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NEOPLASIA - PowerPoint PPT Presentation

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NEOPLASIA
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  1. NEOPLASIA Def.: persistent abnormal relatively autonomous proliferation of cells

  2. NEOPLASIA – classification BEHAVIORAL • benign • borderline • malignant

  3. NEOPLASIA – growth benign expansive borderline - locally destructive malignant infiltrative METASTASES

  4. Metastases Def.: development of secondary neoplastic foci in the distant places

  5. Metastases - pathways • seeding (body cavities) • lymphaticspread • hematogenous spread

  6. General Oncology - 3 • Biology of the neoplastic growth • Precanceroses (& pseudotumours) • Classification of the neoplasms • Methods of tumour diagnostics • Neoplasm prognostification

  7. NEOPLASIA – classification HISTOGENETIC (cell of origin) • mesenchymal • epithelial • neuroectodermal • mixed, teratoma • choriocarcinoma • mesotelioma

  8. General Oncology - 3 • Biology of the neoplastic growth • Precanceroses (& pseudotumours) • Classification of the neoplasms • Methods of tumour diagnostics • Neoplasm prognostification

  9. Methods of Tumour Diagnostics • Clinical symptoms – history • imaging techniques (X-ray, CT, endoscopy, PET…. • laboratory tests • morphology - pathology • cytology & histology & autopsy • Symptomles precanceroses / tumours – screening – e.g. Hemocult, Pap-test • histology incl. special staining methods • immunohistochemistry, electron microscopy • genetic analysis

  10. Malignant Tumour TYPING ICD-O GRADING G1 G2 G3 STAGING pTpNpM Tumour -Noduli-Metastases

  11. General Oncology - 2 • Biology of the neoplastic growth • Precanceroses (& pseudotumours) • Classification of the neoplasms • Methods of tumour diagnostics • Neoplasm prognostification

  12. Typing Grading Staging represent the Most Important Prognostic Factors

  13. Malignant Tumour TYPING ICD-O GRADING G1 G2 G3 STAGING pTpNpM Tumour -Noduli-Metastases

  14. Additional Prognostic Factors • proliferation markers (MIB 1…) • cell cycle regulators (p53, bcl 2…) • hormone receptors ER, PR • growth factors receptors EGFR ---------------- • angiogenesis • others………

  15. NEOPLASIA – classification HISTOGENETIC (cell of origin) • mesenchymal • epithelial • neuroectodermal • mixed, teratoma • choriocarcinoma • mesotelioma

  16. NEOPLASIA – architecture solid glandular papillary cystopapillary dissociated

  17. NEOPLASIA – cytology Benign similar to nonneoplastic Malignant cellular pleomorphism NUCLEAR FEATURES: hyperchromasia(polyploidy, aneuploidy) rough chromatine structure irregular nuclear outline large and/or multiple nucleoli or undifferentiated monotonous cellularity

  18. NEOPLASIA – Nosology-Typing • definition & ICD-O code • prevalance • age/sex predisposition (if any) • typical locations • clinical symptoms • gross level view • histopathology / cytopathology (incl. special diagnostic tools) • ultrastructure (esp. if useful for the diagnosis) • possible complications, prognosis

  19. Mesenchymal neoplasms Terminology Named after the cell of origin (Greek or Latin) • benign - suffix -oma • malignant – suffix -sarcoma

  20. Benign fibroma lipoma leiomyoma rhabdomyoma hemangioma lymphangioma chondroma chordoma osteoma lymphoma Malignant fibrosarcoma liposarcoma leiomyosarcoma rhabdomyosarcoma hemangiosarcoma lymphangiosarcoma chondrosarcoma invasive chordoma osteosarcoma lymphosarcoma Mesenchymal neoplasms Borderline -fibromatoses- -lipoblastoma- -hemangio endotelioma- - chondro blastoma- osteoblastoma

  21. Fibroma • benign tumour derived from fibroblasts • rare • age/sex predisposition no • typical locations ovary, oral cavity • solid white mass • gross level: circumscribed, soft-firm, whittish • fibroblast like fusiform cells (vimentin) • pressure, dif. dg

  22. Fibromatosis • superficial – palms, soles of feet (Dupuytren), m. Peyronie – induratio penis plastica non-neoplastic tumour like lesion • deep: borderline between tumour like lesions and fibrosarcoma – local recidives common • rare • age/sex predisposition F, middle age • gross level: strictures/large infiltrative masses • fibroblast like fusiform cells (vimentin) • mass

  23. Fibrosarcoma • derived from fibroblasts • age/sex predisposition M • soft tissue • clinical symptoms: mass • gross level view: fish flesh look • fusiform cells, mitoses (vimentin+) • hematogenous spread

  24. Myofibroblastic tumours • benign myofibroblastic tumour • myofibroblastic sarcoma • solitary fibrous tumour (CD34+) • hemangiopericytoma

  25. Dermatofibroma • cutaneous fibrous histiocytoma • storiform architecture (myofibroblasts) Dermatofibrosarcoma protuberans • borderline – ulceration & recurrences • increased cellularity & atypiae

  26. Fibrous Histiocytoma • benign (pigmented villonodullar synovitis) Malignant Fibrous Histiocytoma – mostly local malignancy blood & lymph. spread possible • increasing cellularity & atypiae