General Pathology Basic Principles

of Cellular and Organ Pathology

Oncology - II

Jaroslava Dušková

Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague

General Oncology - 2

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

Tumour

swelling of any kind

NEOPLASIA

NEOPLASIA

Def.: persistent abnormal relatively autonomous

proliferation of cells

Neoplasia (Tumour)

DNA disease:

Stepwise accumulation

of genetic abnormalities Escape of immunological

clearing systems

General Oncology - 2

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

NEOPLASIA – classification

BEHAVIORAL

benign borderline malignant

histological vs. clinical behaviour

NEOPLASIA – growth

benign expansive

borderline - locally destructive

malignant infiltrative

METASTASES

Metastasis

Def.: development of secondary tumour foci in the distant places

Metastases - pathways

seeding (body cavities) lymphatic spread hematogenous spread

NEOPLASIA – architecture

solidglandularpapillary

cystopapillarydissociated

NEOPLASIA – cytology

Benign similar to nonneoplastic

Malignant cellular pleomorphismNUCLEAR FEATURES:

hyperchromasia (polyploidy, aneuploidy)

rough chromatine structureirregular nuclear outlinelarge and/or multiple nucleoli

or undifferentiated monotonous cellularity

General Oncology - 2

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

Pseudotumors

Definition:

- pathological lesions of different etiology masquerading real neoplasms

Pseudotumors cysts pseudocysts deposits of pathol. material

(gout, ganglion, amyloid) inflammatory pseudotumors

(tuberculoma) hyperplasia (esp. nodular) embryonal development disturbance

(choristia, hamarcia)

Hamartia – Hamartoma

Def.:

A mass of disorganized tissue indigenous to the particular site.

Precanceroses (preblastomatoses)

Definition:

- pathological conditions of various etiology bearing inscreased risk of malignancy development

Nonneoplastic Growth Disturbances – II

repair hypertrophy / atrophy hyperplasia metaplasia dysplasia anaplasia – undifferentiation

Precanceroses (preblastomatoses)

most pseudotumorous processes with dysplasia features

dysplastic and metaplasticlesions looking not like tumours

(SIL, intest. metaplasia)

PSEUDOTUMORS and PRECANCEROSES (preblastomatoses)

pseudotumors

precanceroses

Diagnosis early less complicated therapy

pseudotumors – clinical– morphological

precanceroses– screening

– morphological

precanceroses– screening

– morphological

General Oncology - 2

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

NEOPLASIA – classification

HISTOGENETIC mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma

General Oncology - 2

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

Methods of tumour diagnostics

Clinical symptoms – history imaging techniques, laboratory tests morphology

– cytology & histology & autopsy Symptomles precanceroses / tumours –

screening – e.g. Hemocult, Pap-test– histology incl. special staining methods – immunohistochemistry, electron microscopy– genetic analysis

Malignant Tumour

TYPING ICD-OGRADING G1 G2 G3STAGING pT pN pM

Tumour -Noduli-Metastases

General Oncology - 2

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

Malignant Tumour

TYPING ICD-OGRADING G1 G2 G3STAGING pT pN pM

Tumour -Noduli-Metastases