Neoplasia%20

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Neoplasia The basics

• Notes by Dr Sanjay A Pai

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Neoplasm

• An abnormal proliferation of cells, resulting in
  a mass called a neoplasm

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Neoplasia

• An autonomous growth of tissue that has escaped
  all restrains on cell proliferation and exhibits
  varying degrees of fidelity to their precursors.

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Neoplasm

• 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 excessive manner after cessation of the
  stimulus which evoked the change
• by Rupert A Willis

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Is there a cancer epidemic?

• No! (except for lung cancer)

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Nomenclature

• Localized tumor or benign OMAs
• Those which spread are malignant
• Carcinoma / Sarcoma / Lymphoma / Melanoma

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Exception Borderline case

• Basal cell carcinoma (rodents ulcer)
• Locally invasive, never metastasize
• Pleomorphic adenoma of salivary gland
  (parotids), fibrobatosis, Giant Cell Tumor of
  soft tissue / bone.

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Eponymous Tumors

• A person after when something is named.
• Eg.
• Ewings sarcoma of bone
• Hodgkins disease Reed-sternberg Cells, and
  non-hodgkins lymphoma.
• Brener tumor of the ovary.

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Benign Tumor

• Benign tumor do not penetrate adjacent tissue
  border and do not metastasize.
• It resembles tissue of origin, they are
  differentiated.
• Benign tumor do not kill the patient. (usually)
• Benign tumor resemble parent tissue.
• Histologically, cytologically and functionally
  similar.

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Benign Tumor

• No invasive / metastatic properties.
• Named after the cell of origin
• E.g. Lipocyte Lipoma
• Blood Vessel Haemangioma / angioma
• Squamous Epithelium epithelioma (?!), papilloma
• Glands Adenoma

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Malignant Tumor

• Malignant Tumor invade contiguous tissue,
  metastasize to different sites and again grow.
• It can kill the patient usually.
• E.g.
• Stomach Gastric adenocarcinoma
• Oesophagus Squamous carcinoma
• Chondrosarcoma, osteosarcoma, liposarcoma

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Exceptions

• Hepatoma Hepatocellular Carcinoma
• Melanoma Malignant melanoma
• Non hodgkins lymphoma
• Seminoma of testis, dysgerminoma of ovary, and
  granuloma.

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Other Tumor

• Teratoma Germ cell tumor, dermoid cyst of the
  ovary
• Hamartoma Abnormal amounts of normal tissue,
  pulmonary chondroma
• Choristoma Normal tissue in a ectopic site
  spleneculi, pancreas in stomach, salivary gland
  in rectum.

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Histologic diagnosis of cancer

• Histopathology is the gold standard for the
  diagnosis of cancer.
• Cytology and pap smears.

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Malignant Tumor Feature.

• Anaplastic
• Mitoses
• Loss of polarity
• Growth pattern
• Invasion
• Metastases

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Exception

• Cancer which will not kill
• E.g.
• Prostetic cancer, Papillary carcinoma of thyroid
• Benign tumor that can kill
• E.g.
• Meningioma

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Why type a cancer?

• Treatment option are different.
• Prognosis are different.
• Follow up investigation are different
• E.g.
• Gastric Carcinoma v/s lymphoma
• Papillary v/s Follicuar Carcinoma of thyroid

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Electron Microscopy

• EM cannot distinguish between benign and
  metastatic tumor