Neoplasia 1: introduction Flashcards
Division of tumors
- Benign
- Malignant
- Local (intermediate) tumor
comapre between Neoplasia & Hyperplasia
- hyperplasia is purposeful & useful, neoplasia is purposless & harmful
- Hyperlasia is caused by stimulus (irritation), neoplasia may not be caused by stimulus
- Hyperplasia is reversible when stimulus is removed, neoplasia is irreversible & doesnt stop (unlimited)
- Neoplasia has abdnormal cytology
- Hyperplasia is multi-focal (many cell sources), neoplasia is unifocal (one cell source)
general difference in benign tumors from malignant tumors
more gentically stable, with little to no changes in phenotype
Most benign tumors are capsulated except ____
- Leiomyoma (in uterus)
- papilloma
- ivory osteoma
describe gross pathology of benign tumors
- Well circumscribed (defined) globular masses
- Mostly capsulated
- cut section shows no (rare) hemorrhage or necrosis
define cell differentiation
extend by which a tumor cell resembles comparable normal cell
define tissue (histological) differentiation
degree of resemblance of structural pattern between tumor mass and normal tissue
describe cell differentiation & histological differnetiation of benign tumors
- perfect cell differentiation (mimics normal cell)
- similar to normal tissue in histological differentiation
rate of growth of benign tumors
slow
local invation & metastis of benign tumors
doesn’t have the capacity to invade, infiltrate or metatstasize
prognosis of benign tumors
- good prognosis overall
- most benign tumors don’t recur if well excised
when does benign tumor prognosis becomes not good/ where does it have serious effects
- Brain: pressure on vital centers
- B cells of islets of langerhans of pancreas: secrete excess hormones (insulin) which leads to hyperinsulinism
- Pituitary gland: pressure on trophic cells
- Larynx or intestine (hollow organ): obstruction
- transform into Malignant tumor
gross pathology of Malignant tumors
- Ill defined infiltrating margins
- with hemorrhage & necrosis
- irregular
- non-capsulated
Microscopic morphology of malignant tumors
Anaplasia/cellular Atypia:
* cellular & nuclear Pleomorphism
* hyperchromatism of nucleus
* enlargement of nucleus (N/C=1:1)
* Nucleoli may be prominent
* Abdundant mitosis
* Abnormal mitotic figures
* Tumor giant cell containing polypoid nucleus or multiple nuclei
Histological differentiation of malignent tumor
loss of polarity:
* total loss of common structure with no recognisable pattern of orientation
Rate of growth of malignant tumors
rapid
spread of maligant tumors
- infiltration, invasion destruction & metastis
what should the surgeon take into account when removing a maligenant tumor
- remove the tumor with a wide safety margin
- Examine the edge of the margin for any cancer cells
Define Metastis
Secondary implantation of the tumor that is discontinuous with the primary (source of) tumor, located in remote tissues
most common form of malignancy
Carcinoma
site of Carcinomas
epithelium
prognosis of Carcinoma
better than sarcoma
most common age group for Carcinoma
above 40 (old)
gross morphology of Carcinomas
- hard consistency
- greyish color
- smaller than sarcoma
- with irregular infiltrating growth
- less necrosis & hemorrhage than sarcoma
Microscopy morphology of Carcinomas
- Cellular anaplasia atypia, however less than Sarcoma
- CT surrounds group of cells= Cell Cohesion
- Less blood vessels & better formed vessles than in Sarcoma (less hemorrhage)
site of Sarcoma
Mesenchyme
most common age group of sarcoma patients
young (below 20)
mode of growth of Carcinoma
mainly infiltrative, but also expansile
Mode of growth of Sarcoma
Expansile
Gross morphology of Sarcoma
- tinged Pink color (due to richer vascularity)
- soft & fleshy consistency
- Large bulky mass (expansile)
Microscopic Morphology of Sarcoma
- worse Cellular anaplasia atypia than carcinoma
- No cell cohesion= CT surrounds indivisual cells
- more & thin walled blood vessels than Carcinoma
- Hemorrhage
- Necrosis
- secondary Hylaine myxomatous degeneration
Compare between distant spread of Sarcoma & Carcinoma
Carcinoma:
* Lymphatics first then blood
* slower than sarcoma
Sarcoma:
* Blood first then lymphatics
* Faster than carcinoma
which malignancy has the worst prognosis
Sarcoma
which malignancy grows fastest
Sarcoma
which malignancy can grow by infilration
Carcinoma
which malignancy has cell cohesion (CT surrounds group of cells)
Carcinoma
which malignancy is hard
Carcinoma
which malignancy spreads early by blood
Sarcoma
Charactaristics of Intermediate (locally malignant) tumors
3 good:
* better prognosis than malignant tumors
* Locally invasive
* rarely metastasizes
1 bad:
* recurrance after surgical removal
Enumerate examples of intermediate tumors
BAGCCC
1. Basal cells carcinoma of skin
2. Ameloblastoma/Adamantinoma
3. Giant cell tumor of bone (osteoclastoma)
4. Carcinoid tumor (neuroendocrine)
5. Craniopharyngioma (CNS)
6. Chordoma
