Disorders of Growth

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"If you let conditions stop you from working,
they'll always stop you." James T. Farrell
"A cloudy day is no match for a sunny
disposition."William Arthur WardAuthor, Editor
and Teacher
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Disorders of Growth
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Objectives

• Understand Growth disorders.
• Neoplastic Non neoplastic growths.
• Classification of growth disorders.
• Nomenclature of tumors.
• Benign and malignant tumors.
• Characters of tumors Biology of tumors

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Introduction

• Inflammatory, Degenerative Neoplastic
• Growth Increase in size, structure function.
  synthesis of tissue components.
• Differentiation functional and structural
  maturity of cells.
• Proliferatation- increase in Cell population.
• Tumor Swelling / new growth / mass

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Cell cycle controls

• Cyclins, CDK.
• Growth factors
• Growth Inhibitors.
• Ca sup gene p53
• Oncogenes.

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Histologic picture of Mitosis
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Controls of Cell division

• Cytokines Cyclins, Cyclin dependent kinases
  (CDK).
• Growth factors
• Growth Inhibitors.
• Cancer suppressor genes p53
• Oncogenes c-onc, p-onc, v-onc etc.

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Factors affecting growth

• Genetic parents, Pygmies.
• Endocrine DM, Iodine, GH.
• Nutrition - deficiencies/excess.
• Stress psycho-social, diseaes.
• Neoplasia DNA mutation loss of control over
  cell division.

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A pessimist is one who sees the difficulty in
every opportunity an optimist is one who sees
the opportunity in every difficulty. - Sir
Winston Churchill
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Disorders of Growth

• Decreased growth
• Atrophy, hypotrophy, Hypoplasia, Aplasia
• Increased growth
• Non Neoplastic Normal DNA
• Due to a need.. Controlled.
• Neoplastic Abnormal DNA
• not needed, auto, uncontrolled.

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Non-Neoplastic Proliferation

• Controlled, Reversible, Normal DNA
• Hypertrophy Increase in Size of cells.
• Hyperplasia Increase in Number of cells.
• Metaplasia Change from one type to other
• Dysplasia Disordered, irregular, no
  maturation.
• Hamartoma Displaced tissues (embryogenesis)

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LVH in Chronic Hypertension
? Path. ? Purp ? Prog ? Prol
Left Ventricular Hypertrophy
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Goitre Iodine Deficiency
? Path. ? Purp ? Prog ? Prol

• Non neoplastic
• Normal DNA
• Reversible

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Neoplastic Proliferation

• Uncontrolled Irreversible, DNA mutation
• Benign
• Localized, non-invasive.
• Malignant (Cancer)
• Spreading, Invasive.

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Neoplastic Proliferation

• Uncontrolled Irreversible
• Benign
• Localized, non-invasive.
• Malignant (Cancer)
• Spreading, Invasive.

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Normal Adaptation Benign
Malignant
Mechanism of Growth Disorders
Non-Neoplastic Neoplastic (Polyclonal)
(Monoclonal)
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Pathogenesis Smoke - Lung Dis.
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Benign Malignant

• Slow growing,
• capsulated,
• Non-invasive
• do not metastasize,
• well differentiated,
• suffix oma eg. Fibroma.

• Fast growing,
• non capsulated,
• Invasive Infiltrate
• Metastasize.
• poorly differentiated,
• Suffix Carcinoma or Sarcoma

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Cervical Dysplasia
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Adenomatous polyp
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Adenoma
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Fibroid uterus (leiomyoma)
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Lipoma Intestine
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(No Transcript)
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Liver - Metastasis
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Carcinoma Lung
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Sarcoma
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Have patience with all things, but chiefly have
patience with yourself. Do not lose courage in
considering your own imperfections, but instantly
set about remedying them every day begin with
the task anew. St Francis de Sales
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Biology of Neoplasm
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Biological Characteristics of a Neoplasm

• Cell of origin
• Rate of growth
• Differentiation
• Invasion Infiltration
• Metastasis

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Nomenclature

• Cell of origin Suffix
• (Oma, Carcinoma Sarcoma)
• Fibroma - Fibrosarcoma
• Osteoma - Osteosarcoma
• Adenoma - Adencarcinoma
• Papilloma - Squamous cell carcinoma
• Chondroma Chondrosarcoma

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Tumor Diagnosis

• History of Clinical examination
• Radiographic analysis X-Ray, US, CT, MRI
• Laboratory analysis Tumor markers
• Cytology Pap smear, FNAB
• Biopsy - Histopathology, markers.

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Biology of Tumor

• Grading ? Differentiation ? Microscopic
• Staging ? Progression ? Clinical - TNM

Low ? Grade ? high
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TNM Staging of tumor

• T Tumor (T1-4)
• N Node (N1-3)
• M Metastasis (M0-1)

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TNM - Staging of tumors
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Summary

• Growth disorders Neoplastic, Non neoplastic.
• Non-neoplastic Controlled, reversible, purpose.
• Neoplasia Uncontrolled, irreversible,
  purposeless, parasitic, pathologic, progressive.
• Hyperplasia, hypertrophy, aplasia, atrophy,
  combined.
• Benign and Malignant
• Nomenclature Cell of origin Suffix oma
• Cancer Carcinoma Sarcoma

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Neoplasmuncontrolled cell division(proliferation
) due to abnormal DNAPPPP, Benign,
Malignant.
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Self Assessment Questions

• Define neoplasm? Tumor? Features?
• Controls of cell division.
• Hyperplasia, Metaplasia, Dysplasia, Anaplasia?
  examples?
• Cell types on Regerative capacity? Examples?
• differentiating features Benign/Malignant
• Features of cancer/malignant tumor?
• Classification, Naming, Staging Grading?

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"Everything works out right in the end. If things
are not working right, it isn't the end yet.
Don't let it bother you, relax and keep on
going." Michael
C. Muhammad
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Medical students should learn beyond their
professional training by reading widely., and try
to get the education, if not of a scholar, at
least of a gentleman!" - - Sir William Osler