Vous êtes sur la page 1sur 23

Neoplasia

By
Prof. J.T. Anim
Department of Pathology
Lecture I
Topics
 Nomenclature
 Definitions
 Classification of neoplasms
 Benign vs. malignant neoplasms
 Characteristics of neoplasms
 Grading of malignant neoplasms
Neoplasia - Terminology
 neo = new, plasia = growth
 Tumour = swelling
 Cancer = ‘crab’
 Desmoplasia = stimulation of
excessive connective tissue (collagen)
formation by parenchyma cells
Neoplasia - Nomenclature
 Benign neoplasms = ….oma eg. fibroma, lipoma, adenoma
(exceptions: melanoma, seminoma, lymphoma)
 Malignant neoplsms
 Mesenchymal: …..sarcoma
 Epithelial: …..carcinoma
 Divergent differentiation of parenchymal cells – mixed
tumour eg. pleomorphic adenoma of salivary gland.
 Neoplasm from more than one germ layer – teratoma

 Ectopic rest of normal tissue – choristoma

 Aberrant differentiation forming a mass of disorganised but


mature specialised cells or tissue indigenous to the particular
site - hamartoma
Neoplasia - Definition
 Willis
 “a neoplasm is an abnormal mass of tissue, the growth of
which exceeds and is unco-ordinated with that of the
normal tissues, and which persists in the same excessive
manner after cessation of the stimulus which has evoked
the change”
 Pitot (1986)
 “a tumour is a heritably altered, relatively autonomous
growth of tissue”
 Summary
 “tumours are purposeless growths of tissue that tend to be
atypical, autonomous and aggressive”
Neoplasia - Characteristics
 Cell proliferation: escape from normal control →
immortalisation → most instances, single cell type; numbers
inappropriate for anatomical site → tumour

 Cell differentiation: impaired differentiation of cell line.


 Poor degree of differentiation → worse behaviour of neoplasm.
 Poor differentiation → acquisition of functional characteristics
foreign to differentiated cells eg. foetal proteins etc.
 Relationship between cells and surrounding stroma:
 Growth in compact mass → benign neoplasm
 Growth in invasive manner → malignant neoplasm
Neoplasia - Characteristics
 Neoplasms are derived from cells that normally
maintain a proliferative capacity (mature neurons
and cardiac myocytes do not give rise to tumours)
 A tumour may express varying degrees of
differentiation, from relatively mature structures that
mimic normal tissues to a collection of cells so
primitive that the cell of origin cannot be identified.
 The stimulus responsible for the uncontrolled
proliferation may not be identifiable; it is not known
in most human neoplasms.
 Neoplasia arises from mutations in genes that
regulate cell growth, apoptosis or DNA repair.
Neoplasia - Classification
 Behaviour (benign vs. malignant)

 Histogenetic (tissue of origin)

 Combination
Morphological pattern of
tumour growth

1. Sessile, polypoid and papillary


growth patterns are usually associated
with benign tumours.

2. Fungating, ulcerative and annular


growth patterns are usually associated
with malignant tumours
Neoplasia - Differentiation

Impaired differentiation is a feature of


dysplasia

Progressive impairment of
differentiation leads to carcinoma in
situ

The undifferentiated cells lose


cohesiveness and acquire the
ability to invade neighbouring
tissues and blood vessels leading to
dissemination
Carcinoma in situ:
Uterine cervix
Comparison of benign and malignant
neoplasms
Principal differences in gross morphology of benign and malignant neoplasms
Grading of Malignant Neoplasms
 Reflects cellular characteristics
 Histological and cytological grading are
subjective
 Grade of tumour does not always reflect
behaviour – useful guide
 Determined by the degree of differentiation
of neoplastic cells
 Low grade neoplasms resemble tissue of origin
– evidence of slow growth
 High grade neoplasms tend to be anaplastic –
evidence of rapid growth.
Grading of Malignant Neoplasms

 Evidence of rapid or abnormal growth


is provided by:
 Large numbers of mitoses
 Atypical mitoses
 Nuclear and cellular pleomorphism
 High N/C ratio
 Irregular, hyperchromatic nuclei
 Presence of tumour giant cells
Low grade urothelial carcinoma

High grade urothelial carcinoma


Anaplastic carcinoma
Anaplasia + abnormal mitoses

Vous aimerez peut-être aussi