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lec.1

make Essay Question

Uploaded by

Ahmed Zaid
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© © All Rights Reserved
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NEOPLASIA (New growth)

DR.AYSER HAMEED
LEC.1
Abnormal mass of tissue, characterized by the followings:-
1. Its growth is uncoordinated & exceeded with that of the normal
tissues.
2. Neoplasm persist its growth after the cessation of stimuli which
cause the change.
3. Loss of responsiveness to normal growth controls
(Autonomous).
4. Tumors increase local size regardless of their local environmental
& nutritional status of the host.

 Neoplasia mean tumors.


 Oncology: is the science that studies the tumors.
 Oncology divided tumors according to their behavior into (Benign
& Malignant).

Nomenclature of Tumors:
All tumors (benign & malignant) have two basic parts:-
1. Parenchymal Part: Formed by neoplastic cells.
2. Supporting part: Made up of blood vessels & connective tissue.
Determine the clinical behavior of tumors.
Parenchymal Part
Derived the name of tumors.

Naming of Benign tumors :- (Cell of origin of tumor + Suffix Oma),


Like
 Fibroma (benign tumor of fibrous tissue).
 Chondroma (benign tumor of cartilage).

Certain Benign Tumors or lesions


1. Adenoma: benign epithelial neoplasm producing glandular pattern or
benign neoplasm derived from glands e.g. Renal adenoma, Adrenal
adenoma.
2. Papilloma: Any benign neoplasm growing on any surface that produce
microscopic or macroscopic finger like fronds, as in the skin.
3. Polyp: is a mass that projects above a mucosal surface, as in the gut.

Some malignant tumors appear as Polyp (mainly in the colon).


4. Cystadenoma: are hollow cystic masses, typically seen in the ovary.

Naming of Malignant Tumors


1. Malignant neoplasm arising in mesenchymal tissue or its derivatives are
called Sarcoma, e.g.
 Fibrosarcoma (malignant neoplasms of fibrous tissue).
 Chondrosarcoma (malignant neoplasm of cartilage).

1
 Osteosarcoma (malignant neoplasm of bone).

2. Malignant neoplasms of epithelial cells origin are called Carcinoma.

These epithelia are derived from germ layers, e.g. renal cell carcinoma
(Mesoderm), Squamous cell carcinoma (ectoderm).

So mesoderm can give rise to carcinoma as well as Sarcoma.

Sometime the type of malignant epithelia gives the name of


malignant tumor, like
1. Squamous cell carcinoma: tumor cells resemble stratified squamous
epithelium.
2. Adenocarcinoma: tumor cells grow in glandular pattern.

Sometime the tissue of origin can identify by the name of tumor, like
1. Renal cell carcinoma.
2. Hepatocellular carcinoma.

Tumors can be divided according to their origin:


1. Monoclonal tumor: Malignant tumor in which the cells are derived from
single progenitor cells (single germ layer).
2. Mixed tumors: tumors in which the stem cells may undergo divergent
differentiation, like pleomorphic adenoma of parotid gland which
contain two parts (epithelial part & fibromyxoid part).
Another example of mixed tumor is fibroadenoma of breast which
consist of two parts (Adenoma & fibroma).

3. Teratoma:
A tumor contains recognizable mature or immature cells or tissues, which
are derived from more than one germ layer (sometime from three germ
layers).
These teratomas are arising from totipotential cells mainly in the ovary &
testis.

May contain: -
 Bone, muscle, fat, hair (these are mesoderm derivatives).

 Epithelia (respiratory, intestinal), this is endoderm derivative.

 Nerve (ectoderm derivatives).


If all components of teratoma are benign, is called mature teratoma
typically seen in the ovary.
If these components are immature, this is called immature teratoma
(Malignant potential), typically seen in testis.

2
Tumor like lesions
1. Hamartoma: is a malformation that present as a mass of disorganized
tissue indigenous to the particular site, e.g. Hamartoma of lung.

2. Choristoma: is a congenital anomaly, it is heterotopic rest of cells,


e.g. small nodule of pancreatic tissue may be found in the submucosa
of stomach, duodenum & small intestine.

Important note:
Lymphoma, melanoma, mesothelioma & meningioma, although they are
end with suffix oma, they are malignant tumors.

Characteristics of Benign & Malignant tumors:


Characteristics of differentiation between benign & malignant tumors are:-
1. Differentiation & anaplasia.
2. Rate of growth.
3. Local invasion.
4. Metastasis.

I. Differentiation & Anaplasia:


 Parenchymal part of tumor is responsible for differentiation &
anaplasia of tumors, while the stromal part of tumors is important for
growth of tumor because it contains blood supply of tumors.

Differentiation of Parenchymal cells refers to the extent to which the


tumor cells resemble their normal original tissue morphologically &
functionally.

Benign tumors composed of well differentiated cells (closely resemble


their normal counterpart), e.g. Lipoma (consist of mature adipose cells),
Chondroma (consist of mature chondrocytes).
Mitosis is extremely rare in number in benign tumors.

Malignant tumors characterized by wide range of parenchymal cell


differentiation (from well differentiated to undifferentiated & anaplasia).

Anaplasia: means loss of structural & functional differentiation of normal


cells.
 Characteristics of anaplastic cells:
1. Pleomorphism (variation in the size & shape of cells).
2. Large hyperchromatic nuclei.
3. Increase Nucleus/ Cytoplasm (N/C) ratio 1:1 normally it is (1:4 or
1:6).
4. Anisonucleosis (variation in the size of nucleus) & poikilonucleosis
(variation in the shape of nucleus).
5. Chromatin is coarse, large prominent nucleolus.
6. Numerous, atypical mitosis.

3
7. Loss of normal orientation of cells (loss of gland formation).

According to degree of differentiation: three grade of differentiation of


malignant tumors:-
1. Well differentiated malignancy (like normal tissue).
2. Moderately differentiated malignancy.
3. Poor differentiated, undifferentiated, anaplastic malignancy.

Important notes:
Usually benign & well differentiated cancer have functional capacity e.g.
like well differentiated malignancy of endocrine glands secrete hormones
resemble the normal endocrine cells.

Dysplasia:
It is non-neoplastic growth disorder; mainly occur in epithelia (not stroma).
It is a loss of uniformity of the individual cells & a loss in their architectural
orientation.
Characteristics of dysplastic cells:-
1. Pleomorphism.
2. Large, hyper chromatic cells.
3. Mitosis more than normal (mitosis not restricted to the basal layer, it
involves the all layers).
4. Loss of normal maturation of cells e.g. loss of maturation of squamous
epithelium.

When dysplastic changes involve the entire thickness of the


epithelium, they are called Carcinoma in Situ or preinvasive stage of
cancer.
 However; foci of carcinoma in situ can present adjacent to area of
cancer.
 Dysplasia does not necessarily progress to cancer & dysplasia not
involve full thickness may be reversible.

THANKS

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