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01 NEOPLASIA.pptx
- 1. Pre by lect: MR.ZAHID REHMAN IPMS(KMU) NEOPLASIA
- 2. Definition Neoplasia means abnormalnew growth. Neo means new and plasia means growth. Cellular proliferation and growth Uncontrolled R.A WILLIS (oncologist) define the neoplasia Abnormal mass of tissue, the growth of which exceed and is uncoordinated with that of the normal tissue and persists in the same excessive manners after the cessation of the stimuli which evoked the changes. The study of neoplasm(tumor) is called oncology.
- 3. Difference between neoplasiaand hyperplasia Neoplasia hyperplasia 1.Not under normal control normal control and it.s uncoordinated 2. Don’t stop when the source stop when the source is Is removed removed. 3.poor differentiated well differentiated
- 4. Nomenclature Components of neoplasm: Paranchyma: It,sContributes the proliferating part of the neoplasm. Made of neoplastic cell. Stroma. It is made up of connective tissue, blood vessel and lymphatics. it provides support for the growth of paranchymal cells. Provide blood supply to neoplastic cell and also give framework.
- 5. On the basisof clinical course 2 types of neoplasms Benign Malignant Benign tumors Well differentiated low mitosis no necrosis Slow growing Well demarcated
- 6. Encapsulated Donot infiltrate or metastasize May not recurrence Low dysplasia
- 7. Named with suffix–oma Example: benign tumor of epithelial origion. Adenoma : adenoma is a benign tumor of epithelial origion that resemble a glandular pattern or a benign tumor of glandular origion that may not resemble glandular structer. It.s means any benign tumor derivates from the glands. Or derivated from the epithelial tissue that.s not glands but the tumor shows glandular structer is called adenoma.
- 8. Papillomas- finger likeprojections raised from an epithelial surface. Cyst adenoma Plyps A polyp is an abnormal growth of tissue projecting fro m a mucous membrane Polyps are commonly found in the colon,stomach, n ose, urinary bladder and uterus Benign tumor arise from the mesenchymal tissue : Smooth muscle-leiomyoma (fibroid) Benign tumor arising from fibroblast cells is called fibroma. Benign tumor arise from menings is called meningioma.
- 9. Osteoma: The benigntumor arise from bones. Chrondoma: Benign tumor arise from the cartilage. Lipoma: Benign tumor arises from fat of cells in subcutanous tissue arises from cartilages.
- 10. Other term whichare not a benign tumor bt sound like a benign tumor Heamatoma Granuloma Choriostoma Presence of normal tissue in normal ectopic location. E.g presence of pancreas tissue in the intestine.
- 14. Malignant tumors Malignent tumormeans cancer (crab) Well to poorly differentiated analplasia High mitosis Grow rapidly bleed Infiltrate metastasize Recur Metastasis
- 15. Cytologic features ofmalignant neoplasms include: Increased nuclear size (with increased nuclear/cytoplasmic ratio--N/C ratio). Variation in nuclear or cell size (pleomorphism). Lack of differentiation (anaplasia). Increased nuclear DNA content with subsequent dark staining (hyperchromatism). Prominent nucleoli or irregular chomatin distribution within nuclei. Mitoses (especially irregular ).
- 16. Spread ofMalignant Neoplasms By direct extension (invasion) into surrounding tissues. Through lymph channels to lymph nodes (lymphatic spread)--typical of carcinomas. Via the bloodstream (hematogenous spread)-- typical of carcinomas or sarcomas. Within body cavities (seeding)--typical of neoplasms impinging upon body cavities, such as the peritoneal cavity.
- 17. Nomenclature Types of malignenttumor: Carcinoma: The malignent tumor of epithelail cell origion are called carcinoma. The word carcinoma is attached to the epithelail tissue e.g. malignent eipithelail tumor of renal cell is called renal cell carcinoma. Epithelial region More common Necrosis common Hemorrhages less frequent
- 18. Example : Adenocarcinoma : Thecarcinoma in which neoplastic epithelial cells grow in gland pattern is called adenocarcinoma. Adenocarcinoma of renal cell , stomach , colon, breast , gall bladder, prostate and uterus. Squamous cell carcinoma : The carcinoma in which neoplastic cells resemble stratifeid squamous epitheluim is called squamous cell carcinoma.the carcinoma arising from the area either coverd by stratifeid squamous epithelium(e.g skin, oral cavity, esophagus)
- 19. Sarcoma : The malignenttumor arsing in mesenchymal tissue are called sarcoma. e.g malignent tumor of fibroblastic cells is called fibrosarcoma. Mesenchyamal origion Less common Necrosis less common Hemorrhages more frequent.
- 20. Example Fibrosarcoma : Thistumor arises most commonly from facia , intermuscular and subcutaneuos tissue. Chondrosarcoma Osteogenic sarcomas Leiomysarcoma Liposarcoma.
- 21. renal cell carcinoma Hepatocellularcarcinoma renal cell carcinoma
- 22. Malignent tumor oflungs Ductal carcinoma of breast
- 23.
- 24. The sarcoma seenat medium magnification is composed of pleomorphic cells that vary markedly in size and shape. The increased amounts of nuclear DNA, making them hyperchromatic. The cell of origin of sarcomas is often difficult to determine because of their tendency to be poorly differentiated or even anaplastic. This sarcoma has many mitoses. A very large abnormal mitotic figure is seen.
- 25. Principle of tumor 1.Non lethal mutation 2. Monoclonolity 3. Protooncogenesis 4. Tumor supressor gene 5. Gene regualating appoptosis 6. Gene regulating DNA repair
- 26. 1. Non lethalmutation: Non lethal mutation is a type of mutation in which there is permanent hereditory changes in the DNA base sequence however the cell did,nt die. If the mutation was lethal , the cell would be die , if the cell deid so there is no way to cancer developed. Non lethal mutation result in carcinogenesis when the mutation will alter protooncogenesis and tumor supressor gene can result caner formation.
- 27. Gene : Gene isa unit of DNA , that encoted a particular protein or RNA molecules or unit of hereditory. Mutation alter the gene. Mutation : Permanent , hereditable changes in the base sequence of DNA of an organ. Mutation due to radiation, toxidity etc.
- 28. Monoclonality : Most ofthe tumor are monoclonol . The tumor is formed from the clonol expansion of the single precurssor cell that had encounterd in non lethal mutation.
- 29. 4 target genefor genetic damage Protooncogenesis : Nomal gene that is found in our cell it.s function is to encote protein that regulate the cell proliferation and cell differentiation and it has some role in signal transdiction, also role in mitosis and cell cycle. We need the protooncogenesis for the normal growth and differentiation of cell. When these protooncogenesis get mutated so its called oncogenesis. Oncogenesis can result cancer developed .
- 30. in non-mutantstate called proto-oncogenes stimulate cell growth and replication when turned “on” by mutation cause uncontrolled growth called oncogeneses.
- 31. Tumor supressor gene: Opposite to oncogene. Inhibit cell proliferate and also inhibit tumor development. negatively regulate proliferation - antioncogenes want these to remain intact takes two “hits” to remove both genes
- 32. Gene regulating apoptosis: Apoptosis is a pathway of programe cell death. Apoptosis is a better alternative when the cell is so much damaged so then DNA can,t be repair so there will be a risk of mutation of DNA result in cancer. Cause are rediation , some viral infection.
- 33. Gene regulating DNArepair : Target of genetic damaged . If there is damaged in these gene that will also result cancer formation indirectly . If the gene damaged it will decrease the regulate the DNA repair. Protooncogenesis and tumor supressor gene when these gene getting damaged , lack of repair it will developed the formation of cancer.
- 34. Genetics andcancer prone families to be passed down, mutations must occur in germ cells inherited mutations almost always in tumor suppressor genes
- 35. Epstein-Barr andKaposi sarcoma both herpes viruses Human T cell leukemia-lymphoma virus blood transfusions, needles, sex and breast feeding Bacterial causes of Cancer Helicobacter pylori infects >1/2 world’s population assoc. with B cell lymphomas of the
- 36. Environmental factors Tobaccouse Diet Alcohol use Sexual and reproductive behavior Air pollution UV radiation and other radiation hormones
- 37. Metastasis Tumor implants discontinuefrom the primary tumor is called metastasis. Spread: Spread by lymphatic system Hematogenous routs Seeding of body cavities
- 38. Malignant neoplasmsare capable of metastasizing. A metastasis represents a malignant neoplasm that has traveled from its primary site of origin to a distant site. This is an example of metastases to the liver. A primary neoplasm is more likely to appear within an organ as a solitary mass. The presence of metastases is an indication that a neoplasm is malignant.
- 39. The original cloneof cells that developed into a neoplasm may not have had the ability to metastasize, but continued proliferation of the neoplastic cells and acquisition of more genetic mutations within the neoplastic cells can give them the ability to metastasize.
- 40. Seeding of bodycavities and surface This occure when a malignent neoplasim penetrate into a natural “open field” such as peritoneal cavity , pleural space, pericardial cavity etc. Example : Ovarian carcinoma Appendicle carcinoma
- 41. Neoplasms can spreadby seeding within body cavities such as the pleural cavity or peritoneal cavity. This pattern of spread is more typical for carcinomas than other neoplasms. Note the multitude of small tan tumor nodules seen over the peritoneal surface of the mesentery shown here.
- 42. Lymphatic spread Most commonpathway for dissemination or spreading of carcinoma ( sarcoma also use this routs) . The pattern of lymphnode involment follows the natural routs of drainage. Hematogenous spread This pathway is typical of sarcoma . Due to elasticity arteries are more difficult for tumor to penetrate then vein. With the venous invasion the tumor cell follow the venous flow drainage.
- 43. Common metastatic sites Liver Lung Bone Brain Adrenal;Lung and breast Gastric carcinoma Krukenberg tumor: Gastric met to ovary
- 44. Staging Staging isa way of describing how much a cancer has grown and spread. A common way of staging cancer is called the TNM classification: T stands for tumour - how far the primary tumour has grown locally. N stands for nodes - if the cancer has spread to the local lymph glands (nodes). M stands for metastases - if the cancer has spread to other parts of the body.
- 45. Example: instomach cancer: T-1 means the primary tumour is still in the stomach wall. T-3 means the primary tumour has grown right through the stomach wall and T-4 means it is invading nearby structures such as the pancreas. N-0 means there is no spread to lymph nodes. N-1 means that some local lymph nodes are affected. N-2 means more extensive spread to local lymph nodes. M-0 means there are no metastases. M-1 means that there are metastases to some other area of the body such as the liver or brain.
- 46. Grading Some cancersare also graded. A sample of the cancer (a biopsy) is looked at under the microscope or tested in other ways. By looking at certain features of the cells, the cancer can be graded as low, intermediate or high. Low-grade means the cancer cells tend to be slow- growing, look quite similar to normal cells (are well differentiated), tend to be less aggressive, and are less likely to spread quickly. Intermediate-grade is a middle grade. High-grade means the cancer cells tend to be fast growing, look very abnormal (are poorly differentiated), tend to be more aggressive, and are more likely to spread quickly.
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