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    Pathology Of: Neoplasia

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    Bryan de Guzman
    The document discusses neoplasia, also known as tumors, which are abnormal masses of tissue that grow uncontrollably. It describes the pathogenesis and development of cancer from normal cells acquiring genetic mutations that allow for uncontrolled growth and spread. Various features of cancers are covered, including classification, grading, staging, metastasis, and approaches to diagnosis.

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    Pathology Of: Neoplasia

    Uploaded by

    Bryan de Guzman
    88 views23 pages
    The document discusses neoplasia, also known as tumors, which are abnormal masses of tissue that grow uncontrollably. It describes the pathogenesis and development of cancer from normal cells acquiring genetic mutations that allow for uncontrolled growth and spread. Various features of cancers are covered, including classification, grading, staging, metastasis, and approaches to diagnosis.

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    Micrology

    Original Title

    Micrology

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    The document discusses neoplasia, also known as tumors, which are abnormal masses of tissue that grow uncontrollably. It describes the pathogenesis and development of cancer from normal cells acquiring genetic mutations that allow for uncontrolled growth and spread. Various features of cancers are covered, including classification, grading, staging, metastasis, and approaches to diagnosis.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    88 views23 pages

    Pathology Of: Neoplasia

    Uploaded by

    Bryan de Guzman
    The document discusses neoplasia, also known as tumors, which are abnormal masses of tissue that grow uncontrollably. It describes the pathogenesis and development of cancer from normal cells acquiring genetic mutations that allow for uncontrolled growth and spread. Various features of cancers are covered, including classification, grading, staging, metastasis, and approaches to diagnosis.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 23

    Neoplasia

    Pathology of
    Neoplasia

    1
    Neoplasia

    Neoplasia:
    • Neo + Plasia  New + Growth.
    • Tumour  Swelling  any swelling*
    • Clinically tumour = neoplasm (technically incorrect..!)
    • Willis definition:
    “A neoplasm is an abnormal mass of tissue, the growth
    of which exceeds and is uncoordinated with that of the
    normal tissue and persists in the same manner after
    cessation of the stimuli which evoked the change”
    • “Cell division without control”
    • Irreversible DNA damage, resulting in
    autonomous growth of abnormal cells *
    Neoplasia

    Cell population / Growth Control:


    • Proliferation  Differentiation  Apoptosis * Normal
    Neoplasia
    Benign - Malignant
    Stem cell
    Carcinogen
    Initiator + Promotor

    Inflam Organ / Tissue

    1.Proto-Oncogenes (growth factors) RAS Apoptosis


    2.Growth/Tumor suppressor genes. Rb
    3.Genes controlling Apoptosis. MYC
    4.Genes controlling DNA Repair. p53
    Neoplasia

    Growth Disorders:
    Non neoplastic Neoplastic
    (Polyclonal) (Monoclonal)

    Hyperplasia
    Hypertrophy
    Aplasia
    Atrophy
    Metaplasia
    Dysplasia

    Normal Adaptation Benign Malignant


    Neoplasia

    Cell division Control - Carcinogenesis*


    Neoplasia
    BENIGN MALIGNANT
    • Benign
    Well differentiated - • Malignant
    Poorly differentiated
    • Slow growth • Rapid growth
    • Cohesive, • Non Cohesive,
    • expansile • No capsule
    • Capsule • invasion/infiltration
    • No invasion/infiltration • Metastases.

    Necrosis

    6
    Neoplasia
    Oma - Tumour
    Neoplasms Nomenclature: Carcin-oma – Hard Tumour
    Sarc-oma - Soft Tumour
    Cell of Origin Benign Malignant
    • Gland. Epithelium • Adenoma - Adencarcinoma
    • Lining. Epithelium • Papilloma - Squamous cell ca.

    • Fibroblast • Fibroma - Fibrosarcoma


    • Osteoblast • Osteoma - Osteosarcoma
    • Chondrocyte • Chondroma Chondrosarcoma
    • Lipocyte • Lipoma Liposarcoma
    • Smooth muscle • Leiomyoma Leiomyosarcoma
    • Skeletal muscle • Rhabdomyoma Rhabdomyosarcoma
    Neoplasia

    Nomenclature: exceptions
    • Teratoma – Tumour of Germ cell – multiple tissues. Benign
    (mature) or malignant (immature)
    • Melanoma (Melano-carcinoma) – Malignancy of
    melanocytes.
    • Seminoma (Seminal carcinoma) –carcinoma of Testes.
    • Leukemia – white blood – Ca. of Haemopoietic stem cells.
    • Lymphoma (Lymphosarcoma)– Malignancy of lymphocytes.
    • Mixed Tumours: Both epithelial & connective tissue
    components. Pleomorphic adenoma (Salivary gland) &
    Carcinosarcoma (breast/uterus)

    What is a Granuloma, Hamartoma & Choristoma?


    Neoplasia

    Cancer Clinical Features

    Cancer Biology

    9
    Neoplasia

    Cancer Biology:
    • Structure:
    – Parenchyma – Neoplastic cells.
    – Stroma: Non neoplastic - normal DNA
    • Features:
    – Differentiation – Maturation of cells.
    – Rate of Growth – Mitotic rate / Ki 67
    – Local invasion – Hemorrhage, necrosis, destruction
    – Metastasis – Distant Spread.

    10
    • Tumors are clonal (one parent)
    Normal
    cell • But have different mutations  different
    shapes & features.
    First • Each new mutation adds a new feature.
    mutation

    Second
    mutation

    Third
    mutation
    Malignant cells
    Fourth or
    later mutation

    More new mutations with time.


    Neoplasia

    6 Features of Cancer cells:


    Clinically each patient’s
    cancer has a different
    mix of features
    depending on quality &
    quantity of mutations
    & changes with time...!
    Neoplasia

    Neoplasia: Retrograde evolution…!


    Embryo Cancer

    Self growth
    auto regulation
    Limitless potential
    Angiogenesis
    Evade apoptosis
    Invasion & infiltration
    Neoplasia

    Pathogenesis of Lung Cancer.


    Irritation  Carcinogens  Initiation  Promotion  Ca.

    Anaplasia

    Smoke
    C-myc K-Ras

    p53

    14
    Neoplasia

    Colon: Normal  Adenoma  Carcinoma

    Carcinogenesis)

    Colon Cancer: Common type - 80%


    Neoplasia

    Stage & Grade of Cancer:


    Staging: Progression or spread in the body.
    Grading: Cell differentiation & Rate of growth – Microscopy.

    Well differentiated (low grade) Adenocarcinoma Grade Undiff. (high grade)


    Neoplasia

    Prostate Ca : Gleason Grading:

    Low Grade
    High Grade

    17
    Neoplasia

    TNM: Staging of tumor: Lung Ca


    Stage - Features
    T0 In-situ
    T1 Primary site
    T2 Sec. Anat. site
    T3 Tertiary site
    T4 Adjacent region T4
    N0 No LN mets.
    N1 Primary LN
    N2 Seondary LN T1
    N3 Tertiary LN
    M0 No metastases
    M1 Metastases +

    Based on - ANATOMY & LYMPHATICS


    Neoplasia

    Staging of Colon cancer:

    Pre-Cancer
    Neoplasia
    Cancer

    Prostate Cancer Staging

    20
    Neoplasia

    Metastasis: Lymphatic, Hematogenous, Direct.


    Metastasis:
    Pathogenesis:
    1. Cell loosening
    2. BM degradation
    3. Invasion
    4. Locomotion
    5. BV adhesion
    6. Intra-vasation
    7. Tumour embolus
    8. Adhesion
    9. Extra-vasation
    10. Angiogenesis
    11. Growth. • E-Cadherin, β-catenin
    • Matrix Metalloproteinases (MMP)
    • Collagenase (not in benign)
    • Actin Cytoskeleton, chemokine
    What chemical mediators are involved?
    22
    Neoplasia

    Cancer Diagnosis: e.g. Lung Cancer.


    • Cell of origin • Bronchial Epith.
    • Rate of growth • Mitotic rate – grade.
    – Low, Intermediate, high

    Grade
    • Differentiation • Maturation of cells
    – Well – Mod – Poor – Un diff.
    • Local Invasion • Tumour Stage.. 1,2,3,4.

    Stage
    • Metastasis • Distant Spread..

    DIAGNOSIS: (Lung cancer)


    Bronchogenic Squamous cell Carcinoma, high grade,
    Stage T2, N1, M1, Liver+ LN++ (in.. patient details..).

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