Dr.

Faisal Habeeb

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 Definition

 A neoplasm is : abnormal mass of

tissue which grows in an
uncoordinated manner.
 a new and abnormal growth of
tissue in a part of the body,
especially as a characteristic of
cancer.
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 Tumor = neoplasm
 Benign tumor = innocent-acting tumor
 Malignant tumor = evil-acting tumor

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 Nomenclature
Neoplasm

Benign Malignant

Carcinoma Sarcoma

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Neoplastic Proliferation:
Benign
 Localized, non-invasive.
Malignant (Cancer)
Spreading, Invasive.

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Tumors
 Benign  Malignant
 Grow slowly  Grow rapidly
 Well-defined capsule  Not encapsulated
 Are not invasive  Invade local tissue
 Well differentiated  Anaplasia: poorly
 Low mitotic index differentiated
 Do not metastatize  High mitotic index
 Metastasis )secondary
tumor)

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Gross (macroscopic)
features of two breast
neoplasms
Benign –
circumscribed, often
encapsulated, pushes
normal tissue aside

Malignant –
infiltrative growth, no
capsule, destructive
of normal tissues

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Naming Cancers
 Carcinoma: epithelial cells
 Adenocarcinoma: glandular tissue
 Sarcoma: connective tissue
 Lymphoma: lymph tissue
 Leukemia: blood forming tissue )marrow)
 Fibroma
 Osteoma

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Difficult to Define
 A new and abnormal growth of tissue in a part of the
body, especially as a characteristic of cancer.
 Tumor
 Original definition: mass greater than 2cm
 Neoplasm
 Not all are cancer
 Malignant vs. benign

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What is a “neoplasm”?
 Term of “tumor” conveys new growth or mass
 Definition revolves around these features:
 Monoclonal proliferation of cells with specific
mutations
 Excessive and unregulated growth of these cells, often
at the expense of surrounding normal tissue

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Biology of tumor growth

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 Terms to know about when
discussing neoplasia
 Metastasis - spread of a malignant tumor from one
site to another via blood or lymph
 Benign – typically refers to those tumors incapable
of metastasis and having a good clinical outcome
(prognosis)
 Malignant – those tumors capable of invasive growth
and/or metastasis, often fatal if not treated
effectively

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Cellular differentiation
 Tumors are often “graded” as to how closely they
resemble the normal parent tissue that they are
derived from.
 Poorly-differentiated means the cells are very similar
in appearance and architectural arrangement to
normal tissue of that organ

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Differentiation
 “Well-differentiated” refers to tumors that show only
minimal resemblance to the normal parent tissue
they are derived from.
 “Anaplastic” means the tumor shows no obvious
similarity to it’s parent tissue, usually associated with
aggressive behavior

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Precursors of neoplasia
 Hyperplasia
 Metaplasia
 Chronic inflammation
 dysplasia

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Radiation
 Ionizing radiation – x-rays, gamma rays, radioactive
materials such as Radon gas – all cause a variety of
defects to DNA
 UV light (non-ionizing) – primarily sun-exposure and T
-T dimerization – skin cancers

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Common features of viral
carcinogenesis
 Oncogenic viruses typically integrate their genomes
into host cells and enter a period of “latency”
 May be of DNA or RNA type
 DNA virus: Hepatitis B virus
 RNA viruses: HIV

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 EFFECTS OF TUMOURS

I.Local effects: local destruction of tissues

causes loss of function, ulceration,
hemorrhage, obstruction, …
Hormone production: well differentiated
(benign) tumors of endocrine glands may
secrete hormones, and cause hyperfunction.

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II. Cancer cachexia: i.e. wasting and
weakness. May be due to loss of
appetite, and production of TNF-
alpha (cachectin) and possibly other
factors by tumor cells and by
reactive macrophages.

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Grading of Malignant
Neoplasms

Grade Definition
I Well differentiated
II Moderately differentiated
III Poorly differentiated
IV Nearly anaplastic
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Cancer Mets and Staging
 Common mets sites: BBLL
 Brain
 Bones
 Liver
 Lungs
 Staging systems (various): carcinoma
 Stage 1: confined to organ
 Stage 2: locally invasive
 Stage 3: lymph node invasion
 Stage 4: spread to distant sites

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TNM system:
tumor spread
Lymphnode involvement
presence of distant metastasis

Staging may influence choice of treatment

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 Carcinogens – substances known to cause cancer or
produces an increase in incidence of cancer in animals
or humans
 Cause of most cancers is unknown
 Known carcinogenic agents constitute a small
percentage of cases
 Unidentified ‘environmental’ agents probably play a role in
95% of cancers

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 NOTE

 Carcinogenesis is caused by mutation of the genetic

material of normal cells .
 More than one mutation is necessary for
carcinogenesis.
 This results in uncontrolled cell devision and the
evolution of those cells by natural selection in the
body.

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Mutations of genes play vital roles in
cell division,
 Mutation of gene regulating
apoptosis (cell death), and DNA repair
will cause a cell to lose control of its
cell proliferation
 Cancer is fundamentally a disease of
disregulation of tissue growth.

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Sarcoma
 Malignant tumor arising from
connective tissue (i.e.
bone, cartilage, fat, nerve) develop
from cells originating in
mesenchymal cells outside the
bone marrow.

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 Sarcomas –
• Chondrosarcoma –
malignant tumor of
chondrocytes .
• Angiosarcoma – malignant
tumor of blood vessels .
• Rhabdomyosarcoma –
malignant tumor of skeletal
muscle cells .
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WHAT IS Ca Insitu

When dys pla s tic cha nges a re

m a r ke d a n d i n vo l ve t h e e n t i r e
thickness of the epithelium but
remains conf in ed by the basement
m em bra ne, i t i s co ns i dered a
preinvasive neoplasm or carcinoma
in situ

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