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Page 1: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Abdulmalik Alsheikh, MD, Abdulmalik Alsheikh, MD, FRCPCFRCPC

Page 2: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia DefinitionsDefinitions ClassificationClassification NomenclatureNomenclature Characteristics of benign and Characteristics of benign and

malignant neoplasmsmalignant neoplasms

Page 3: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Cancer is one of the leading causes Cancer is one of the leading causes of death worldwide.of death worldwide.

Emotional and physical suffering by Emotional and physical suffering by the patient.the patient.

Different mortality rate …..Different mortality rate ….. Some are curable Some are curable Others are fatalOthers are fatal

Page 4: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Neoplasia = new growthNeoplasia = new growth Neoplasm = tumorNeoplasm = tumor Tumor = swellingTumor = swelling The study of tumors = OncologyThe study of tumors = Oncology

Oncos = tumor + ology = study of Oncos = tumor + ology = study of

Page 5: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Definition:Definition: is an abnormal mass of tissue, is an abnormal mass of tissue, the growth of which is uncoordinated with the growth of which is uncoordinated with

that of normal tissues, that of normal tissues, and that persists in the same excessive and that persists in the same excessive

manner after the cessation of the manner after the cessation of the stimulus which evoked the changestimulus which evoked the change

With the loss of responsiveness to normal With the loss of responsiveness to normal growth controlsgrowth controls

Page 6: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Classification Classification

Benign Benign malignantmalignant

Page 7: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Benign tumors :Benign tumors : Will remain localizedWill remain localized Cannot spread to distant sitesCannot spread to distant sites Generally can be locally excisedGenerally can be locally excised Patient generally survives Patient generally survives

Page 8: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Malignant neoplasms:Malignant neoplasms: Can invade and destroy adjacent Can invade and destroy adjacent

structurestructure Can spread to distant sitesCan spread to distant sites Cause death (if not treated )Cause death (if not treated )

Page 9: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

All tumors have two basic All tumors have two basic components:components: Parechyma: Parechyma: made up of made up of

neoplastic cellsneoplastic cells Stroma: Stroma: made up of non-made up of non-

neoplastic, host-derived neoplastic, host-derived connective tissue and blood connective tissue and blood vesselsvessels

Page 10: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

The parenchyma:The parenchyma: Determines the biological behavior of Determines the biological behavior of

the tumorthe tumor From which the tumor derives its name From which the tumor derives its name

Page 11: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

The stroma:The stroma: Carries the blood supplyCarries the blood supply Provides support for the growth of the Provides support for the growth of the

parenchymaparenchyma

Page 12: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 13: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 14: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

NomenclatureNomenclature Benign tumors: Benign tumors:

prefix + suffixprefix + suffix Type of cell + (-oma)Type of cell + (-oma)

Page 15: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Examples:Examples: Benign tumor arising in fibrous tissue:Benign tumor arising in fibrous tissue:

Fibro + oma = FibromaFibro + oma = Fibroma

Benign tumor arising in fatty tissue:Benign tumor arising in fatty tissue:

Lipo + oma = lipomaLipo + oma = lipoma

Page 16: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Benign tumor arising in cartilageBenign tumor arising in cartilage

chondro + oma = chondromachondro + oma = chondroma Benign tumor arising in smooth Benign tumor arising in smooth

musclemuscle

Leiomyo + oma = leiomyomaLeiomyo + oma = leiomyoma Benign tumor arising in skeletal Benign tumor arising in skeletal

musclemuscle

Rhabdomyo + oma = rhabdomyomaRhabdomyo + oma = rhabdomyoma

Page 17: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

epithelial benign tumors are epithelial benign tumors are classified on the basis of :classified on the basis of : The cell of origin The cell of origin Microscopic patternMicroscopic pattern Macroscopic patternMacroscopic pattern

Page 18: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Adenoma Adenoma : benign epithelial neoplasms : benign epithelial neoplasms producing gland pattern….OR … producing gland pattern….OR … derived from glands but not necessarily derived from glands but not necessarily exhibiting gland pattern exhibiting gland pattern

Papilloma Papilloma : benign epithelial : benign epithelial neoplasms growing on any surface that neoplasms growing on any surface that produce microscopic or macroscopic produce microscopic or macroscopic finger-like patternfinger-like pattern

Page 19: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 20: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 21: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

PolypPolyp : a mass that projects above a : a mass that projects above a mucosal surface to form a mucosal surface to form a macroscopically visible structure. macroscopically visible structure.

e.g. - colonic polype.g. - colonic polyp

- nasal polyp - nasal polyp

Page 22: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 23: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Examples : Examples : Respiratory airways: Bronchial Respiratory airways: Bronchial

adenomaadenoma Renal epithelium: Renal tubular Renal epithelium: Renal tubular

adenomaadenoma Liver cell : Liver cell adenomaLiver cell : Liver cell adenoma Squamous epithelium: squamous Squamous epithelium: squamous

papilloma papilloma

Page 24: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Malignant tumors:Malignant tumors: Malignant tumor arising in Malignant tumor arising in

mesenchymal tissue : SARCOMAmesenchymal tissue : SARCOMA From fibrous tissue: FibrosarcomaFrom fibrous tissue: Fibrosarcoma From bone : OsteosarcomaFrom bone : Osteosarcoma From cartilage : chondrosarcomaFrom cartilage : chondrosarcoma

Page 25: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Malignant tumors arising from Malignant tumors arising from epithelial origin : CARCINOMAepithelial origin : CARCINOMA Squamous cell carcinomaSquamous cell carcinoma Renal cell adenocarcinomaRenal cell adenocarcinoma cholangiocarcinomacholangiocarcinoma

Page 26: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Melanoma ( skin )Melanoma ( skin ) Mesothelioma (mesothelium )Mesothelioma (mesothelium ) Seminoma ( testis )Seminoma ( testis ) Lymphoma ( lymphoid tissue ) Lymphoma ( lymphoid tissue )

See table 6 – 1 page 176 ( Robbins )See table 6 – 1 page 176 ( Robbins )

Page 27: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Eponymically named tumorsEponymically named tumors Hodgkin’s LymphomaHodgkin’s Lymphoma Wilm’s Tumor ( nephroblastoma )Wilm’s Tumor ( nephroblastoma ) Burkitt’s LymphomaBurkitt’s Lymphoma

Page 28: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Characteristics of benign and Characteristics of benign and malignant neoplasmsmalignant neoplasms

Differentiation and anaplasiaDifferentiation and anaplasia Rate of growthRate of growth Local invasionLocal invasion metastasis metastasis

Page 29: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

1.1. Differentiation and anaplasia: Differentiation and anaplasia:

Differentiation means : the extent Differentiation means : the extent to which the parenchymal cells of to which the parenchymal cells of the tumor resemble their normal the tumor resemble their normal counterparts morphologically and counterparts morphologically and functionallyfunctionally

Page 30: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

well differentiated = closely well differentiated = closely resemble their normal counterpartsresemble their normal counterparts

Moderately differentiatedModerately differentiated Poorly differentiatedPoorly differentiated Undifferentiated ( Anaplasia ) Undifferentiated ( Anaplasia )

Page 31: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Benign tumors = well differentiatedBenign tumors = well differentiated Malignant tumors = Malignant tumors =

well differentiated -----> anaplasticwell differentiated -----> anaplastic

Page 32: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 33: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 34: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 35: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

In the histological examination of a In the histological examination of a tumor you should look for :tumor you should look for : Pleomorphism : variation in sizePleomorphism : variation in size High nuclear/ cytoplasm ratio ( N/C High nuclear/ cytoplasm ratio ( N/C

ratio)ratio) Hyperchrmasia ( dark cell )Hyperchrmasia ( dark cell ) Mitosis ….?abnormal one Mitosis ….?abnormal one

Page 36: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Characteristics of benign and Characteristics of benign and malignant neoplasmsmalignant neoplasms

Differentiation and anaplasiaDifferentiation and anaplasia Rate of growthRate of growth Local invasionLocal invasion metastasis metastasis

Page 37: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Rate of growth: Rate of growth: Benign tumors: Benign tumors:

grows slowly grows slowly are affected by blood supply, hormonal are affected by blood supply, hormonal

effects , locationeffects , location Malignant tumors : Malignant tumors :

grows faster grows faster Correlate with the level of differentiationCorrelate with the level of differentiation

Page 38: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Characteristics of benign and Characteristics of benign and malignant neoplasmsmalignant neoplasms

Differentiation and anaplasiaDifferentiation and anaplasia Rate of growthRate of growth Local invasionLocal invasion metastasis metastasis

Page 39: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Local invasion :Local invasion : Benign tumors : Benign tumors :

Remain localizedRemain localized Cannot invadeCannot invade Usually capsulatedUsually capsulated

Malignant tumors : Malignant tumors : Progressive invasionProgressive invasion DestructionDestruction Usually not capsulatedUsually not capsulated

Page 40: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 41: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 42: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 43: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 44: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Characteristics of benign and Characteristics of benign and malignant neoplasmsmalignant neoplasms

Differentiation and anaplasiaDifferentiation and anaplasia Rate of growthRate of growth Local invasionLocal invasion metastasis metastasis

Page 45: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Metastasis : Metastasis : Definition : the development of Definition : the development of

secondary implants discontinuous with secondary implants discontinuous with the primary tumor, possibly in remote the primary tumor, possibly in remote tissuestissues

Page 46: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 47: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Metastasis : Metastasis : Cancers have different ability to Cancers have different ability to

metastasizemetastasize Approximately 30% patients present Approximately 30% patients present

with clinically evident metastases.with clinically evident metastases. Generally, the more anaplastic and the Generally, the more anaplastic and the

larger the primary tumor, the more larger the primary tumor, the more likely is metastasislikely is metastasis

Page 48: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Metastasis : three pathways Metastasis : three pathways Lymphatic Lymphatic spread :spread : Hematogenous Hematogenous spread : spread : Seeding of the Seeding of the body cavitiesbody cavities: pleural, : pleural,

peritoneal cavities and cerebral peritoneal cavities and cerebral ventriclesventricles

Page 49: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Lymphatic Lymphatic spread :spread : favored by carcinomasfavored by carcinomas Breasr carcinoma Breasr carcinoma axillary lymph axillary lymph

nodesnodes Lung carcinomas Lung carcinomas bronchial lymph bronchial lymph

nodes nodes

Page 50: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Hematogenous Hematogenous spread : spread : favored by sarcomasfavored by sarcomas Also used by carcinomasAlso used by carcinomas Veins are more commonly invadedVeins are more commonly invaded The liver and lungs are the most The liver and lungs are the most

frequently involved secondary sites frequently involved secondary sites

Page 51: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 52: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

In the histological examination of a In the histological examination of a tumor you should look for :tumor you should look for : Pleomorphism : variation in sizePleomorphism : variation in size High nuclear/ cytoplasm ratio ( N/C High nuclear/ cytoplasm ratio ( N/C

ratio)ratio) Hyperchrmasia ( dark cell )Hyperchrmasia ( dark cell ) Mitosis ….?abnormal one Mitosis ….?abnormal one

Page 53: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Dysplasia : Dysplasia : Definiton: a loss in the uniformity of the Definiton: a loss in the uniformity of the

individual cells and a loss in their individual cells and a loss in their architectural orientation.architectural orientation.

Non-neoplasticNon-neoplastic Occurs mainly in the epitheliaOccurs mainly in the epithelia Dysplastic cells shows a degree of : Dysplastic cells shows a degree of :

pleomorphism, hyperchrmasia,increased pleomorphism, hyperchrmasia,increased mitosis and loss of polarity.mitosis and loss of polarity.

Page 54: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Dysplasia does not mean cancerDysplasia does not mean cancer Dyplasia does not necessarily Dyplasia does not necessarily

progress to cancerprogress to cancer Dysplasia may be reversibleDysplasia may be reversible If dysplastic changes involve the If dysplastic changes involve the

entire thickness of the epithelium it entire thickness of the epithelium it is called : is called :

CARCINOMA IN-SITUCARCINOMA IN-SITU

Page 55: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 56: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Carcinoma in-situCarcinoma in-situ Definition: an intraepithelial malignancy Definition: an intraepithelial malignancy

in which malignant cells involve the in which malignant cells involve the entire thickness of the epithelium entire thickness of the epithelium without penetration of the basement without penetration of the basement membrane.membrane.

Applicable only to epithelial neoplasms. Applicable only to epithelial neoplasms.

Page 57: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 58: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Based on the biological behavior : Based on the biological behavior : Benign and malignantBenign and malignant

Based on the cell of origin : Based on the cell of origin : One neoplastic cell type : lipoma, One neoplastic cell type : lipoma,

adenocarcinomaadenocarcinoma More than one neoplastic cell type : More than one neoplastic cell type :

fibroadenomafibroadenoma More than one neoplastic cell type derived More than one neoplastic cell type derived

from more than one germ-cell layer: teratomafrom more than one germ-cell layer: teratoma

Page 59: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 60: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 61: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 62: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Teratoma:Teratoma: Teratoma contains recognizable Teratoma contains recognizable

mature or immature cells or tissues mature or immature cells or tissues representative of more than one germ-representative of more than one germ-cell layer and some times all three.cell layer and some times all three.

Teratomas originate from totipotential Teratomas originate from totipotential cells such as those normally present in cells such as those normally present in the ovary and testis.the ovary and testis.

Page 63: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Such cells have the capacity to Such cells have the capacity to differentiate into any of the cell types differentiate into any of the cell types found in the adult body. So they may found in the adult body. So they may give rise to neoplasms that mimic give rise to neoplasms that mimic bone, epithelium, muscle, fat, nerve bone, epithelium, muscle, fat, nerve and other tissues.and other tissues.

Most common sites are: ovary, testisMost common sites are: ovary, testis

Page 64: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

If all the components parts are well If all the components parts are well differentiated, it is a benign (mature) differentiated, it is a benign (mature) teratoma.teratoma.

If less well differentiated, it is an If less well differentiated, it is an immature (malignant) teratoma. immature (malignant) teratoma.

Page 65: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeplasiaNeplasia Hamartoma is apparently developmental Hamartoma is apparently developmental

malformation that presents as a mass of malformation that presents as a mass of disorganized tissue indigenous to disorganized tissue indigenous to particular site. particular site. They are distinguished from neoplasms by the They are distinguished from neoplasms by the

fact that they do not exhibit continued growth. fact that they do not exhibit continued growth. they are group of tumor-like tissue masses they are group of tumor-like tissue masses which may be confused with neoplasmswhich may be confused with neoplasms

ChoristomaChoristoma Congenital anomalyCongenital anomaly Heterotopic rest of cellsHeterotopic rest of cells

Page 66: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

EpidemiologyEpidemiology Will help to discover aetiologyWill help to discover aetiology Planning of preventive measuresPlanning of preventive measures To know what is common and what To know what is common and what

is rare.is rare. Development of screening methods Development of screening methods

for early diagnosisfor early diagnosis

Page 67: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 68: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 69: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 70: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of
Page 71: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Factors affecting incidence of Factors affecting incidence of cancercancer

Geographic and EnvironmentalGeographic and Environmental AgeAge HeredityHeredity Aquired preneoplastic disordersAquired preneoplastic disorders

Page 72: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Geographic and Environmental Geographic and Environmental factors:factors: Rate of stomach carcinoma in Japan is Rate of stomach carcinoma in Japan is

seven times the rate in North America seven times the rate in North America and Europe.and Europe.

Breast carcinoma is five times higher in Breast carcinoma is five times higher in North America comparing to JapanNorth America comparing to Japan

Liver cell carcinoma is more common in Liver cell carcinoma is more common in African populations African populations

Page 73: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Geographic and Geographic and EnvironmentalEnvironmental factors:factors: Asbestos : mesotheliomaAsbestos : mesothelioma Smoking : lung cancerSmoking : lung cancer Multiple sexual partners: cervical cancerMultiple sexual partners: cervical cancer Fatty diets : colonic cancerFatty diets : colonic cancer

Please see table 6-2 for occupational Please see table 6-2 for occupational cancerscancers

Page 74: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Factors affecting incidence of cancerFactors affecting incidence of cancer Geographic and EnvironmentalGeographic and Environmental AgeAge HeredityHeredity Aquired preneoplastic disordersAquired preneoplastic disorders

Page 75: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Age:Age: Generally, the frequency of cancer Generally, the frequency of cancer

increases with age.increases with age. Most cancer mortality occurs between 55 Most cancer mortality occurs between 55

and 75. and 75. Cancer mortality is also increased during Cancer mortality is also increased during

childhoodchildhood Most common tumors of children: Most common tumors of children:

Leukemia, tumors of CNS, Lymphomas, Leukemia, tumors of CNS, Lymphomas, soft tissue and bone sarcomas. soft tissue and bone sarcomas.

Page 76: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Factors affecting incidence of cancerFactors affecting incidence of cancer Geographic and EnvironmentalGeographic and Environmental AgeAge HeredityHeredity Aquired preneoplastic disordersAquired preneoplastic disorders

Page 77: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

HeredityHeredity Inherited Cancer SyndromesInherited Cancer Syndromes Familial CancersFamilial Cancers Autosomal Recessive Syndromes of Autosomal Recessive Syndromes of

Defective DNA repair Defective DNA repair

Page 78: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

HeredityHeredity

Inherited Cancer Syndromes:Inherited Cancer Syndromes: Inheritance of a single mutant gene Inheritance of a single mutant gene

greatly increases the risk of developing greatly increases the risk of developing neoplasmneoplasm

E.g. Retinoblastoma in children : E.g. Retinoblastoma in children : 40% of Retinoblastomas are familial40% of Retinoblastomas are familial carriers of the gene have 10000 fold carriers of the gene have 10000 fold

increase in the risk of developing increase in the risk of developing RetinoblastomaRetinoblastoma

E.g. multiple endocrine neoplasiaE.g. multiple endocrine neoplasia

Page 79: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

HeredityHeredity

Familial Cancers:Familial Cancers: All common types of cancers occur in All common types of cancers occur in

familial formfamilial form E.g. breast, colon, ovary,brainE.g. breast, colon, ovary,brain Familial cancers usually have unique Familial cancers usually have unique

features:features: Start at early ageStart at early age Multiple or bilateralMultiple or bilateral Two or more relatives Two or more relatives

Page 80: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

HeredityHeredity

Autosomal Recessive Syndromes of Autosomal Recessive Syndromes of Defective DNA repair :Defective DNA repair : Small group of autosomal recessive Small group of autosomal recessive

disordersdisorders Characterized by DNA instabilityCharacterized by DNA instability

Please see table 6-3 for more Please see table 6-3 for more examplesexamples

Page 81: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Factors affecting incidence of cancerFactors affecting incidence of cancer Geographic and EnvironmentalGeographic and Environmental AgeAge HeredityHeredity Aquired preneoplastic disordersAquired preneoplastic disorders

Page 82: Neoplasia Abdulmalik Alsheikh, MD, FRCPC. Neoplasia Definitions Definitions Classification Classification Nomenclature Nomenclature Characteristics of

NeoplasiaNeoplasia

Aquired preneoplastic Aquired preneoplastic disorders: disorders: Some Clinical Some Clinical conditions that predispose to cancerconditions that predispose to cancer Dysplastic bronchial mucosa in Dysplastic bronchial mucosa in

smokerssmokers lung carcinoma lung carcinoma Atypical endometrial hypeplasia Atypical endometrial hypeplasia

endometrial carcinomaendometrial carcinoma Liver cirrhosis Liver cirrhosis liver cell carcinoma liver cell carcinoma Margins of chronic skin fistula Margins of chronic skin fistula

squamous cell carcinomasquamous cell carcinoma


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