General Path Neoplasia

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Oncology Definition

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study of neoplastic growth

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Neoplasia Definition

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"New Growth"
and the mass of cells composing the new growth is a neoplasm

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Neoplasm Definition

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new abnormal growth or mass of tissue whose growth rate exceeds & is uncoordinated with that of normal tissue, which serves no useful purpose & which persists in the same excessive manner after cessation of the evoking stimuli which caused the change

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Tumor Definition

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Used to refer to any swelling, but now used to refer to a neoplastic growth

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Cancer Definition

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Common term for all malignant neoplasm

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Benign Neoplasm Definition

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Neoplasm that tends to grow slowly, is well differentiated, does not metastasize & is usually non-life threatening

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Malignant Neoplasm Definition

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Neoplasm that tends to grow rapidly, is poorly differentiated, often metastasizes & frequently causes death of the host

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Metastasis Definition

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Refers to the transfer to disease manifestations from one organ to another. It is used mainly to refer to the secondary growth of a malignant neoplasm in an organ or site remote from the primary site

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Differentiation Definition

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Process where by 1 form, typically the immature, develops into another, usually the mature. As it relates to cells, this generally involves the development of immature cells into mature ones

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Anaplasia Definition

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"to form backwards"
refers to the tendency of a neoplasm to be composed of less differentiated/mature cells

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Suffix for most Benign Tumors

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-OMA

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Suffix for most Malignant neoplasms of connective tissue

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-Sarcoma

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Suffix for most Malignant neoplasms of epithelial origin

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-Carcinoma

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Mesenchymal tissues?

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Muscle
Bone
Tendons
Cartilage
Fat
Vessels
Lymphoid tissue
Fibrous tissue

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Name 2 characteristics of Mesenchymal Benign Neoplasms

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1) cells usually closely resemble their normal counter part
2) various adult mesenchymal cells are sufficiently distinctive to be readily differentiated from one another

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What are some methods of classifying Benign Neoplasms of Epithelial origin?

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cell or origin
microscopic architecture
gross appearance

ie. adenoma = benign epithelial neoplasm that forms a glandular pattern or is derived from glands...
ie. Papilloma = benign epithelial neoplasm growing on any surface producing micro or macroscopic finger like projections

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Describe a Papilloma

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aka polyp
Benign Epithelial neoplasm producing microscopically or grossly visible "finger-like" or "wart-like" projections from epithelial surface

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Describe Cystoma

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aka cystadenoma
Benign Epithelial neoplasm producing large cystic masses

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What is a malignant neoplasm of fibroblast called?

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Fibrosarcoma

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What is a malignant neoplasm of fat called?

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Liposarcoma

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What's a malignant neoplasm of epithelial origin called?

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Carcinoma

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What do you call a malignant neoplasm of epithelial origin with a glandular growth pattern microscopically?

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Adenocarcinoma

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Malignant neoplasm of stratified squamous epithelia origin producing recognizable squamous cells

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Squamous cell carcinoma

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What do you call a malignant neoplasm made of very primitive or undifferentiated cells?

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Undifferentiated malignant tumor
or
Undifferentiated Carcinoma
or
Undifferentiated Sarcoma

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Teratoma Definition

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designates a tumor composed of a variety of cell types representative of more than one germ layer

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What are the 3 primary criteria for differentiating Benign from Malignant Neoplasms

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1) Degree of cellular differentiation or cellular anaplasia
2) Rate of Growth
3) Mode of Growth & Spread

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What are the 2 "hallmarks" of malignancy?

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Anaplasia & Metastasis

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Describe Differentiated cells
Describe level of differentiation seen in benign & malignant neoplams

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Differentiated cells resemble their normal cells of origin & includes extent to which they achieve their fully mature morphologic & functional characteristics
More they resemble the normal cell the better the differentiation
The greater the departure from normal characteristics, the poorer the differentiation. Poorly differentiated cells are often called Anaplastic or undifferentiated...
Benign neoplasm is generally well differentiated
Malignant neoplasm can be well differentiated to primitive looking undifferentiated. Even well differentiated malignant neoplasms generally have some degree of anaplasia

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Characteristics of Anaplasia

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1) Pleomorphism (variation in size & shape of cell & nuclei)
2) Hyperchromatism (nuclei contain abundant dark staining chromatin)
3) Enlarged nucleoli
4) Increased mitosis with abnormal mitotic figures
5) Formation of tumor giant cells

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Difference in Growth Rate of Malignant & Benign Tumors

...exceptions?

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Benign - grow slowly over a period of years at a rather steady pace
Malignant - grow rapidly, sometimes at an erratic pace, eventually to spread and kill the host

Exceptions: Benign tumors may be dormant for a long time, during this time they don't seem to enlarge at all
Some get to a certain size & seem to stop growing or decrease in size
Malignant neoplasms generally progressively enlarge, some may shrink in size & may be dormant for some time... generally, the more anaplastic the neoplasm, the more numerous the mitoses & more rapid the growth

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What are the modes of Growth & Spread?

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1) Encapsulation -neoplasm grows as a localized expansive mass enclosed in fibrous capsule.
2) Metastasis -spread of neoplastic cells from one part of the body to another by way of bloodstream
3) Implantation -transfer of neoplastic cells from one serous or mucous surface to another by direct contact

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Describe Encapsulation

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Neoplasm grows as a localized expansive mass enclosed within fibrous capsule. Do not metastasize.
Characteristic of benign neoplasm.
Lack of capsule does not make it malignant.
Malignant neoplasm can be encapsulated or not.
Malignant neoplasm characterized by infiltrative, erosive growth extending into adjacent tissues -no normal anatomic boundary recognized

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Describe Metastasis

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Spread of neoplastic cells from one part of the body to another via bloodstream or lymph channels.
As neoplastic cells infiltrate, they may erode into blood vessels or lymphatics, become detached & act as emboli.
May lodge in other tissues, grow & develop into secondary tumor nodules (metastases)
When traveling thru bloodstream, neoplastic cells usually lodge in 1st capillary bed encountered (lung & liver)
Cells traveling thru lymph channels usually lodge in sinuses of regional lymph nodes
Epithelial neoplasms tend to metastasize by lymphatics
Connective tissue neoplasms tend to metastasize by bloodstream

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Which cell type usually metastasizes by lymphatics & which usually metastasizes by bloodstream?

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Epithelial neoplasms tend to metastasize by Lymphatics (producing carcinoma)

Connective tissues tend to metastasize by Bloodstream (producing sarcomas)

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Describe implantation

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Transplantation = mechanical transport of neoplastic cells from one serous or mucous surface to another by direct contact from instruments or gloved hands.
Body cavities are often involved
Neoplastic cells tend to lack cohesiveness, so epithelial neoplasms are prone to shed into the surrounding spaces
Implantation is a feature of some malignant neoplasms