from Ancient Greek - neo- "new" and plasia "formation, creation"), tumor or tumour is an abnormal mass of tissue as a result of abnormal growth or division of cells The term "cancer" implies malignancy, but neoplasms can be subclassified as either benign or malignant.

1. Progeria syndrome
By : Ahmed Elshahat Saied
Supervisor :DR,AZZA ATIA

2. Neoplasia
from Ancient Greek - neo- "new" and plasia
"formation, creation"), tumor or tumour
is an abnormal mass of tissue as a result of
abnormal growth or division of cells
The term "cancer" implies malignancy, but
neoplasms can be subclassified as either benign or
malignant.

3. Nomenclature:
Neoplasms are named based upon two
factors
1. on the histologic types :
2. on behavioral patterns : benign and
malignant neoplasms

4. Thus, the suffix -oma denotes a benign
neoplasm.
originating from, bone, fat, blood vessel
nerve, fibrous tissue and cartilages are
named as, osteoma, lipoma,
hemangioma, neuroma, fibroma and
chondroma respectively.

5. Malignant neoplasia :
arising from tissue embryologically derived from
ectoderm or endoderm are usually carcinomas. Examples
include:
Squamous cell carcinoma of cervix
Adenocarcinoma of stomach
Hepatocellular carcinoma
Renal cell carcinoma
Malignancies arising from mesoderm (connective tissues)
are usually sarcomas. Examples include:
Leiomyosarcoma
Chondrosarcoma
Osteosarcoma
Liposarcoma

6. Neoplasms with more than one cell type but
arising from only one germ layer are called
"mixed tumors".
Neoplasms with more than one cell type and
arising from more than one germ layer are
called teratomas. Such neoplasms are common
in the ovary.

7. Neoplasms ending in "-blastoma" resemble primitive
embryonic tissues, which are often pediatric neoplasms.
Examples include:
Retinoblastoma
Neuroblastoma
Hepatoblastoma
Medulloblastoma
Not all malignant neoplasms have benign counterparts:
Hematopoietic and lymphoid cells (as in bone marrow and
lymph node) give rise to leukemias and lymphomas. They
have no benign counterpart.
Gliomas (astrocytomas, oligodengrogliomas, glioblastoma
multiforme, etc) arise from glial cells in the CNS. They have
no
benign counterpart.

8. Any increase in tissue size is not necessarily
neoplasia.
Here is an example of left ventricular cardiac
hypertrophy in which there has been an increase
in the size of the myocardial fibers in response to
an increased pressure load from hypertension.
With hypertrophy, the cells increase in size, but
the cells do not increase in number. Except for
being larger, the cells are normal in appearance.

9. left ventricular cardiac

10. Hypertrophy: an increase in cell size. Increase in
skeletal muscle fiber size is a physiologic
response to exercise, but the cardiac
hypertrophy shown above is a pathologic
response to abnormally elevated blood pressure.
Hyperplasia: an increase in the number of cells.
Postpartum breast lobules undergo hyperplasia
for lactation, but endometrial hyperplasia in a
postmenopausal woman is abnormal.

11. Tissue evidence of carcinogenic factors
at work
Metaplasia: an initial change from normal cells to a
different cell type (such as chronic irritation of
cigarette smoke causing ciliated pseudostratified
epithelium to be replaced by squamous epithelium
more able to withstand the insult).

12. The first step toward neoplasia is cellular transformation. The
chronic irritation from cigarette smoke has led to an exchanging
of one type of epithelium (the normal respiratory epithelium at
the right) for another (the more resilient squamous epithelium
at the left). Thus, there is metaplasia of normal respiratory
laryngeal epithelium to squamous epithelium in response to
chronic irritation of smoking.

13. The two forms of cellular transformation that
are potentially reversible, but may be steps
toward a neoplasm, are:
Metaplasia: the exchange of normal
epithelium for another type of epithelium.
Metaplasia is reversible when the stimulus for
it is taken away.

14. DYSPLASIA
variation in somatotype (as in degree of ectomorphy,
endomorphy, or mesomorphy) from one part of a human body to
another
: abnormal growth or development (as of organs or cells); broadly
: abnormal anatomic structure due to such growth

15. This biopsy of the lower esophagus in a patient
with chronic gastroesophageal reflux disease
(GERD) shows columnar metaplasia (Barrett's
esophagus), and the goblet cells are typical of an
intestinal type of epithelium. Squamous
epithelium typical of the normal esophagus
appears at the right

16. Characteristics of Benign Neoplasms
A benign neoplasm looks a lot like the tissue
with normal cells from which it originated, and
has a slow growth rate. Benign neoplasms do not
invade surrounding tissues and they do not
metastasize. Thus, characteristics include:
Slow growth
Resemblance to tissue of origin (well
differentiated)
Circumscription
Lack of invasion
Absence of metastases

17. Neoplasms can be benign or malignant, though it is not always easy
to tell how a neoplasm will act based upon gross or even microscopic
appearances. Here is a benign lipoma on the serosal surface of the
small intestine. It has the characteristics of a benign neoplasm: it is
well circumscribed, slow growing, non-invasive, and closely
resembles the tissue of origin (fat).

18. Remember that the most common neoplasm is a
benign nevus (pigmented mole) of the skin, and
most people have several, as seen here over the
skin of the chest. As a general rule, benign
neoplasms do not give rise to malignant neoplasms
unless a series of transforming events occur.

19. Malignant Neoplasms
characteristics of malignant neoplasms include:
1. More rapid increase in size
2. Less differentiation (or lack of differentiation, called anaplasia)
3. Tendency to invade surrounding tissues
4. Ability to metastasize to distant tissues
Cytologic features of malignant neoplasms include:
 Increased nuclear size
 Variation in nuclear or cell size (pleomorphism).
 Lack of differentiation (anaplasia).
 Increased nuclear DNA content with subsequent dark staining
on H and E slides (hyperchromatism).
 Prominent nucleoli or irregular chomatin distribution within
nuclei.
 Mitoses (especially irregular or bizarre mitoses).

20. Causes of Neoplasia
1. The origin for many neoplasms is obscure. However, there are
several theories of origin:
2. Environmental causes:
3. Chemicals: including those that are man-made (such as aniline dyes
and bladder cancer), drugs (cigarette smoke and lung cancer), and
natural compounds (aflatoxins and liver cancer) which are
carcinogenic.
4. Oncogenic viruses: such as human papillomavirus (HPV) implicated
in most squamous cell carcinomas of cervix and anogenital
squamous papillomas, Epstein-Barr virus (EBV) implicated in African
Burkitt's lymphoma, and hepatitis B virus (HBV) implicated in
development of hepatocellular carcinomas.
5. Radiation: including ultraviolet light that induces pyrimidine dimers
in DNA and promotes skin cancers. Ionizing radiation (such as
gamma radiation) induces mutations in DNA and promotes
malignancies such as leukemia, thyroid, lung, colon, and breast
cancers.

21. Spread of Malignant Neoplasms
By direct extension (invasion) into surrounding
tissues.
1. Through lymph channels to lymph nodes
(lymphatic spread)--typical of carcinomas.
2. Via the bloodstream (hematogenous
spread)--typical of carcinomas or sarcomas.
3. Within body cavities (seeding)--typical of
neoplasms impinging upon body cavities,
such as the peritoneal cavity.

22. This renal cell carcinoma
demonstrates distortion
and displacement of the
normal renal
parenchyma by the
tumor mass in the lower
pole of this kidney. This
malignant neoplasm has
a variegated appearance
on its cut surface, with
yellow to white to red to
brown areas.

23. Malignant neoplasms are
also characterized by
their tendency to invade
surrounding tissues.
Here, the tan tissue of a
lung cancer is seen to be
spreading along the
bronchi into the
surrounding lung. The
dark round areas are
lymph nodes also
involved by the
neoplasm.

24. Bacteria 24
Classification based upon
staining
Gram Positive vs
Gram Negative
Gram positive structure
-- thick layer of
peptidoglycan
Gram negative structure
-- inner vs outer membranes
-- lipopolysaccharides and
endotoxins
Effect of penicillin

26. The characteristics are present in gram-positive
bacteria:
Cytoplasmic lipid membrane
Thick peptidoglycan layer
Teichoic acids and lipoids are present, forming
lipoteichoic acids, which serve as chelating
agents, and also for certain types of adherence.

27. Cytoplasmic membrane
Thin peptidoglycan layer (which is much thicker in gram-positive bacteria)
Outer membrane containing lipopolysaccharide (LPS, which consists of lipid A,
core polysaccharide, and O antigen) in its outer leaflet and phospholipids in
the inner leaflet
Porins exist in the outer membrane, which act like pores for particular
molecules
There is a space between the peptidoglycan layer and the secondary cell
membrane called the periplasmic space
The S-layer is directly attached to the outer membrane rather than the
peptidoglycan
If present, flagella have four supporting rings instead of two
No teichoic acids or lipoteichoic acids are present
Lipoproteins are attached to the polysaccharide backbone.
Some of them contain Braun's lipoprotein, which serves as a link between the
outer membrane and the peptidoglycan chain by a covalent bond
Most, with very few exceptions, do not form spores.
Release some endotoxin

28. 1. Gram Stain Technique
2. Flood the slide with crystal violet solution for up to one minute.
Wash off briefly with tap water (not over 5 seconds). Drain.
3. Flood slide with Gram's Iodine solution, and allow to act (as a
mordant) for about one minute. Wash off with tap water. Drain.
4. Remove excess water from slide and blot, so that alcohol used
for decolorization is not diluted. Flood slide with 95% alcohol for
10 seconds and wash off with tap water. (Smears that are
excessively thick may require longer decolorization. This is the
most sensitive and variable step of the procedure, and requires
experience to know just how much to decolorize). Drain the
slide.
5. Flood slide with safranin solution and allow to counterstain for
30 seconds. Wash off with tap water. Drain and blot dry with
bibulous paper. Do not rub.
6. All slides of bacteria must be examined under the oil immersion
lens.

30. Staining and Identification
Microscopic view of dental plaque, showing Gram-
positive (purple) and negative (red) bacteria
In a Gram stain test, bacteria are washed with a
decolorizing solution after being dyed with crystal
violet. On adding a counter stain such as safranin or
fuchsine after washing, Gram-negative bacteria are
stained red or pink while Gram-positive bacteria retain
their crystal violet dye.
This is due to the difference in the structure of their
bacterial cell wall. Gram-positive bacteria do not have
an outer cell membrane found in Gram-negative
bacteria. The cell wall of Gram-positive bacteria is high
in peptidoglycan which is responsible for retaining the
crystal violet dye.

31. Pathogenesis in humans
90-95% of Gram negative bacteria
are pathogenic. On the other hand,
many Gram-positive bacteria are
non-pathogenic.

32. H. Pylori which infects up to 50% of the human
population. Some strains of this bacterium are
pathogenic to humans as it is strongly associated
with peptic ulcers, chronic gastritis, duodenitis,
and stomach cancer

33. Pseudomonas aeruginosa
Pneumonia
Septic shock
Urinary tract infection
Skin and
soft tissue infections