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General Pathology Basic Principles
of Cellular and Organ Pathology
Oncology - II
Jaroslava Dušková
Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague
General Oncology - I
Disorders of the cell proliferation and growth (hypertrophy, hyperplasia,
metaplasia) Neoplasms – disorders of cell proliferation and differentiation Molecular biology of neoplasia - oncogenesis Host - neoplasm interactions
General Oncology - II
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
General Oncology - II
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
Clinical manifestation of neoplasms Benign
nomass (palpable or visible on
imaging) compression obstruction
pressurebleedinghormonal production
Malignantnomasspressurebleeding hormonal production
destructioninflammatory
responsedistant metastases
Borderline
combined…!
Metastasis
Def.: development of secondary tumour foci in the distant places
Metastases - pathways
seeding (body cavities) lymphatic spread hematogenous spread
cellular embolism!!!
Invasion & Metastasis - steps Invasion into the extracellular matrix - ECM
– dyscohesion of cells – loss of – E-cadherine– ECM degradation – proteolytic enzymes– migration
epithelio-mesenchymal conversion ameboid migration or groups
Angioinvasion – esp. into newly formed vessels Extravasation – local factors promoting or
inhibiting the subsequent growth tropism late metastases
NEOPLASIA – macroscopy whittish/grayish mass yellow nodule lipoma, clear cell kidney carcinoma,
adrenocortical adenoma red nodule hemangioma brown nodule nevocellular nevus, melanoma, pigm.
basalioma organ enlargement leukemia organ consolidation (& superficial ulceration)
tongue carcinoma organ softening – necrosis glioblastoma branched outgrowth papilloma, villous adenoma cystic (cystopapillary) cystadenoma, ca
NEOPLASIA – histological 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)
Precanceroses (preblastomatoses)
most pseudotumorous processes with dysplasia features
dysplastic lesions looking not like tumours (SIL, intest. metaplasia
with dysplasia)
Nonneoplastic Growth Disturbances – II
repair hypertrophy / atrophy hyperplasia metaplasia dysplasia anaplasia – undifferentiation
Dysplasia
Definition:
- disturbance of cell growth, maturation, architecture
(frequently, but not always preneoplastic condition)
PSEUDOTUMORS and PRECANCEROSES (preblastomatoses)
pseudotumors
precanceroses
Diagnosis early less complicated therapy
pseudotumors – clinical– morphological
precanceroses– screening
– morphological
precanceroses– screening
– morphological
General Oncology - II
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
NEOPLASIA – classification
HISTOGENETIC mesenchymal epithelial neuroectodermal mixed germ cell, teratoma, choriocarcinoma mesothelioma
General Oncology - I
Disorders of the cell proliferation and growth (hypertrophy, hyperplasia,
metaplasia) Neoplasms – disorders of cell proliferation and differentiation Molecular biology of neoplasia - oncogenesis Host - neoplasm interactionsGeneral Oncology - II
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms
General Oncology - III Methods of tumour diagnostics Neoplasm prognostification Prediction of the response to the therapy