form a second neoplastic mass through transfer of the neoplastic cells from the first neoplasm to a distant site on separate from the original tumor.

Metastasis Routes of metastasis Lymphatogenous metastasis- The most common pathway for initial dissemination of carcinomas, but sarcomas may also use this route. Hematogenous metastasis- This route is typical of sarcomas but is also seen with carcinoma.. Metastasis in body cavities ( seeding )- Direct seeding of body cavities or surface (exfoliation and implantation on peritoneum, pleura, subarachnoid) The routes of malignant tumors metastasis include Lymphatogenous metastasis- Metastasis via the lymphatic usually occurs in carcinoma and melanoma. For sarcomas, they tend to spread mainly via the blood stream. Malignant cells are carried by the lymphatic to the regional lymph nodes. The brief that cancerous cells spread first to the regional nodes is rationale for radical surgery. So, clinician should get hold of the lymphatic drainage of various tissues to predict the most likely sites of lymph nodes involvement. Hematogenous metastasis- Entry of cancerous cells into the bloodstream is believed to occur in the early clinical course of many malignant neoplasms. Some types of cancer apparently favor particular metastatic sites. For example, skeletal metastases are common in cancer of prostate, thyroid, lung, breast, and kidney. Adrenal metastases are common in lung cancer. But the mechanisms responsible are unknown. Metastasis in body cavities ( seeding We will discuss all the three points one by one.

Benign Malignant characteristics Differentiation Well differentiated Range from well differentiate to undifferentiated Rate of growth Slow growth over a period of years Rapid growth, sometimes erratic Type of growth Expansile Progressive infiltration, invasion, and destruction of surrounding tissue Separated from Yes, has fibrous capsule composed of stroma of native tissue Poorly separated Metastasis No Yes Effect on host Often insignificant Significant, fever, anemia, infections, etc. Recurrence Rare Often Cell shape Monomorphic Pleomorphic Tumor giant cells Nuclear chromatin Normal Inreased, hyperchromatic; Peripheral clumping Nucleoli Not prominent Prominent, irregular shape

Precancerous Lesions What is precancerous lesions? A premalignant or precancerous lesion is an abnormality in a tissue area which is a just a step away from cancer. Not all precancerous lesions change to cancer, but most have potential to become malignant. It is important to recognize precancerous lesions because surgical excision is curative. Table 5-5 page114

Dysplasia What is dysplasia? Dysplasia is an abnormality of both differentiation and maturation. This term should be restricted to abnormalities of cell growth with the characteristics as following: Increased size of the nucleus, (absolute and relative to the amount of cytoplasm) Hyperchromatism Abnormal chromatin distribution (coarse clumping) Nuclear membrane is thickneng and wrinkling. In squamous epithelium, mitotic figures appear in many layers.

Carcinoma in situ What is carcinoma in situ? The term carcinoma in situ refers to an epithelial neoplasm exhibiting all the malignant cellular features. But it has not yet invaded with through the epithelial basement membranes separating it from potential route of metastasis. It is only at this very early stage the excision of the tumor will guarantee a cure. So detection of carcinoma in situ is very important. In clinical practice, detection of carcinoma at the in situ stage, or detection of precancerous lesions is the aim of population screening programs for cervical, breast and some other carcinoma. Through these popular screening, many lives have been saved.