Neoplasia

Neoplasia is new, uncontrolled growth of cells that is not under physiologic control. A "tumor" or "mass
lesion" is simply a "growth" or "enlargement" which may not be neoplastic (such as a granuloma). The
term "cancer" implies malignancy, but neoplasms can be subclassified as either benign or malignant.

There is no single mechanism by which a neoplasm arises. Many different mechanisms give rise to
neoplasms, and that is what makes diagnosis and treatment so challenging.

Nomenclature of Neoplasia

Based upon origin:

Malignant neoplasms arising from tissue embryologically derived from ectoderm or endoderm are
usually carcinomas. Examples include:

Squamous cell carcinoma of cervix

Adenocarcinoma of stomach

Hepatocellular carcinoma

Renal cell carcinoma

Malignancies arising from mesoderm (connective tissues) are usually sarcomas. Examples include:
Leiomyosarcoma
Chondrosarcoma
Osteosarcoma
Liposarcoma

Neoplasms with more than one cell type but arising from only one germ layer are called "mixed tumors".
The best example is the benign mixed tumor (also called pleomorphic adenoma) of salivary gland.

Neoplasms with more than one cell type and arising from more than one germ layer are called teratomas.
Such neoplasms are common in the ovary.

Neoplasms ending in "-blastoma" resemble primitive embryonic tissues, which are often pediatric
neoplasms. Examples include:

Retinoblastoma
Neuroblastoma
Hepatoblastoma
Medulloblastoma

Not all malignant neoplasms have benign counterparts:

Hematopoietic and lymphoid cells (as in bone marrow and lymph node) give rise to leukemias and
lymphomas. They have no benign counterpart.

Gliomas (astrocytomas, oligodengrogliomas, glioblastoma multiforme, etc) arise from glial cells in the
CNS. They have no benign counterpart.

Characteristics of Benign Neoplasms

A benign neoplasm looks a lot like the tissue with normal cells from which it originated, and has a slow
growth rate. Benign neoplasms do not invade surrounding tissues and they do not metastasize. Thus,
characteristics include:
Slow growth
Resemblance to tissue of origin (well differentiated)
Circumscription
Lack of invasion
Absence of metastases
Benign neoplasms usually arise in a solitary manner (e.g., lipoma of colon, meningioma of brain), but may
be multiple (e.g., leiomyomata of uterus, intradermal nevi of skin)

Malignant Neoplasms

A malignant neoplasm is composed of cells that look less like the normal cell of origin. It has a higher rate
of proliferation. It can potentially invade and metastasize. Malignant neoplasms derived from epithelial
cells are called carcinomas. Those derived from mesenchymal (connective tissue) cells are called
sarcomas. Malignant brain neoplasms and neoplasms of the immune system are special categories with
complex nomenclature.

characteristics of malignant neoplasms include:

More rapid increase in size

Less differentiation (or lack of differentiation, called anaplasia)

Tendency to invade surrounding tissues

Ability to metastasize to distant tissues

Cytologic features of malignant 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 on H and E slides (hyperchromatism).
Prominent nucleoli or irregular chomatin distribution within nuclei.
Mitoses (especially irregular or bizarre mitoses).

All of these features are "atypical" microscopic findings. Atypia implies a change for the worse from
normal.

Spread of Malignant 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.

Precancerous oral lesion : morphologically alterd tissue in which oral cancer most likely to occur thn its
normal counter part eg:
lukoplakia, Erythroplakia

Precancerous oral conditions

significant risk of cancer eg:
submucosal fibrosis. ackiniti keratosis, lichen planus, discoid lupus erythromatus
keep in mind difference of word LESION & CONDITION

SECOND AMONG LESION MOST LETHAL & MOST COMMON

Leukoplakia
White potentially malignant lesions are far more common than red, however
they are less likely to be dysplastic or to transform into OCSCC over time.
- Erythroplakia
Red potentially malignant lesions are far less common than white lesions,
however they are much more likely to be dysplastic or to transform into
OCSCC over time.

common cancers in children

ALL, AML. NUROBLASTOMA, WILLIMS,retinoblastoma, rhabdomyosarccoma, hodgkin, non
hodgkin,brain

females
breast, lung,colorectal

Males
prostate, bladder,stomach,lung,lukemia

HEIGHLY RADIOSENSITIVE TUMORS

Willms, Ewings,Seminoma, Myeloma,Lypmhoma

Limited Radio Sensitive

Squamus basal carcinoma of skin
Carcinoma of mouth,tongue,lip
bladder carcinoma
carcinoma of accessory sinuses
Other Radio Sensitive tumors
angiosarcoma,kaposisarcoma,neuroblastoma,mycosis fungoidosis, thymus,retticularv cell sarcoma, giant
follicular lymphhoblastoma, undifferntiated medullary carcinoma of cervix,

Radioresistant tumours
biare pleomorphic sq cell carcinoma
renal cell ca
osteosarcoma
fibrosarcoma
liposarcoma
myosarcoma
malignant melanoma
large bowel adenocarcinomas
gliomas
thyroid cancer is the fastest-increasing cancer in both males and females in the UK
Malignant melanoma is the second-fastest increasing cancer in both males and females
Liver cancer, though rare in the UK is the third-fastest increasing cancer in males and the fifth fastest in females
Kidney cancer is the fifth-fastest increasing cancer in males and the third-fastest in females
prostatecancer is the sixth-fastest increasing cancer in male
cervical cancer is slow growing and can take a long time to develop
colon cancers are slow growing
carcinoid is slowly growing
lymphoplasmacytic lymphoma, slow growing
Insulinomas are usually slow-growing tumors
Adult T-cell leukaemia/lymphoma (ATLL) is a potentially aggressive
Burkitt lymphoma is an aggressive
Diffuse large B-cell lymphoma (DLBCL) is an aggressive type
Lymphoblastic lymphoma is an aggressive

pre-malignant conditions
actinic keratosis, Barrett's esophagus, atrophic gastritis, Dyskeratosis congenita, Sideropenic dysphagia,
Lichen planus, Oral submucous fibrosis, Solar elastosis and cervical dysplasia.

Metastasis to Liver
Breast cancer
Colorectal cancer
Esophageal cancer
Lung cancer
Melanoma
Pancreatic cancer
Stomach cancer

Metastasis to Bone
breast, lungs(females), prostate,lungs(males), kidny, thyroid abt 20% in both sexes

Metastasis to Brain
Lung cancer, 48%
Breast cancer, 15%
Genitourinary tract cancers, 11%
Osteosarcoma, 10%
Melanoma, 9%
Head and neck cancer, 6%
Neuroblastoma, 5%
Gastrointestinal cancers, especially colorectal and pancreatic carcinoma, 3%
Lymphoma, 1%

Metastasis to Breast
The most frequent source of a metastatic breast lesion is the contralateral breast
The most common extra-mammary cancers that metastasise to breast are:
lymphoma / leukaemia: most common extra mammary source
melanoma
sarcomas
prostate cancer: considered on the most frequent primary sites in men
lung cancer
gastric cancer
ovarian cancer
renal cell cancer

Tumor metastasizing to ovary(krukenbergs)

Krukenberg tumors are most commonly metastases from gastric cancer, particularly adenocarcinoma, or
breast cancer[1] particularly invasive lobular breast carcinoma,[2] but they can arise in the appendix,
colon, small intestine, rectum, gallbladder, and urinary bladder, or gallbladder, biliary tract, pancreas,
ampulla of Vater or uterine cervix.
Tumor metastasizing to Thyroid
3% of thyroid malignancies are metastases usually from kidney, lung, breast, melanoma, colon
Metastasis to Lungs
Bladder cancer
Breast cancer
Colon cancer
Kidney cancer
Neuroblastoma
Prostate cancer
Sarcoma
Wilm's tumor
Tumor metastasize to...

Bladder
Bladder cancer tends to stay in the same area (the pelvis) and grow into nearby tissues such as the pelvic
wall. It can also spread to the lungs, liver, and bone.

Brain
Brain tumors rarely spread outside the brain. They mainly grow within the brain and sometimes into the
spinal cord.,

Breast
Breast cancer most commonly spreads to the bones, but also can spread to the liver, lungs, and brain,
lymphnodes. As the cancer progresses, it may affect any organ. It can also spread to the skin of the chest
(near where the cancer started).

Cervix
Cancer of the cervix tends to grow near where it started, into the vagina and uterus and then other parts
of the pelvis, such as the rectum and bladder. It can also grow into the bones and nerves of the spine,
and spread to the liver, lungs, and bones.

Colon and rectum

The most common sites for colon or rectal cancer spread are the liver and lungs. These cancers may also
spread to nearly any other organ, including the bones and brain.
Rectal cancer can also spread within in the pelvis, where the cancer started. This can be painful because
it often grows into nerves and bones in this area.

Esophagus
Esophageal cancer mostly grows near where it started (in the chest and belly). As it progresses, it may
grow into nearby organs or major blood vessels, which can make it hard to treat.

Kidney
Kidney (renal) cancer can grow where it started and invade nearby tissues. It can grow from the kidney
into the large vein that drains the blood from the kidney (the renal vein). From there it can grow into a
large vein that empties into the heart (the inferior vena cava). It can also grow from the kidney into the
adrenal gland, which sits on top of the kidney. When it spreads, the lungs and bones are the most
common sites.

Leukemia
Because they are already in the blood, leukemias can be considered to have spread throughout the body
when they are diagnosed. They can progress by filling the bone marrow with leukemia cells. The normal
bone marrow is replaced and cannot make new blood cells.
Some leukemias may spread outside the blood and into the fluid that surrounds the brain and spinal cord.
Tumors made up of leukemia cells can also occur in the skin or in other parts of the body, but this is not
common. In some types of leukemia, the cancer cells collect in the spleen, causing it to become large.
Less often, leukemia cells settle in the liver, causing it to enlarge. In one type of leukemia, the cells
deposit in the gums, so that they become red and swollen.

Liver
Liver cancer doesnt often spread outside the liver. It tends to grow throughout the liver as it becomes
advanced. If it does spread, its most often to the lungs or bones.
Lung
Lung cancer can spread to almost any organ of the body, but most often it will spread to the adrenal
glands, liver, bones, or brain. It can also spread to the other lung.

Lymphoma
Lymphoma can affect any part of the body. While most start in the lymph nodes, spleen, and/or bone
marrow, some start in lymph tissue in the stomach, intestines, or even the eye socket. Lymphomas can
spread within the lymph system to distant parts of the body. Less often, they spread outside the lymph
system to other organs, such as the lungs, liver, or bone. Lymphomas can affect the brain and spinal
cord, either initially (called primary central nervous system lymphoma) or as spread to the fluid and
tissues (the meninges) surrounding the brain and spinal cord. This is called lymphomatous meningitis.

Melanoma
Melanoma can spread anywhere in the body. It first tends to go to lymph nodes near where it started, but
then can spread to the brain, lungs, liver, and bones. It can also spread to other areas of skin.

Mouth and throat

Cancers of the mouth, throat, or nasal passages tend to stay in the same area. When they spread, its
usually to the lungs. Less often they may spread to the liver or bones.

Multiple myeloma
Multiple myeloma can cause tumors called plasmacytomas. These tumors can spread to the bones
anywhere in the body, but they rarely spread to other organs.

Ovary
Ovarian cancer most often spreads to the lining of the abdomen (belly) and pelvis (this lining is called the
peritoneum), the omentum (a layer of connective tissue that drapes the abdominal cavity like an apron),
and organs in the pelvis and belly. It can cause a build-up of fluid and swelling in the abdomen. It can also
spread to the outer lining of the lungs and cause fluid to build up there. As it becomes more advanced, it
may spread to the lung and liver, or, rarely, to the brain or skin.

Pancreas
Pancreatic cancer mainly stays in the abdomen (belly). It tends to grow into nearby tissues and may
spread to the liver or other nearby organs. It can also spread to the lungs.

Prostate
Advanced prostate cancer most often goes to the bones. Much less often, it will spread to other organs,
including the lungs and liver.

Stomach
Stomach (gastric) cancer tends to spread to nearby tissues and stay within the abdomen (belly). It may
also spread to the liver or distant lymph nodes. Spread to the lungs, bones, and brain is less common.

Uterus
Cancer that starts in the uterus can grow into the vagina as well as nearby tissues in the pelvis. It also
commonly spreads to the peritoneum (the lining of the abdominal cavity and pelvis) and the omentum (a
layer of connective tissue that drapes the abdominal cavity like an apron). Other sites of cancer spread
include the liver, lungs, and, less often, bones.

Types of skin cancer

Basal cell carcinoma

Basal cell carcinoma, is a cancer of the basal cells at the bottom of the epidermis. Its very common and
accounts for more than 75% of all skin cancers.
BCCs are very slow-growing and almost never spread to other parts of the body.

Squamous cell carcinoma

Squamous cell carcinoma, or SCC, is a cancer of the cells (called keratinocytes) found in the outermost
layer of the skin (the epidermis). Its the second most common type of skin cancer in the UK. One in five
skin cancers (20%) are this type. Usually squamous cell carcinomas are slow-growing and only spread
to other parts of the body if they are left untreated for a long time. Occasionally though, they can
behave more aggressively and spread at a relatively early stage.

Malignant melanoma
This is a less common type of skin cancer than the two other types
It can grow quickly and needs to be treated early.

BOWENS is precancerous may leads to sq cell ca

Rarer types of non-melanoma skin cancer

There are a number of other rare types of cancer that can occur in the skin:

Merkel cell carcinoma

Kaposi's sarcoma
cutaneous T-cell lymphoma of the skin
sarcoma.
Thyroid cancer
more common in females then male
Papillary thyroid cancer. Papillary thyroid cancer develops from the follicular cells and grows slowly. It
is the most common type of thyroid cancer. It is usually found in one lobe; only 10% to 20% of
papillary thyroid cancers appear in both lobes. Papillary thyroid cancer is a differentiated thyroid cancer,
meaning that the tumor looks similar to normal thyroid tissue under a microscope.

Follicular thyroid cancer. Follicular thyroid cancer also develops from the follicular cells and usually
grows slowly. Follicular thyroid cancer is also a differentiated thyroid cancer, but it is less common than
papillary thyroid cancer.
Anaplastic thyroid cancer. This type is rare, accounting for about 2% of thyroid cancers. It is a fast-
growing,

Medullary thyroid cancer (MTC). MTC develops in the C cells and is sometimes the result of a genetic
syndrome called multiple endocrine neoplasia type 2 (MEN2). MTC accounts for about 5% of thyroid
cancers

Lung Cancer

1.Non-Small Cell Lung Cancer

Non-small cell lung cancer accounts for about 85 percent of lung cancers. Among them are these types of
tumors:

Adenocarcinoma is the most common form of lung cancer in the United States among both men and
women.
Squamous cell carcinoma (which is also called epidermoid carcinoma) forms in the lining of the bronchial
tubes.
Large cell carcinomas refer to non-small cell lung cancers that are neither adenocarcinomas nor
epidermoid cancers.

Small Cell Lung Cancer

Small cell lung cancer accounts for the remaining 15 percent of lung cancers in the United States. Small
cell lung cancer results from smoking even more so than non-small cell lung cancer, and grows more
rapidly and spreads to other parts of the body earlier than non-small cell lung cancer. It is also more
responsive to chemotherapy.

Blood cancer
Leukemia, a type of cancer found in your blood and bone marrow, is caused by the rapid production of
abnormal white blood cells
Lymphoma is a type of blood cancer that affects the lymphatic system, which removes excess fluids from
your body and produces immune cells.
Myeloma is a type of blood cancer that specifically targets plasma cells. Plasma cells are white blood cells
that produce disease- and infection-fighting antibodies.Myeloma cells prevent the normal production of
antibodies,