Neoplasia I.pptx

Neoplasia I Presented by Dr. Sahar Gamal Elbager Assistant Professor of Molecular Haematology Dean of MLS Head of Haematology Department University of Medical Sciences and Technology (UMST)  Neoplasia...

Neoplasia I Presented by Dr. Sahar Gamal Elbager Assistant Professor of Molecular Haematology Dean of MLS Head of Haematology Department University of Medical Sciences and Technology (UMST)  Neoplasia Upon completion of these lectures, the student should: Know the neoplasm definition and classification. Know the structure characteristics of tumors. Know the basic principles of the nomenclature Know the basic clinical effects of benign and malignant tumour. Dr.Sahar Elbager 2  Neoplasia Neoplasia = new growth Neoplasm = Tumor Oncology (oncos = tumor) is the study of tumors or neoplasm Dr.Sahar Elbager 3  Neoplasia Definition Neoplasia is an abnormal mass of tissue, the growth of which is uncoordinated with that of normal tissues, and that persists in the same excessive manner after the cessation of the stimulus which induced the change, with the loss of responsiveness to normal growth controls. (Dr. RA Willis) “Cell division without control” Dr.Sahar Elbager 4  Neoplasia Definition At molecular level, neoplasm is disorder of growth regulatory genes ( the activation of proto- oncogenes and the inactivation of tumor suppressor genes ). Dr.Sahar Elbager 5  Neoplasia The Neoplasia/tumor is a common disease all over the world. In many countries especially developed countries, malignant tumor has become the first or second leading cause of death. Although many research works focused on oncology and great progress has been made in understanding tumors in the past decades, the morbidity and mortality rate of malignant tumor is increasing. The underlying causes include air pollution, pressure, genetics, unhealthy lifestyle, ageing population and so on. Dr.Sahar Elbager 6  Neoplasia Classification 1.Benign. 2. Malignant (cancer). Dr.Sahar Elbager 7  Benign Neoplasia A benign tumor is usually localized and typically slow growing. Most benign tumors respond well to treatment Most benign have well defined borders, so surgical removal can be an effective treatment Patient generally survives However, if left untreated, some benign tumors can grow large and leads to serious disease because of their size. eg : fibroid in the uterus, lipomas in skin. Dr.Sahar Elbager 8  Malignant Neoplasms Malignant neoplasms: Divide uncontrollably without order. Can invade and destroy adjacent structure. Can spread to distant sites (metastasis) Cause death (if not treated ). Dr.Sahar Elbager 9  Structure Characteristics of Tumors All tumors have two basic components: Parechyma and Stroma Parechyma: made up of neoplastic cells. Stroma: made up of non-neoplastic, host- derived connective tissue and blood vessels The parenchyma: The stroma: Determines the biological Carries the blood supply. behavior of the tumor from which Provides support for the growth the tumor derives its name. of the parenchyma Dr.Sahar Elbager 10 Structure Characteristics of Tumors Dr.Sahar Elbager 11  Neoplasms Nomenclature Nomenclature basic principle: Neoplasms are named according to binomial system denoting their histological origin of the parenchymal component and the biologic behavior. Dr.Sahar Elbager 12 13  Benign Neoplasms Nomenclature benign tumors of mesenchymal origin all cells of mesenchymal origin follows this rule :type of cell + (-oma) Examples: Benign tumor arising in fibrous tissue: Fibro + oma = Fibroma Benign tumor arising in fatty tissue: Lipo + oma = lipoma Benign tumor arising in cartilage chondro + oma = chondroma Benign tumor arising in smooth muscle Leiomyo + oma = leiomyoma Dr.Sahar Elbager 14  Lipoma Dr.Sahar Elbager 15  Benign Neoplasms Nomenclature Epithelial benign tumors are classified on the basis of : 1. The cell of origin 2. Microscopic pattern 3. Macroscopic pattern Gross appearance of tumor-shape: polypoid, Papillary, nodular , lobulated cystic and ulcerated Dr.Sahar Elbager 16  Benign Neoplasms Nomenclature Epithelial benign tumors eg. Adenoma: benign epithelial neoplasms producing gland pattern….OR … derived from glands but not necessarily displaying gland pattern Glandular tissues with non-glandular patterns e.g. Thyroid adenoma Non-glandular tissues with glandular patterns e.g. renal tubular adenoma Dr.Sahar Elbager 17 Adenoma Dr.Sahar Elbager 18  Benign Neoplasms Nomenclature Epithelial benign tumors eg. Papilloma: benign epithelial neoplasms growing on any surface that produce microscopic or macroscopic finger-like pattern. E.g. Oral papilloma. Dr.Sahar Elbager 19  Benign Neoplasms Nomenclature Epithelial benign tumors eg. Cystadenoma A form of adenoma that form cystic masses.E.g ovarian cystadenoma. Dr.Sahar Elbager 20  Benign Neoplasms Nomenclature Epithelial benign tumors eg. Polyp: a mass that projects above a mucosal surface to form a macroscopically visible structure. e.g. - colonic polyp - nasal polyp Dr.Sahar Elbager 21  Polyp Dr.Sahar Elbager 22  Benign Neoplasms Examples 1. Respiratory airways: Bronchial adenoma 2. Renal epithelium: Renal tubular adenoma 3. Liver cell : Liver cell adenoma 4. Squamous epithelium: squamous papilloma Dr.Sahar Elbager 23  Malignant Neoplasms Nomenclature Malignant tumors: 1. Malignant tumor arising in mesenchymal tissue : SARCOMA 2. Malignant tumors arising from epithelial origin : CARCINOMA Dr.Sahar Elbager 24 Dr.Sahar Elbager 25 Osteosarcoma Dr.Sahar Elbager 26 Dr.Sahar Elbager 27  Neoplasms Nomenclature Based on the cell of origin : One neoplastic cell type : lipoma, adenocarcinoma More than one neoplastic cell type : fibroadenoma (including both epithelial and stromal tissues). More than one neoplastic cell type derived from tumor formed by different types of tissue: Teratoma (including teeth, hair, bone and muscle), normally present in the ovary and testis. Derived from embryonic tissue: blastoma (could be benign e.g. osteoblastoma, or malignant e.g. neuroblastoma Dr.Sahar Elbager 28 Fibroadenoma Dr.Sahar Elbager 29 Teratoma Dr.Sahar Elbager 30  Neoplasm differentiation Neoplasm differentiation denotes the degree to which a neoplasm cell look like the normal mature cells of the tissue both morphologically and functionally. Dr.Sahar Elbager 31  Differentiation and Anaplasia Benign tumors are usually well differentiated. They resemble closely their normal counterpart. Malignant tumors, on the other hand, show variable degree of differentiation. Well differentiated Undifferentiated Malignant tumors that are composed of undifferentiated cells are said to be “anaplastic”, that means no morphological resemblance to normal tissue. (lack of differentiation) Dr.Sahar Elbager 32  Neoplasm differentiation A small hepatic adenoma that shows Well- Poorly differentiated tumor, with large basophilic differentiated neoplasm composed of tumor cells that no longer resemble hepatocytes normal appearing hepatocytes Dr.Sahar Elbager 33  Characteristic Benign Malignant Differentiation Well differentiated Range from well differentiate to undifferentiated Rate of growth Slow growth over a Rapid growth period of years Type of growth Expansible Progressive infiltration, invasion, and destruction of surrounding tissue Separated from Yes, has fibrous Poorly separated Metastasis capsule composed of stroma of native Comparison Metastasis No Yes Effect on host Often Significant, fever, anemia, infections, etc. Recurrence Rare Often Cell shape Monomorphic Pleomorphic, Tumor giant cells Nuclear chromatin Normal Inreased, hyperchromatic; Peripheral clumping Nucleoli Not prominent Prominent, irregular shape Dr.Sahar Elbager 34  Clinical Effects of Benign Tumors 1. Pressure effects: Can compress surrounding tissues, leading to pain, obstruction, or functional loss. 2. Hormonal effects: Some benign tumors secrete hormones, causing hormonal imbalances. 3. Cosmetic effects: Can cause visible deformity. 4. Usually non-life-threatening: Benign tumors rarely cause death, unless located in a critical area. Lipoma Dr.Sahar Elbager 35  Clinical Effects of Malignant Tumors 1. Local effects: Can cause pain, bleeding, obstruction, or functional impairment. 2. Metastatic spread: Can spread to distant sites, leading to secondary tumors and organ dysfunction. 3. Cachexia: Wasting syndrome characterized by weight loss, muscle atrophy, and weakness. 4. Life-threatening: Malignant tumors can cause death if untreated or if they spread to vital organs. Dr.Sahar Elbager 36  Benign Tumors Treatment In many cases, benign tumors need no treatment. Doctors may simply use “watchful waiting” to make sure they cause no problem. Treatment may be needed if symptoms are a problem. Surgery is a common type of treatment for benign tumors. The goal is to remove the tumor without damaging surrounding tissues. Dr.Sahar Elbager 37  Malignant Tumors Treatment Surgery Chemotherapy Radiotherapy Hormone therapy Stem cell therapy Dr.Sahar Elbager 38 Thank you Dr.Sahar Elbager 39