Cancer is one of the leading causes of death
worldwide.
Emotional and physical suffering by the
patient.
Different mortality rate …..
Some are curable
Others are fatal
Neoplasia = latin word (new growth)
Neoplasm = tumor
Tumor = swelling
Neoplasia means new growth and is
characterized by unceasing abnormal and
excessive proliferation of cells.
The study of tumors = Oncology
Oncos= tumor + ology = study of
"Oncology" is the study of tumors.
ONCOLOGISTS
DIFFERENTIATION:Extent to which
neoplastic parenchymal cell resemble their
normal parent cells, both morphologically
and functionally.
Anaplasia:Irreversible loss of differentiation
Classification
Benign
Malignant
Benign tumors :It is tumor with relatively
innocent characteristics as :
Will remain localized
Cannot spread to distant sites
Generally can be locally excised
Patient generally survives
Characteristics Benign Malignant
1.Differentiation Well differentiated Ranges from well differentiated to
undifferentiated
2. Anaplasia No anaplasia Certainly present
3. Spread/Infiltration Remains localized Invades and penetrates the surrounding
tissue
4. Metastasis No metastasis Metastasize to regional lymph nodes and
distant organs
5. Rate of growth Usually slow except leiomyoma Usually rapid except cancer of cervix
grows slowly
6. Encapsulation Enclosed within capsule which separates
it from host tissues, except leiomyoma
Capsule never present
7.Gross appearance Degeneration, necrosis ulceration,
hemorrhage less frequent
Degeneration, necrosis ulceration,
hemorrhage more frequent
8. Clinical Effects Do not endanger life until vital organs
involved
Act as parasite and tends to kill the
patient whenever it grows
9.Recurrence Easily local removal-no recurrence Recurrence common
Components of neoplasms:
1. Parenchyma: made up of proliferating parts of neoplastic
cells
Determines biological behavior of tumor from which the
tumor derives its name
2. The stroma:
made up of non-neoplastic, host-derived connective tissue
and blood vessels
Provides support for the growth of the parenchyma
3. Desmoplasia-the excess of stromal component in tumor
is called desmoplasia and a such tumor is called scirrhous
tumor.
Tumor is named on the basis of
Based on the biological behavior :
Benign and malignant
Based on the cell or tissue of origin :
One neoplastic cell type : lipoma,adenocarcinoma
More than one neoplastic cell type : MIXED like
fibroadenoma
More than one neoplastic cell type derived from
more than one germ-cell layer: teratoma
Nomenclature
Benign tumors:
▪prefix + suffix
▪Type of cell + (-oma)
Examples:
Benign tumor arising in fibrous tissue:
Fibro + oma = Fibroma
Benign tumor arising in fatty tissue:
Lipo + oma = lipoma
Benign tumor arising in cartilage
chondro + oma = chondroma
Benign tumor arising in smooth muscle
fibrous + oma = fibroma
Benign tumor arising in skeletal muscle
Rhabdomyo + oma = rhabdomyoma
Epithelial benign tumors are classified on the
basis of :
The cell of origin
Microscopic pattern
Macroscopic pattern
Adenoma : benign epithelial neoplasms
producing gland pattern….OR … derived from
glands but not necessarily exhibiting gland
pattern
Papilloma : benign epithelial neoplasms growing
on any surface that produce microscopic or
macroscopic finger-like pattern
Neoplasms composed of more than one
neoplastic cell type are called mixed tumors.
two epithelial components, as in
adenosquamous carcinoma;
two mesenchymal components, as in
malignant fibrous histiocytoma; or
an epithelial and a mesenchymal component,
as in carcinosarcoma of the lung and
malignant mixed müllerian tumor(MMMT)of
the uterus.
MIXED TUMORS:More than one type of
cells derived from same germ layer
TERATOMAS
HAMARTOMAS: Disorganized
overgrowth of mature cells indigenous to
that part
CHORISTOMA:Presence of well
developed & normally organized tissue of
one organ in another
1.Gross/Clinical Features
2.Microscopic Features
3.Growth Rate
4.Local Invasion
5.Metastasis
6.Prognosis
Dysplasia :
Definiton: a loss in the uniformity of the individual
cells and a loss in their architectural orientation.
Non-neoplastic and does not necessarily cause
cancer
Or doesn’t mean cancer and is REVERSIBLE
Occurs mainly in the epithelia
Dysplastic cells shows a degree of :
pleomorphism, hyperchromasia,increased mitosis
and loss of polarity.
Metastasis :
Definition : the development of secondary implants
discontinuous with the primary tumor, possibly in remote
tissues.
Cancers have different ability to metastasize
Approximately 30% patients present with clinically evident
metastases.
Generally, the more anaplastic and the larger the primary
tumor, the more likely is metastasis
Metastasis : three pathways
Lymphatic spread :
Hematogenous spread :
Seeding of the body cavities: pleural, peritoneal
cavities and cerebral ventricles
Lymphatic spread :
favored by carcinomas
Breast carcinoma axillary lymph nodes
Lung carcinomas bronchial lymph nodes
Hematogenous spread :
favored by sarcomas
Also used by carcinomas
Veins are more commonly invaded
The liver and lungs are the most frequently involved secondary sites
Seeding Body Cavities:
Malignant neoplasm penetrate into natural cavity (pleural, pericardial,
peritoneal, subarachnoid and joint space)
This mode of transmission is characteristic of cancers of ovary