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Neoplasia. Dr. Raid Jastania. Neoplasia: Terminology. Cancer is the 2 nd cause of death in the US Neoplasia is “new growth”

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neoplasia

Neoplasia

Dr. Raid Jastania

neoplasia terminology
Neoplasia: Terminology
  • Cancer is the 2nd cause of death in the US
  • Neoplasia is “new growth”
  • Neoplasm is an abnormal mass of tissue the growth of which exceeds and is uncoordinated with that of the normal tissues and persists after cessation of stimuli (By Willis)
neoplasia terminology3
Neoplasia: Terminology
  • Loss of normal growth (growth autonomy)
  • Loss of normal differentiation
  • Transformation
  • Tumor: swelling, mass of tissue
  • Oncology: Study of tumors
  • Benign vs Malignant
    • Benign: localized, not fatal
    • Malignant: cancer, invasive, metastasize, fatal
neoplasia concept of origin
Neoplasia: concept of origin
  • Zygote – cells – tissues – organs – human
  • DNA, genetic material, genes are the present in all the cells of the body
  • Cells differ in gene expression
  • Type of cells (based on genes expressed)
    • Control of growth
    • Differentiation
  • Monoclonality is the basis of neoplasia
  • Tumor progression, divergent differentiation
nomenclature
Nomenclature
  • Benign tumors
    • Suffix “–oma” is added to the cell type
      • Fibrous: fibroma
      • Cartilage: chondroma
      • Bone: osteoma
      • Adipose tissue: lipoma
      • Smooth muscle: leiomyoma
      • Skeletal muscle: rhabdomyoma
      • Blood vessels: hemangioma
      • Epithelial: adenoma (cystadenoma, papilloma)
nomenclature6
Nomenclature
  • Malignant tumors
    • Mesenchymal: sarcoma
      • Fibrous: fibrosarcoma
      • Cartilage: chondrosarcoma
      • Bone: osteosarcoma
      • Adipose: liposarcoma
      • Smooth muscle: leiomyosarcoma
      • Skeletal muscle: rhabdomyosarcoma
      • Blood vessels: angiosarcoma
    • Epithelial: carcinoma
      • Gland forming: adenocarcinoma
      • Squamous: Squamous cell carcinoma
      • Transitional cell: Transitional cell carcinoma (urothelial carcinoma)
nomenclature7
Nomenclature
  • Mixed tumors:
    • Pleomorphic adenoma of salivary gland
    • Fibroadenoma of breast
  • Teratoma: more than one germ-cell layer
    • Teratoma contains: bone, epithelium, muscle, fat, nerve….
nomenclature8
Nomenclature
  • Exceptions:
    • Malignant tumors
      • Lymphoma, melanoma, mesothelioma, seminoma
  • Hamartoma: not neoplastic, it is rather a malformation. Hamartoma contain mixture of mature (adult-type) tissue in abnormal distribution and arrangement
  • Choristoma: Hetrotopic rest. It is normal tissue in abnormal place.
benign and malignant
Benign and Malignant
  • How do we know benign from malignant tumor?
  • Features:
    • Differentiation and Anaplasia
    • Rate of Growth
    • Local Invasion
    • Metastasis
differentiation and anaplasia
Differentiation and Anaplasia
  • Differentiation is the extent to which tumor cells resemble their normal cells morphologically and functionally
  • Generally:
    • Benign tumors are well differntiated
    • Malignant tumors can be well differentiated, moderately differentiated or poorly differentiated. They can be “undifferentiated”
  • Anaplasia is lack of differentiation
differentiation and anaplasia11
Differentiation and Anaplasia
  • Anaplasia is lack of differentiation
    • Peomorphism
    • Hyperchromatic nuclei
    • High nuclear to cytoplsmic ratio (N/C ratio)
    • Giant cells
    • Mitosis
    • Loss of polarity and normal arrangement
    • Loss of sturcture
differentiation and anaplasia12
Differentiation and Anaplasia
  • Function:
    • Benign tumors: have normal function eg. Adrenal cortical adenoma
    • Malignant tumors: have variable function according to the degree of differentiation eg. Hepatocellular carcinoma produces bile
differentiation and anaplasia13
Differentiation and Anaplasia
  • Dysplasia:
    • Not neoplstic growth
    • Disordered growth and differentiation
    • Show mild anaplastic features eg. Nuclear pleomophism, hyperchromasia, mitosis….
rate of growth
Rate of Growth
  • Benign: slow growing
  • Malignant: fast growing
local invasion
Local Invasion
  • Benign tumors: localized, may be surrounded by pseudocapsule “capsule”
  • Malignant: invasive, infiltrating, destructiv, penetrating
metastasis
Metastasis
  • Secondary implants discontinuous from the primary tumor
    • 30% of newly diagnosed cancer has metastasis
    • 20% has occult metastasis
  • Modes of metastasis:
    • 1. Seeding in body cavity
    • 2. Lymphtics: lymph nodes
    • 3. Hematogenous: liver, lung, brain….
benign and malignant18
Benign and Malignant
  • In summary, Features of malignancy are
    • Less Differentiation and More Anaplasia
    • Rate of Growth - high
    • Local Invasion
    • Metastasis