NEOPLASIA

Def.: persistent abnormal relatively autonomous

proliferation of cells

NEOPLASIA – classification

BEHAVIORAL

benign borderline malignant

NEOPLASIA – growth

benign expansive

borderline - locally destructive

malignant infiltrative

METASTASES

Metastases

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

Metastases - pathways

seeding (body cavities) lymphatic spread hematogenous spread

General Oncology - 3

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

NEOPLASIA – classification

HISTOGENETIC (cell of origin) mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma

General Oncology - 3

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 (X-ray, CT, endoscopy,

PET…. laboratory tests morphology - pathology

– 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

Typing Grading Staging

represent

the Most Important Prognostic

Factors

Malignant Tumour

TYPING ICD-OGRADING G1 G2 G3STAGING pT pN pM

Tumour -Noduli-Metastases

Additional Prognostic Factors

proliferation markers (MIB 1…) cell cycle regulators (p53, bcl 2…) hormone receptors ER, PR growth factors receptors EGFR

---------------- angiogenesis others………

NEOPLASIA – classification

HISTOGENETIC (cell of origin) mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma

NEOPLASIA – architecture

solidglandularpapillary

cystopapillary

dissociated

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

NEOPLASIA – Nosology-Typing definition & ICD-O code prevalance age/sex predisposition (if any) typical locations clinical symptoms gross level view histopathology / cytopathology

(incl. special diagnostic tools) ultrastructure (esp. if useful for the diagnosis) possible complications, prognosis

Mesenchymal neoplasms

Terminology

Named after the cell of origin (Greek or

Latin) benign - suffix -oma malignant – suffix -sarcoma

Mesenchymal neoplasmsBenign fibroma lipoma leiomyoma rhabdomyoma hemangioma lymphangioma chondroma chordoma osteoma lymphoma

Malignant fibrosarcoma liposarcoma

leiomyosarcoma rhabdomyosarcoma

hemangiosarcoma lymphangiosarcoma

chondrosarcoma invasive chordoma

osteosarcoma lymphosarcoma

Borderline

-fibromatoses-

-lipoblastoma-

-hemangio

endotelioma-

- chondro

blastoma-

osteoblastoma

Fibromabenign tumour derived from fibroblasts rare age/sex predisposition no typical locations ovary, oral cavity solid white mass gross level: circumscribed, soft-firm,

whittish fibroblast like fusiform cells (vimentin) pressure, dif. dg

Fibromatosis superficial – palms, soles of feet (Dupuytren),

m. Peyronie – induratio penis plasticanon-neoplastic tumour like lesion

deep: borderline between tumour like lesions and fibrosarcoma – local recidives common

rare age/sex predisposition F, middle age gross level: strictures/large infiltrative masses fibroblast like fusiform cells

(vimentin) mass

Fibrosarcoma derived from fibroblasts age/sex predisposition M soft tissue clinical symptoms: mass gross level view: fish flesh look fusiform cells, mitoses

(vimentin+) hematogenous spread

Myofibroblastic tumours

benign myofibroblastic tumour myofibroblastic sarcoma solitary fibrous tumour (CD34+)

– hemangiopericytoma

Dermatofibroma cutaneous fibrous histiocytoma storiform architecture (myofibroblasts)

Dermatofibrosarcoma protuberans

borderline – ulceration & recurrences increased cellularity & atypiae

Fibrous Histiocytoma

benign (pigmented villonodullar synovitis)

Malignant Fibrous Histiocytoma – mostly local malignancy blood & lymph. spread possible

increasing cellularity & atypiae