Neoplasia

1
"You are your own raw material. When you know
what you consist of and what you want to make of
it, then you can invent yourself." - Warren B.
Bennis
2
Neoplasia
Dr. Venkatesh M. Shashidhar. Senior Lecturer in
Pathology Fiji School of Medicine
3
Neoplasia

• Progressive, Purposeless, Pathologic,
  Proliferation of cells characterized by loss of
  control over (Uncontrolled) cell division
• DNA damage at growth control genes is central to
  development of neoplasms.
• Carcinogens Chemical, physical genetic ? DNA
  damage ? Neoplasm.

4
Willis Definition

• Neoplasm is an abnormal mass of tissue the growth
  of which exceeds and is uncoordinated with that
  of normal tissue and persists in the same
  excessive manner after cessation of the stimuli
  which evoked the change

5
Pathogenesis of Neoplasia

• Normal ? Hyperplasia ? Metaplasia ?(DNA damage) ?
  Dysplasia ? (DNA damage) ? (DNA damage)
  Anaplasia? (DNA damage) Infiltration ? (DNA
  damage) ? Metastasis.
• Progressive DNA Damage features of neoplasia.

6
Pathogenesis of Neoplasia

• Non lethal DNA Damage leading to uncontrolled
  cell division.

7
Normal Adaptation Benign Malignant
Mechanism of Neoplams
Non-Neoplastic Neoplastic (Polyclonal)
(Monoclonal)
8
Nomenclature Cell of origin Suffix

• Suffix - oma
• Fibroma
• Osteoma
• Adenoma
• Papilloma
• Chondroma

• Carcinoma / Sarcoma
• Fibrosarcoma
• Osteosarcoma
• Adencarcinoma
• Squamous cell carcinoma
• Chondrosarcoma

Exceptions Leukemia, Lymphoma, Glioma,
9
Structure of Neoplasm

• Neoplastic cells parenchyma.
• Non-neoplastic - stroma (Connective tissue BV)
• Fast growth ? less stroma
• Less stroma ? more necrosis,

10
Biology of Neoplasm

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

• Lung cancer
• Grade - low, high
• Well, Mod, P, Un.
• Staging
• Staging

Lung cancer Squamus cell carcinoma. Poorly
differentiated, high grade, stage 4, Liver
11
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

12
(No Transcript)
13
Grading Staging of Tumor

• Grading Cellular Differentiation (Microscopic)
• Staging Progression or Spread (clinical)

14
TNM Staging of tumor
15
Pathways of Spread

• Direct Spread
• Body cavities
• Blood vessels
• Lymphatic vessels
• Lungs Systemic Venous blood
• Liver GIT venous return, nutrition.
• Brain End arteries.

16
Tumor Diagnosis

• History and Clinical examination
• Imaging - X-Ray, US, CT, MRI
• Tumor markers Laboratory analysis
• Cytology Pap smear, FNAB
• Biopsy - Histopathology, markers.
• Molecular Tech Gene detection.

17
Lung carcinoma
18
Biopsy Slide preparation
19
staining
20
Bilateral Cystadenoma Ovary
21
Lipoma Intestine
22
MRI metastatic adenocarcinoma
23
meningioma
24
Colon Polyp
25
Hepatic Adenoma
26
Hepatic Adenoma
Normal Adenoma
27
Carcinoma Lung
28
Osteo - sarcoma
29
MRI metastatic adenocarcinoma
30
Anaplasia in Sarcoma
31
Anaplasia
32
Hepatic Adenocarcinoma
33
Hepatic Adenocarcinoma
34
Liver Metastasis
35
Carcinoma Breast
36
summary

• neoplasia- an abnormal mass of tissue which has
  lost its responsiveness to growth controls
• benign neoplasms tend to be slow-growing,
  well-differentiated tumors which lack the ability
  to metastasize
• benign neoplasms, in general, remain localized
  and are amenable to surgery

37
summary

• malignant neoplasms tend to be fast-growing
  lesions which invade normal structures
• malignant neoplasms vary in the degree of
  differentiation and some show anaplasia
• malignant neoplasms are capable of metastasis

38
summary

• The prognosis of a patient with any type of
  neoplasm depends on a number of factors
  including the rate of growth of the tumor, the
  size of the tumor, the tumor site, the cell type
  and degree of differentiation, the presence of
  metastasis, responsiveness to therapy, and the
  general health of the patient.

39
Summary

• Neoplasia - Uncontrolled proliferation of cells
• Growth, differentiation, invasion Metastasis
• Benign and Malignant
• Naming Cell of origin Suffix
• Oma, Carcinoma, Sarcoma
• Cancer Carcinoma Sarcoma

40
NEOPLASM Uncontrolled cell Division(DNA
abnormality)
41
Self Assessment Questions

• What is a neoplasm? Write two characters? What is
  a papilloma, adenoma
• What is dysplasia, Metaplasia, Anaplasia
  Hyperplasia? Mention examples?
• Mention major classes of neoplasms with three
  differentiating features? Benign/malignant
• Mention three features of malignant tumor?

42
Self Assessment Questions

• What is carcinoma-in-situ?
• What is grading? And staging?
• How are neoplasms named?
• What is CIN? Classify
• What are the common routes of cancer spread?
• How do we diagnose cancer?

43

• Learning is the beginning of wealth.
• Learning is the beginning of health.
• Learning is the beginning of spirituality.
• Learning is where miracles begin.
• Jim Rohn