[B] 1.69 Terminology and classification of tumors (beningn, semimalignant tumors, in situ carcinoma, malignant tumors, preneoplastic changes, tumor-like lesions)

Question 1

Clinicopathologic groups

Answer 1

• Pre-neoplastic/dysplastic lesions
• Neoplasias
• Tumour-like lesions

Question 2

Neoplasia types

Answer 2

• Benign
• Semimalignant (borderline)
• In situ carcinoma
• Malignant

Question 3

Benign neoplasia are usually called by…

Answer 3

• Tissue of origin
• “-oma”

Question 4

Malignant tumours are usually called by…

Answer 4

Similar to benign

• Emphasising the malignant character
  
  • E.g Malignant mixed mammary gland tumour

Question 5

“-oma” suffix is also used for…

Answer 5

Tumour-like lesions

• Granuloma
• Haematoma
• Actinobacilloma

Question 6

Tumour naming: Epithelial malignant tumours

Answer 6

• Carcinoma
• Mesenchymal malignant tumours : Sarcoma

Question 7

Tumour naming: Individual naming

Answer 7

• Rous-sarcoma
• Wilms-tumour
• Hodgkin-lymphoma
• Burkitt-lymphoma

Question 8

Tumour naming: In case of highly undifferentiated tumours

Answer 8

Suffix: “-blastoma”

• Used after naming the tissue of origin
  
  • Nephroblastoma
  • Retinoblastoma

Question 9

Dysontogenic tumours

Answer 9

Between neoplasias and developmental anomalies

• Choristoma
• Hamartoma

Question 10

Choristoma

Answer 10

• Heterotopia
• Differentiated tissue developed at an incorrect location
• E.g:
  
  • Pancreas tissue in enteric mucosa
  • Adrenal glandular tissue under the renal capsule

Question 11

Hamartoma

Answer 11

Focal malformation

• Abnormally differentiated tissue at an anatomically normal location
• E.g:
  
  • ​Hamartoma of lung cartilage
    
    • Vessel structure, bronchus-like tissue can be found
  • Teratomas

Question 12

Differentiation of neoplasias

Answer 12

• Morpholigic variability of tumour cells
• Abnormal tissue structure
• Losing normal cell/tissue function
• Benign tumour are well-differentiated
• Mlignant tumours are less differentiated

Question 13

Classification of benign tumours

Answer 13

• Localised, slower growth, well removable
• No invasion/metastasis
• No recurrence
• Doesn’t harm the patient’s life
• Genetically simple & stable

E.g Lipomas rarely get malignant

Question 14

Classification of malignant tumours

Answer 14

• Faster growth, local invasion into surrounding tissues
• Metastasis to distant organs
• Less differentiated, differing grade
• Can cause death

Question 15

Classification of benign or malignant tumours often…

Answer 15

Overlap

Question 16

Give the criteria for tumour classification

Answer 16

1. Differentiation and anaplasia
2. Pace of growth
3. Local invasion
4. Metastasis

Question 17

Semimalignant tumours

Answer 17

• Benign neoplasia can turn into malignant ones
• Benign tumours can obturate bronchi, GI tract, urinary tract
• Secondary changes in tumour substance can cause unexpected symptoms:
  
  • Infection
  • Rupture
  • Bleeding
  • Ectopic hormone production

Question 18

Character of semi malignant tumours

Answer 18

• Locally invasive, infiltrating surrounding tissues
• No metastasis
• Usually gives recurrence

E.g: Myxoma, papilloma, trichoblastoma

Question 19

In situ carcinoma

Answer 19

• Pre-invasive phase of an epithelial malignancy
• Disorientated, atypical cells, marked dysplasia
• No infiltration through basement membrane

Question 20

In situ carcinoma: Mammary gland

Answer 20

Intraductal & intralobular carcinoma

Question 21

In situ carcinoma: Mucosa basement membrane invasion

Answer 21

• Early neoplasia

• E.g Superficial gastric tumour*
• Lamina muscularis mucosae is intact*

Question 22

Neoangiogenesis

Answer 22

If cell proliferation & vessel forming are not in balance then the following can occur due to hypoxia & anoxia

• Central necrosis
• Bleedings due to vessel damage

Question 23

Grade of differentiation of tumour is in connection with…

Answer 23

• Growing ability
• Invasion ability
• Prognosis of disease
• Therapy modality

Question 24

Anaplasia

Answer 24

• Imperfect differentiation process
• New functions can appear
  
  • Ectopic hormone production

Question 25

Anaplasia: Characteristics

Answer 25

• Increased nuclear : cytoplasmic ratio
• Hypo-/hyperchromasia
• Prominent nucleolus
• Increased mitotic activity
• Irregular chromosomes

Question 26

Pre-neoplastic lesions

Answer 26

Act as precursors to neoplastic progression

Can be marked with molecular methods before the clinical signs

Question 27

Acquired pre-neoplasia

Answer 27

Chronic regenerative cell proliferation

• E.g liver cirrhosis → Hepatocellular carcinoma

Question 28

Hyperplastic & dysplastic tissue proliferation: Example

Answer 28

Chronic dermatitis

• Epidermal hyperplasia

Question 29

Tumour-like lesions: With examples

Answer 29

• Difficult to differentiate macroscopically
  
  • Idiopathic nodular hyperplasia - Liver, pancreas, spleen
  • cholangiocellular hyperplasia
  • Cystic mucinous hyperplasia in gall bladder
  • Chronic inflammatory tissue proliferations