1. NEOPLASIA Def.: persistent abnormal
relatively autonomous proliferation of cells

2. NEOPLASIA – classification
BEHAVIORAL
benign
borderline
malignant

3. NEOPLASIA – growth
benign expansive
borderline - locally destructive
malignant infiltrative
METASTASES

4. Metastases
Def.:
development of secondary neoplastic foci in the distant places

5. Metastases - pathways
seeding (body cavities)
lymphatic spread
hematogenous spread

6. General Oncology - 3 Precanceroses (& pseudotumours)
Biology of the neoplastic growth
Precanceroses (& pseudotumours)
Classification of the neoplasms
Methods of tumour diagnostics
Neoplasm prognostification

7. NEOPLASIA – classification
HISTOGENETIC (cell of origin)
mesenchymal
epithelial
neuroectodermal
mixed, teratoma
choriocarcinoma
mesotelioma

8. General Oncology - 3 Precanceroses (& pseudotumours)
Biology of the neoplastic growth
Precanceroses (& pseudotumours)
Classification of the neoplasms
Methods of tumour diagnostics
Neoplasm prognostification

9. Methods of Tumour Diagnostics
Clinical symptoms – history
imaging techniques (X-ray, CT, endoscopy, PET….
laboratory tests
morphology - pathology
cytology & histology & autopsy
Symptomles precanceroses / tumours – screening – e.g. Hemocult, Pap-test
histology incl. special staining methods
immunohistochemistry, electron microscopy
genetic analysis

10. Tumour -Noduli-Metastases
Malignant Tumour
TYPING ICD-O
GRADING G1 G2 G3
STAGING pT pN pM
Tumour -Noduli-Metastases

11. General Oncology - 2 Precanceroses (& pseudotumours)
Biology of the neoplastic growth
Precanceroses (& pseudotumours)
Classification of the neoplasms
Methods of tumour diagnostics
Neoplasm prognostification

12. Typing Grading Staging represent the Most Important Prognostic Factors

13. Tumour -Noduli-Metastases
Malignant Tumour
TYPING ICD-O
GRADING G1 G2 G3
STAGING pT pN pM
Tumour -Noduli-Metastases

14. Additional Prognostic Factors
proliferation markers (MIB 1…)
cell cycle regulators (p53, bcl 2…)
hormone receptors ER, PR
growth factors receptors EGFR
angiogenesis
others………
1. Introduction
The c-erbB-2 gene (HER-2/neu) is a member of the class of oncogene associated with tyrosine protein kinase [1 and 2]. The protein encoded by c-erbB-2 is a 185-kDa transmembrane receptor (p185); it is also a glycoprotein having intracellular, transmembrane and extracellular domains [3 and 4]. The tyrosine kinase activity of the protein is associated with the intracellular or cytosolic domain of the receptor, whereas the extracellular domain is responsible to react with extracellular growth factors. The c-erbB-2 protein shows structural and functional homology with the epidermal growth factor receptor (EGFR). The cytosolic tyrosine kinase domains of these two receptors are almost identical. They differ at the ectodomain of the molecule, therefore, a monoclonal antibody reacting with the extracellular domain of c-erbB-2 oncoprotein would not cross-react with the EGFR. This transmembrane receptor is presumably involved in the regulation of cell growth and cell transformation through signal transduction pathway.

15. NEOPLASIA – classification
HISTOGENETIC (cell of origin)
mesenchymal
epithelial
neuroectodermal
mixed, teratoma
choriocarcinoma
mesotelioma

16. NEOPLASIA – architecture
solid
glandular
papillary cystopapillary
dissociated

17. Benign similar to nonneoplastic Malignant cellular pleomorphism
NEOPLASIA – cytology
Benign similar to nonneoplastic
Malignant cellular pleomorphism
NUCLEAR FEATURES:
hyperchromasia (polyploidy, aneuploidy)
rough chromatine structure
irregular nuclear outline
large and/or multiple nucleoli
or undifferentiated monotonous cellularity

18. NEOPLASIA – Nosology-Typing
definition & ICD-O code
prevalance
age/sex predisposition (if any)
typical locations
clinical symptoms
gross level view
histopathology / cytopathology (incl. special diagnostic tools)
ultrastructure (esp. if useful for the diagnosis)
possible complications, prognosis
prevalAnce= výskyt, prevalence = převaha

19. Mesenchymal neoplasms
Terminology
Named after the cell of origin (Greek or Latin)
benign - suffix -oma
malignant – suffix -sarcoma

20. Mesenchymal neoplasms
Benign
fibroma
lipoma
leiomyoma
rhabdomyoma
hemangioma
lymphangioma
chondroma
chordoma
osteoma
lymphoma
Borderline
-fibromatoses-
-lipoblastoma-
-hemangio
endotelioma-
- chondro
blastoma-
osteoblastoma
Malignant
fibrosarcoma
liposarcoma
leiomyosarcoma
rhabdomyosarcoma
hemangiosarcoma
lymphangiosarcoma
chondrosarcoma
invasive chordoma
osteosarcoma
lymphosarcoma

21. Fibroma benign tumour derived from fibroblasts rare
age/sex predisposition no
typical locations ovary, oral cavity
solid white mass
gross level: circumscribed, soft-firm, whittish
fibroblast like fusiform cells (vimentin)
pressure, dif. dg

22. Fibromatosis
superficial – palms, soles of feet (Dupuytren), m. Peyronie – induratio penis plastica
non-neoplastic tumour like lesion
deep: borderline between tumour like lesions and fibrosarcoma – local recidives common
rare
age/sex predisposition F, middle age
gross level: strictures/large infiltrative masses
fibroblast like fusiform cells (vimentin)
mass

23. Fibrosarcoma derived from fibroblasts age/sex predisposition M
soft tissue
clinical symptoms: mass
gross level view: fish flesh look
fusiform cells, mitoses (vimentin+)
hematogenous spread

24. Myofibroblastic tumours
benign myofibroblastic tumour
myofibroblastic sarcoma
solitary fibrous tumour (CD34+)
hemangiopericytoma

25. Dermatofibrosarcoma protuberans
Dermatofibroma
cutaneous fibrous histiocytoma
storiform architecture (myofibroblasts)
Dermatofibrosarcoma protuberans
borderline – ulceration & recurrences
increased cellularity & atypiae

26. Fibrous Histiocytoma
benign (pigmented villonodullar synovitis)
Malignant Fibrous Histiocytoma – mostly local malignancy blood & lymph. spread possible
increasing cellularity & atypiae