Pathology Lecture - Neoplasia
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The document discusses neoplasia (abnormal growths) and cancer biology. It provides definitions of key terms like neoplasia, benign and malignant tumors. It describes factors involved in carcinogenesis like oncogenes, growth factors and tumor suppressor genes. It also summarizes cancer features including differentiation, growth rate, invasion, metastasis and staging/grading systems. Overall, the document provides a comprehensive overview of the pathogenesis and classification of neoplasms.
Pathology Lecture - Neoplasia
- 1. “The world in which you were born is just one model of reality. Other cultures are not failed attempts at being you; they are unique manifestations of the human spirit, Just like you!” -- Wade Davis Antrhopologist
- 2. Pathology of Neoplasia Dr. Venkatesh M. Shashidhar. A/Prof. & Head of Pathology
- 3. Neoplasia Neoplasia: • Neo + Plasia New + Growth. • Tumour Swelling any swelling* • Clinically tumour = neoplasm (technically incorrect..!) • Willis definition: “A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissue and persists in the same manner after cessation of the stimuli which evoked the change” • “Cell division without control” • Irreversible DNA damage, resulting in autonomous growth of abnormal cells *
- 4. Neoplasia Cell population / Growth Control: • Proliferation Differentiation Apoptosis * Normal Stem cell Apoptosis Neoplasia Benign - Malignant Organ / Tissue Carcinogen Initiator + Promotor Inflam 1.Proto-Oncogenes (growth factors) 2.Growth/Tumor suppressor genes. 3.Genes controlling Apoptosis. 4.Genes controlling DNA Repair. RAS Rb MYC p53
- 5. Neoplasia Growth Disorders: Non neoplastic Neoplastic (Polyclonal) (Monoclonal) Hyperplasia Hypertrophy Aplasia Atrophy Metaplasia Dysplasia Normal Adaptation Benign Malignant
- 6. Neoplasia Cell division Control - Carcinogenesis*
- 7. Growth Control, Oncogenes & Therapy
- 8. The mind is everything. What you think you become! -- Buddha
- 9. Neoplasia Clinical Pathology • Etiology (Carcinogenesis) • Pathogenesis • Morphology • Clinical Features (Cancer Biology)
- 10. Neoplasia Benign - Malignant Necrosis 10 BENIGN • Well differentiated • Slow growth • Cohesive, • expansile • Capsule • No invasion/infiltration MALIGNANT • Poorly differentiated • Rapid growth • Non Cohesive, • No capsule • invasion/infiltration • Metastases.
- 11. Neoplasia Neoplasms Nomenclature: Oma - Tumour Carcin-oma – Hard Tumour Sarc-oma - Soft Tumour Benign Malignant • Adenoma - Adencarcinoma • Papilloma - Squamous cell ca. • Fibroma - Fibrosarcoma • Osteoma - Osteosarcoma • Chondroma Chondrosarcoma • Lipoma Liposarcoma • Leiomyoma Leiomyosarcoma • Rhabdomyoma Rhabdomyosarcoma Cell of Origin • Gland. Epithelium • Lining. Epithelium • Fibroblast • Osteoblast • Chondrocyte • Lipocyte • Smooth muscle • Skeletal muscle
- 12. Neoplasia Nomenclature: exceptions • Teratoma – Tumour of Germ cell – multiple tissues. Benign (mature) or malignant (immature) • Melanoma (Melano-carcinoma) – Malignancy of melanocytes. • Seminoma (Seminal carcinoma) –carcinoma of Testes. • Leukemia – white blood – Ca. of Haemopoietic stem cells. • Lymphoma (Lymphosarcoma)– Malignancy of lymphocytes. • Mixed Tumours: Both epithelial & connective tissue components. Pleomorphic adenoma (Salivary gland) & Carcinosarcoma (breast/uterus) What is a Granuloma, Hamartoma & Choristoma?
- 13. The searching out and thorough investigation of truth ought to be the primary study of man. -- Cicero
- 14. Cancer Clinical Features Cancer Biology
- 15. Neoplasia Cancer Biology: • Structure: – Parenchyma – Neoplastic cells. – Stroma: Non neoplastic - normal DNA • Features: – Differentiation – Maturation of cells. – Rate of Growth – Mitotic rate / Ki 67 – Local invasion – Hemorrhage, necrosis, destruction – Metastasis – Distant Spread. 15
- 16. • Tumors are clonal (one parent) • But have different mutations different shapes & features. • Each new mutation adds a new feature. Malignant cells Normal cell Fourth or Third mutation later mutation Second mutation First mutation More new mutations with time.
- 17. Neoplasia 6 Features of Cancer cells: Clinically each patient’s cancer has a different mix of features depending on quality & quantity of mutations & changes with time...!
- 18. Neoplasia Neoplasia: Retrograde evolution…! Embryo Cancer Self growth auto regulation Limitless potential Angiogenesis Evade apoptosis Invasion & infiltration
- 19. Neoplasia Irritation Carcinogens Initiation Promotion Ca. 19 Pathogenesis of Lung Cancer. C-myc K-Ras p53 Smoke Anaplasia
- 20. Neoplasia Colon: Normal Adenoma Carcinoma Carcinogenesis) Colon Cancer: Common type - 80%
- 21. Neoplasia Stage & Grade of Cancer: Staging: Progression or spread in the body. Grading: Cell differentiation & Rate of growth – Microscopy. Well differentiated (low grade) Adenocarcinoma Grade Undiff. (high grade)
- 22. Neoplasia Prostate Ca : Gleason Grading: 22 Low Grade High Grade
- 23. “Beware of this world, for it is sweet and tempting.” Control your desires. — alsunna
- 24. Neoplasia TNM: Staging of tumor: Lung Ca Stage - Features T0 In-situ T1 Primary site T2 Sec. Anat. site T3 Tertiary site T4 Adjacent region N0 No LN mets. N1 Primary LN N2 Seondary LN N3 Tertiary LN M0 No metastases M1 Metastases + T1 T4 Based on - ANATOMY & LYMPHATICS
- 25. Neoplasia Staging of Colon cancer: Pre-Cancer
- 26. Neoplasia 26 Cancer Prostate Cancer Staging
- 27. Neoplasia Metastasis: Lymphatic, Hematogenous, Direct.
- 28. Metastasis: Pathogenesis: 1. Cell loosening 2. BM degradation 3. Invasion 4. Locomotion 5. BV adhesion 6. Intra-vasation 7. Tumour embolus 8. Adhesion 9. Extra-vasation 10. Angiogenesis 11. Growth. 28 • E-Cadherin, β-catenin • Matrix Metalloproteinases (MMP) • Collagenase (not in benign) • Actin Cytoskeleton, chemokine What chemical mediators are involved?
- 29. Neoplasia Cancer Diagnosis: e.g. Lung Cancer. • Cell of origin • Rate of growth • Differentiation • Local Invasion • Metastasis • Bronchial Epith. • Mitotic rate – grade. – Low, Intermediate, high • Maturation of cells – Well – Mod – Poor – Un diff. • Tumour Stage.. 1,2,3,4. • Distant Spread.. DIAGNOSIS: (Lung cancer) Bronchogenic Squamous cell Carcinoma, high grade, Stage T2, N1, M1, Liver+ LN++ (in.. patient details..). Grade Stage
- 30. “Our character is but the stamp on our souls of the free choices of good and evil we have made through life. -- John C. Geikie
- 31. “Good & Evil, Happiness and Misery, Merit and sin depend on our actions. As is the action, so is the result. It is easy & fun to indulge in sinful deeds but it is extremely painful to bear the results they yield” Karma - You reap what you sow! -- Baba
- 32. If diversity is a source of wonder, its opposite..! “Cultural supremacy, indeed, is a fire burning over the earth, taking with it plants and animals, cultures, languages, ancient skills and visionary wisdom. Quelling this flame, and re-inventing the poetry of diversity is perhaps the most important challenge of our times.” ― Wade Davis