NEOPLASM

Group 2
Diosomito
Dizon
Donato
Dy
Enriquez
Fauni
Fermin
Galicia
Neoplasia
 “new growth”
Tumor
 swelling caused by inflammation

Oncology
 Greek oncos = tumor
 study of tumors or neoplasms
 British oncologist Willis
“A neoplasm is an abnormal mass of
tissue, the growth of which exceeds and is
uncoordinated with that of the normal
tissues and persists in the same
excessive manner after cessation of the
stimuli which evoked the change.”
 TUMOR
BENIGN MALIGNANT
 The tumor will remain  The lesion can invade
localized, cannot and destroy adjacent
spread to other sites structures and spread
and is generally to distant sites
amenable to surgical (metastasize) to
removal. However the cause death.
tumor can produce
more than localized
lumps and sometimes
are responsible for
serious disease.
 All tumors, benign and malignant, have
two basic components:
(1) clonal neoplastic cells that constitute
their parenchyma and
(2) reactive stroma made up of connective
tissue, blood vessels, and variable
numbers of macrophages and
lymphocytes.
 The nomenclature of tumors and their
biologic behavior are based primarily on
the parenchymal component.
 Polyp is termed when a neoplasm, benign
or malignant, produces a macroscopically
visible projection above a mucosal surface
and projects, for example, into the gastric
or colonic lumen.
 BENIGN TUMORS
 Attach the suffix –oma to the cell of origin
(mesenchymal cells in general)
e.g. fibroma- tumor arising in fibrous tissue
chondroma- cartilaginous tumor
 Adenoma is applied to benign epithelial
neoplasms derived from glands.
 Papillomas are epithelial neoplasms
producing microscopically or
macroscopically visible finger-like or warty
projections from epithelial surfaces
 Cystadenomas are epithelial neoplasms
that form large cystic masses, as in the
ovary.
 Papillary cystadenomas are tumors which
produce papillary patterns that protrude
into cystic spaces.
 MALIGNANT TUMORS
 Sarcomas (Gk sar = fleshy) are tumors
arising in mesenchymal tissues. They
have little connective tissue stroma and
are fleshy. (e.g. fibrosarcoma)
 Carcinomas are neoplasms of epithelial
cell origin derived from any of three germ
layers.
 Squamous cell carcinoma- tumor cells
resemble stratified squamous epithelium
 Adenocarcinoma- the neoplastic epithelial
cells grow in glandular patterns
 Mixed tumors- divergent differentiation of
a single neoplastic clone along two
lineages
 Example: mixed tumor of salivary gland
origin- contain epithelial components scattered within
a myxoid stoma that sometimes contains islands of
cartilage or bone
 Teratoma- contains recognizable mature
or immature cells or tissues representative
of more than one germ cell layer and
sometimes all three
 NOMENCLATURE OF TUMORS
Tissue of Origin Benign Malignant
COMPOSED OF ONE PARENCHYMAL CELL TYPE
•Tumors of Mesenchymal Origin
Connective Fibroma Fibrosarcoma
Tissue and Lipoma Liposarcoma
derivatives
Chondroma Chondrosarcoma
Osteoma Osteogenic sarcoma
•Endothelial and Related Tissues
Blood Vessels Hemangioma Angiosarcoma
Lymph Vessels Lymphangioma Lymphangiosarcoma
Synovium Synovial sarcoma
Mesothelium Mesothelioma
Brain Coverings Meningioma Invasive meningioma
Tissue of Origin Benign Malignant

•Blood Cells and Related Cells

Hematopoietic Cells Leukemias

Lymphoid Tissue Lymphomas

• Muscle

Smooth Leiomyoma Leiomyosarcoma

Striated Rhabdomyoma Rhabdomyosarcoma

•Tumors of Nevus Malignant melanoma

Melanocytes
Tissue of Origin Benign Malignant
• Tumors of Epithelial Origin
Stratified squamous Squamous cell papilloma Squamous cell carcinoma
Basal cells of skin or Basal cell carcinoma
adnexa
Epithelial lining of Adenoma Adenocarcinoma
glands or ducts
Papilloma Papillary carcinomas
Cystadenoma Cystadenocarcinoma
Respiratory passages Bronchial adenoma Bronchogenic carcinoma
Renal epithelium Renal tubular adenoma Renal cell carcinoma
Liver cells Liver cell adenoma Hepatocellular carcinoma
Urinary tract epithelium Transitional-cell papilloma Transitional-cell carcinoma
(transitional)

Placental epithelium Hydatidiform mole Choriocarcinoma

Testicular epithelium Seminoma
(germ cells)
Embryonal carcinoma
Tissue of Origin Benign Malignant
MORE THAN ONE NEOPLASTIC CELL TYPE- MIXED TUMORS, USUALLY
DERIVED FROM ONE GERM CELL LAYER

Salivary glands Pleomorphic adenoma Malignant mixed

(mixed tumor of salivary tumor of salivary
origin) gland origin
Renal anlage Wilms tumor

MORE THAN ONE NEOPLASTIC CELL TYPE DERIVED FROM MORE

THAN ONE GERM CELL LAYER- TERATOGENOUS

Totipotential cells Mature teratoma, Immature teratoma,

in gonads or in dermoid cyst teratocarcinoma
embryonic rests
 In general, benign and
malignant tumors can be
distinguished on the basis of
differentiation and anaplasia, rate
of growth, local invasion, and
metastasis.
 DIFFERENTIATION AND ANAPLASIA
 Differentiation refers to the extent to which
neoplastic parenchymal cells resemble the
corresponding normal parenchymal cells, both
morphologically and functionally; lack of
differentiation is called Anaplasia (literally means to
form backward).
 In general, benign tumors are well differentiated.
 Malignant neoplasms are characterized by a wide
range of parenchymal cell differentiation, from
surprisingly well differentiated to completely
undifferentiated.
 Anaplasia is often associated with many
other morphologic changes.
 Pleomorphism- variation in size and shape of the cells
and the nuclei.
 Abnormal nuclear morphology- characteristically the
nuclei contain abundant chromatinand are dark staining
(hyperchromatic); nuclei are disproportionately large for
the cell.
 Mitoses- undifferentiated tumors usually possess large
numbers of mitoses, reflecting the higher proliferative
activity of the parenchymal cells. The presence of
mitoses, however, does not necessarily indicate that a
tumor is malignant or that the tissue is neoplastic.
 Loss of polarity- the orientation of
anaplastic cells is markedly disturbed (i.e.
they lose normal polarity).
 Other changes- formation of tumor giant
cells.
METAPLASIA
 the replacement of one type of cell with
another type

DYSPLASIA
 disordered growth
 include a loss in the uniformity of the
individual cells as well as a loss in their
architectural orientation
 does not necessarily progress to cancer
 RATES OF GROWTH
 By the time a solid tumor is clinically
detected, it has already completed a major
portion of its life span.
 The rate of growth of a tumor is
determined by three main factors:
 The doubling time of tumor cells
 The fraction of tumor cells that are in
replicative pool
 Rate at which cells are shed or die
 Growth fraction- the proportion of cells
within the tumor population that are in the
proliferative pool (during early,
submicroscopic phase of tumor growth)
 In general, the growth rate of tumors
correlates with their level of differentiation,
and thus most malignant tumors grow
more rapidly than do benign lesions.
 CANCER STEM CELLS AND CANCER
CELL LINEAGES
 Cancers are immortal and have limitless
proliferative capacity, indicating that like
normal tissues, they also must contain
cells with “stemlike” properties.
 If cancer stem cells are essential for tumor
persistence, it follows that these cells
must be eliminated to cure the affected
patient.
 LOCAL INVASION
 Nearly all benign tumors grow as cohesive
expansile masses that remain localized to
their site of origin and do not have the
capacity to infiltrate, invade, or
metastasize to distant sites, as do
malignant tumors.
 Fibrous capsule- rim of compressed
connective tissue
 The growth of cancer is accompanied by
progressive infiltration, invasion, and
destruction of the surrounding tissue.
 Next to the development of metastases,
invasiveness is the most reliable feature
that differentiates malignant from benign
tumors.
 METASTASIS
 Metastases are tumor implants
discontinuous with the primary tumor.
 Only malignant tumors metastasize
 Exception: gliomas (glial cells in CNS) and
basal cell carcinomas of the skin rarely
metastasize
 Dissemination of cancers may occur
through one of three pathways:
 Direct seeding of body cavities or surfaces
 Lymphatic spread
 Hematogenous spread
(1) Seeding of Body Cavities and Surfaces
 Occur when malignant neoplasms penetrate into a
natural “open field”
(2) Lymphatic Spread
 Sentinal lymph node- the first node in a regional
lymphatic basin that receives lymph flow from the
primary tumor”
 Nodal enlargement in proximity to a cancer does
not necessarily mean dissemination of the primary
lesion.
(3) Hematogenous Spread
 liver and lungs are most frequently involved in
hematogenous dissemination
 Comparison bet. Benign and Malignant Tumors
Characteristics Benign Malignant
Differentiation/ Well differentiated; structure Some lack of differentiation
sometimes typical of tissue of with anaplasia; structure
Anaplasia origin often atypical

Rate of Growth Usually progressive and Erratic and may be slow to

slow; may come to a rapid; mitotic figures may
standstill or regress; mitotic be numerous and
figures rare and normal abnormal

Local Invasion Usually cohesive expansile Locally invasive, infiltrating

well-demarcated masses that surrounding tissue;
do not invade or infiltrate sometimes may be
surrounding normal tissues seemingly cohesive and
expansile

Metastasis Absent Frequently present; the

larger and more
undifferentiated the
primary, the more likely are
metastases