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Understanding Neoplasia: Cell Division and Growth Disorders

Neoplasia refers to the abnormal growth of tissue, characterized by uncontrolled cell division. It can manifest as benign or malignant tumors and is governed by various genetic factors. This overview explores the pathology, nomenclature, and clinical features of neoplasia, along with the process of carcinogenesis and metastasis. Key terms like granuloma, hamartoma, and choristoma are also elucidated.

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Understanding Neoplasia: Cell Division and Growth Disorders

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  1. Pathology of Neoplasia Dr.athmarmohamedredh

  2. Neoplasia Neoplasia: • Neo + Plasia  New + Growth. • Tumour  Swelling  any swelling* • definition: “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 manner after cessation of the stimuli which evoked the change” • “Cell division without control” • *

  3. Neoplasia Cell population / Growth Control: • Proliferation  Differentiation  Apoptosis * Normal Neoplasia Benign - Malignant Stem cell Carcinogen Initiator + Promotor Inflam Organ / Tissue RAS Rb MYC p53 1.Proto-Oncogenes (growth factors) 2.Growth/Tumor suppressor genes. 3.Genes controlling Apoptosis. 4.Genes controlling DNA Repair. Apoptosis

  4. Neoplasia Growth Disorders: Non neoplastic (Polyclonal) Neoplastic (Monoclonal) Hyperplasia Hypertrophy Aplasia Atrophy Metaplasia Dysplasia Normal Adaptation Benign Malignant

  5. Neoplasia Cell division Control - Carcinogenesis*

  6. Neoplasia Clinical Pathology Etiology (Carcinogenesis) Pathogenesis Morphology Clinical Features • • • • (Cancer Biology)

  7. Neoplasia BENIGN MALIGNANT Malignant • Poorly differentiated • Rapid growth • Non Cohesive, • No capsule • invasion/infiltration • Metastases. - Benign • Well differentiated • Slow growth • Cohesive, • expansile • Capsule • No invasion/infiltration Necrosis 10

  8. Neoplasia Neoplasms Nomenclature: Oma - Tumour Carcin-oma – HardTumour Sarc-oma - SoftTumour Benign Adenoma - Papilloma - Cell of Origin Malignant Adencarcinoma Squamous cell ca. • Gland. Epithelium• • Lining. Epithelium• Fibrosarcoma Osteosarcoma Chondrosarcoma Liposarcoma Leiomyosarcoma • Fibroma - • Osteoma - • Chondroma • Lipoma • Leiomyoma • Rhabdomyoma Rhabdomyosarcoma • Fibroblast • Osteoblast • Chondrocyte • Lipocyte • Smooth muscle • Skeletal muscle

  9. Neoplasia Nomenclature: exceptions • Teratoma – Tumour of Germ cell – multiple tissues. Benign (mature) or malignant (immature) • Melanoma (Melano-carcinoma) – Malignancy of melanocytes. • Seminoma (Seminal carcinoma) –carcinoma of Testes. • Leukemia – white blood – Ca. of Haemopoietic stem cells. • Lymphoma (Lymphosarcoma)– Malignancy of lymphocytes. • Mixed Tumours: Both epithelial & connective tissue components. Pleomorphic adenoma (Salivary gland) & Carcinosarcoma (breast/uterus) What is a Granuloma, Hamartoma & Choristoma?

  10. Cancer Clinical Features Cancer Biology

  11. Neoplasia Cancer Biology: • Structure: – Parenchyma – Neoplastic cells. – Stroma: Non neoplastic - normal DNA • Features: – Differentiation – Maturation of cells. – Rate of Growth – Mitotic rate Local invasion – Hemorrhage, necrosis, destruction – Metastasis – Distant Spread. 15

  12. • Tumors are clonal (one parent) • But have different mutations  different shapes & features. • Each new mutation adds a new feature. Normal cell First mutation Second mutation Third mutation Malignant cells Fourth or later mutation More new mutations with time.

  13. Neoplasia 6 Features of Cancer cells: Clinically each patient’s cancer has a different mix of features depending on quality & quantity of mutations & changes with time...!

  14. Neoplasia Pathogenesis of Lung Cancer. Irritation Carcinogens Initiation Promotion Ca. Anaplasia Smoke K-Ras C-myc p53 19

  15. Neoplasia Colon: Normal  Adenoma  Carcinoma Carcinogenesis) Colon Cancer: Common type - 80%

  16. Neoplasia Stage & Grade of Cancer: Staging: Progression or spread in thebody. Grading: Cell differentiation & Rate of growth –Microscopy. Well differentiated (low grade) Adenocarcinoma Grade Undiff. (high grade)

  17. Neoplasia Prostate Ca : Gleason Grading: Low Grade High Grade 22

  18. Neoplasia Metastasis: Lymphatic, Hematogenous, Direct.

  19. Metastasis: Pathogenesis: 1. Cell loosening 2. BM degradation 3. Invasion 4. Locomotion 5. BV adhesion 6. Intra-vasation 7. Tumour embolus 8. Adhesion 9. Extra-vasation 10. Angiogenesis 11. Growth. E-Cadherin, β-catenin Matrix Metalloproteinases (MMP) Collagenase (not in benign) Actin Cytoskeleton, chemokine • • • • What chemical mediators are involved? 28

  20. Thank you

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