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Neoplasia
- -new growth of abnormal tissue
- -serves no physiologic function
- -has the ability to replicate without growth factors
- -75%-90% of human neoplasia is due to enviromental factors
- -neoplastic transformations involves somatic mutations of DNA
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"tumors" are denotes by what suffix
-oma
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carcinoma
epithelial malignancies
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sarcoma
mesenchymal/ connective tissue malignancies
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melanoma
malignant neoplasm of melanocytes
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lymphoma
malignant neoplasm
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glioma
malignant neoplasms of supporting tissue of the CNS
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blastoma
malignant tumors arising from early, partially differentiated embryonal tissue
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teratoma
neoplasm which contains cell from more than one embryonic germ cell layer and may be benign or malignant
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hamartoma
is a non-neoplastic "tumor" that represents abnormal overgrowth or differentiation of cells native to the tissue of origin
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choristoma
refers to the presence of normal tissue in an abnormal location
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hematoma
coagulated blood non-neoplastic
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granuloma
chronic inflammation
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squamous
skin and mucosal tissue
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adeno
grandular and all other epithelium except: squamous and transitional
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transitional
urinary tract
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fibro
fibrous connective tissue
-
-
rhabdomyo
skeletal muscle
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-
-
-
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lymphangio
lymphatic vessel
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-
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colloid
gelatinous, mucinous
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cystic
fluid or gas filled space
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papillary
forming "nipple-like" projections
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villous
forming shaggy, "finger-like" projections
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tubular
forming cylindrical tubules
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cribriform
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Benign v. Malignant
- -cellular morphology
- -cellular differentiation
- -rate of growth
- -manner of growth
- -ability to metastasize
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Benign v. Malignant
-Cellular morphology
- - nuclear pleomorphism (due to alterations in the cell cytoskeleton
- -increased nuclear/ cytoplamic ratio
- -not well defined boundry
- - loss of normal function
- - loss of organization
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Benign v. Malignant
-cellular differentiation
- -refers to the extent to which neoplastic cells resemble their cell of origin histologically
- -malignant cells: show abnormalities in the number or structure of chromosomes
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Benign v. Malignant
-rate of growth
- Benign: normal gowth or regress
- Malignant: growth rate is faster, and usually does not regress or cease growth
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Benign v. Malignant
-manner of growth
- -benign: grow by expansion and tend to compress the surrounding tissue into a capsule
- -malignant: growth by infiltration and invasion of the surrounding tissue and not confined
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Benign v. malignant
-metastasis
- Bening: does NOT metastasize
- Malignant: ALL have metastatic potential
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How does metastsis occur:
- Lymphatic dissemination: most common, systemic disease (carcinomas)
- Hematogenous dissemination- characteristic of connective tissue neoplasms (sarcoma)
- Transcoelomic seeding-coelomic (peritoneal, pleural) surfaces. spread by touch
- Traumatic seeding-cutting into malignant tumors may detach and carry small portions of the tumor to other sites
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Clinical significance -anatomic location
Benign and malignant tumors can both have serious affect due to location
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Clinical Significance- local effects
Both benign and malignant neoplasms may cause compression of surrounding structures.
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Clinical Significance- systemic effect
Some tumors (benign or malignant) may produce hormones or hormone-like substances that can have systemic effects
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Intrinsic factors that contribute to neoplasias
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External factors that can increase risk of neoplasms
- sun exposure
- radiation
- food
- smoking
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Neoplasia
Carcinogenic Agents- chemicals
- Initiation: DNA changes
- Promotion: growth stimulation
- Conversion: promoter independence
- Progression: continues DNA changes
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Neoplasis
-Carcinogenic Agents- radiation
- Produces free radicals
- alters protein
- DNA damage
- -point mutation
- -transclutions
- -strand breaks
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Neoplasia
Carcinogenic Agents- Viruses
- Both DNA and RNA viruses
- Transduction
- Insertinal mutagenesis
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Features of Malignant Cells
- increased stem cell renewal
- loss of contact inhibition
- anchorage independent growth
- immortality
- ability to invade and metastasize
- transplantibility
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Proto-oncogenes v. cellular oncogenes
Proto-oncogenes are normal. Proto-oncogenes have the potential of being converted to oncogenes that can promote excessive or inappropriate cell proliferation.
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Tumor Suppressor Genes
- serves to protect the sell from the events leading to neoplastic transformation
- without this regulation, neoplasms may arise
- ex) RAB-1 and p53
- -p53 check DNA sequences before translation to make sure it has the right coding
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Inherited v. acquired neoplasia
if a mutated allele is inherited, it is present in all cells and there is a greater tendency to develop multi tumors
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Neoplastic Transformation
- multistep process
- sequential activation of oncogenes
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Tumor Growth
- cell to replicate rather than to continue to differentiate
- -Growth fraction: degree of imbalance between cell production and cell loss (lower GF, harder to get rid of)
- -Angiogenesis: tumor must have vascularization
- -Double timing: growth rate slows down when increasing in size
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Tumor specific antigens
antigens not associated with normal cells
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tumor associated antigens
antigens are found in normal cells but which are present in higher concentrations in tumor cells
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Grading
- pathologic determination of tumor
- -based on degree of differentiation, number of mitoses
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Staging
- clinical AND pathologic determination of tummor aggressiveness
- based on size, regional lyph node status, metastatic disease
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A malignant tumor arising from connective tissue would be called what?
fibrosarcoma
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Which of the following indicate a neoplasm is growning
-hemorrhage
-necrosis
-both
-neither
Both
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Anti-oncogenes represent
-genes altered by chemical mutation
-genes altered by viral mutations
-genes altered by radiation mutation
-normal genes that induce neoplasia
-normal genes that prevent neoplasia
normal genes that prevent neoplasia
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which of the following statements concerning benign tumurs are true
-they are usually slow growing
-they usually grow by expansion and compression fo the surrounding tissue
-both
-neither
Both
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Each of the following is a benign neoplasm except:
-adenoma
-fibroma
-leiomyoma
-lipoma
-lymphoma
lymphoma
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Althought many factors probably play a role in the development of neoplasia, the basic underlying mechanism most like relates
-aging
-altered genetic function
-hormonal immune
-viral infection
altered genetic function
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which of the following features most accurately distingushes a malignant neoplasm from a benign neoplasm
-anatomic location
-cytoplasmic differentiation
-presence of metastases
-production of functional hormones
-rate of growth
presence of metastases
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staging of malignant neoplasms refers to the determination of
-degree of differentiation
-extent of spread
-nuclear pleomorphism
-rate of growth
-structural patterens
extent of spread
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Which of the following terms describes a primary malignant neoplasm
-angiosarcoma
-histiocytoma
-lieomysarcoma
-myelolipoma
-rhabdomysarcoma
lieomysarcoma
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Which of the following is not considered to be a true neoplasm
-carcinoma
-hamartoma
-melanoma
-sarcoma
-teratoma
hamartoma
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All of the follwoing statements about benign tumors are true except
-they are usually slow growing
-attain a high degree of structural differentiation and closely resemble their tissue of origin
-they can metastasize
-they usually grow by expansion and compression of surrounding tissues to form a capsule
they can metastasize
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Which of the following would be an appropriate name for a benign tumor of epithelial origin which forms cyctic spaces and glandular structures
-papillary adenosarcoma
-follicular cytosarcoma
-cytadenoma
-villous cystadenosarcoma
cytadenoma
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Which of the following is a malignant tumor of epithelial origin
-papilloma
-carcinoma
-adenoma
-sarcoma
-melanoma
carcinoma
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Which of the following features is most characteristic of a neoplasm
-autonomous growth
-increased cascularity
-large size
-necrosis
-rapid growth
autonomous growth
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All of the following are clinical manifestations of bronchogenic carcinomas except:
-acute respiratory failure
-hemoptsis
-weight loss
-hormone production
-bronchial obstruction
acute respiratory failure
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Lung cancer is
-less common than colon and rectal cancer
-is more common in males tha in females
-both
-neither
is more common in males than in females
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