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7 Cards in this Set
- Front
- Back
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Possible problems associated with benign neoplasms:
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1) strategic location (eg brain)
2) Hormone production 3) Cosmetics 4) Malignant transformation |
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Origin of Neoplasm =
Mixed examples: |
a single cell, therefore neoplasms usually clonal (one cell type)
Some are mixed: Mixed tumor of salivary gland - epithelial and myoepithelial cells - both are neoplastic/clonal Basal Cell Carcinoma - epithelial and melanocytic - only epithel is neoplastic Teratoma - Derived from totipotent cells (gonadal) - Different along various germ lines (skin, fat, gut, teeth) |
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Malignant Neoplasm:
Invasion = Process of invasion - Metastasis = Process of metastasis - |
Malignant cells traverse boundaries such as BM
Malignant cells in blood adhere to endothelium -> Collagenase and other proteolytic enzymes expressed -> holes in capillary BM -> malignant cells move through holes -> invade interstitium Malignant cells separate and move active or passively to new location vascular invasion (enhanced by angiogenesis driven by tumor-induced growth factors) -> localize to target tissue (based on cell surface molecules and via vascular adhesion molecules) -> proliferation in target tissue |
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3 routes of metastasis:
Rates of invasion: |
Seeding of Body cavities - peritoneal, pleural, pericardial
Lymphatic spread - carcinoma and sarcoma, there are predictable drainage pathways Hematogenous spread - Sarcoma and carcinoma, Liver and lungs usually venous, arterial spread possible by alveolar capillaries -> arterial circ vary widely depending on type of malignancy, and individual cases - not predictable with certainty |
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2 ways to ID Autonomous growth:
3 phenotypic expressions of altered differentiation: |
1) In vivo: uncontrolled clone cell growth -> becomes a mass, tumor or spot
malignancy defined by - invasion, metastasis, transplantibility (to mouse) 2) In Vitro: in cell culture defined by - loss of contact inhibition, ability to grow in soft agar (without attachment), immortality (grow indefinitely) Diminished or inappropriate gene expression: 1) Loss of normal products 2) New products 3) Fetal Gene expression |
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Characteristics of Malignant cells:
Functional Morphologic Tumor Heterogeneity = |
Functional Characteristics:
Transformation Less Differentiation Lack response to normal growth control immortality, lose contact inhib, lose apoptosis (in vitro) Morphologic Characteristics: Less differentiation/more anaplasia Pleomorphic Increased mitotic activity Often central necrosis Tumor Heterogeneity = all characteristics vary from area to area within tumor |
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Predictions of neoplasm behavior based on:
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1) Tumor Type
2) Tumor Grade: - to plan treatment based on AGGRESSIVENESS via degree of differentiation and Mitotic activity - Greater predictor for some cancers (better for prostate than melanoma) - Less helpful predictor than Stage 3) Stage: - to plan treatment based on EXTENT OF TUMOR (basically size of primary neop, location, and extent of metastases) - Two systems: UICC (Union Internationale Contre Cancer)/TNM System = T = tumor size N = nodal involvement M = distant metastases American Joint Committee on Cancer Staging = Stage 0 - IV based on - size of primary neoplasm - local invasion - regional lymph nodes - distant lymph nodes - metastases to distant organs/tissues |
