Classification of tumors

2. NeoplasiaNeoplasia
literally means "new growth,"literally means "new growth,"
““Neoplasm abnormal mass of tissue,Neoplasm abnormal mass of tissue,
growth exceeds and uncoordinated withgrowth exceeds and uncoordinated with
normal tissues and persists in excessivenormal tissues and persists in excessive
manner after cessation of stimuli whichmanner after cessation of stimuli which
evoked change”evoked change”
Neoplasm abnormal excessive andNeoplasm abnormal excessive and
unregulated proliferation of cellsunregulated proliferation of cells
independent of physiologic growth stimuliindependent of physiologic growth stimuli
as a result of accumulated heritableas a result of accumulated heritable
genetic alterations by neoplastic cellsgenetic alterations by neoplastic cells

3. NeoplasmNeoplasm
Oncology (Greek oncos = tumor), study of tumors
or neoplasms.
Cancer common term for all malignant tumors.
Latin for crab, cancer— because cancer
"adheres to any part that it seizes upon in an
obstinate manner like crab."

4. CLASSIFICATION OF NEOPLASIACLASSIFICATION OF NEOPLASIA
On the bases of :On the bases of :
1.1. Naked eye appearance including organ of originNaked eye appearance including organ of origin
e.g fungating, scirrhouse.g fungating, scirrhous
2.2. Histogenetic: cell type of origin e.gHistogenetic: cell type of origin e.g
embryological epithelial / connective tissue -embryological epithelial / connective tissue -
retinoblastoma ,teratomaretinoblastoma ,teratoma
3.3. Histological e.g small or large cell, pleomorphic,Histological e.g small or large cell, pleomorphic,
giant cell, degree of differentiationgiant cell, degree of differentiation
4.4. Behavioral e.g benign or malignantBehavioral e.g benign or malignant
5.5. Etiological classificationEtiological classification
6.6. Functional e.g hormones producing likeFunctional e.g hormones producing like
carcinoid, insulinomacarcinoid, insulinoma
Histogenetic and behavioral pattern form the basisHistogenetic and behavioral pattern form the basis
of present classification, supplemented byof present classification, supplemented by
histological descriptionhistological description

5. Naked Eye AppearanceNaked Eye Appearance

8. NeoplasmNeoplasm
Benign and malignant, have twoBenign and malignant, have two
basic components:basic components:
1. Proliferating neoplastic cells-1. Proliferating neoplastic cells-
constituteconstitute parenchymaparenchyma
2 . Supportive2 . Supportive stroma-stroma- connectiveconnective
tissue and blood vesselstissue and blood vessels
Sometimes parenchymal cells stimulate formation of abundant
collagenous stroma- desmoplasia, for example, some cancers of
female breast— stony hard or scirrhous. However
nomenclature is based on parenchymal component.

9. Benign NeoplasmBenign Neoplasm
Designated by attaching suffix -Designated by attaching suffix -omaoma toto
cell of origin.cell of origin.
Tumors of mesenchymal cells generallyTumors of mesenchymal cells generally
follow this rulefollow this rule
Fibroblastic cells -Fibroblastic cells - fibromafibroma
Chondrocytes -Chondrocytes - chondromachondroma
Osteoblasts -Osteoblasts - osteomaosteoma

10. Benign NeoplasmBenign Neoplasm
Nomenclature of benign epithelial tumorsNomenclature of benign epithelial tumors
based on cells of origin, microscopic architecture,based on cells of origin, microscopic architecture,
or macroscopic patternsor macroscopic patterns
Benign epithelial neoplasm:Benign epithelial neoplasm:
Renal tubular cells adenoma, colonic adenomasRenal tubular cells adenoma, colonic adenomas
Benign epithelial neoplasms producingBenign epithelial neoplasms producing
microscopically or macroscopically visible finger-microscopically or macroscopically visible finger-
like or warty projections from epithelial surfaceslike or warty projections from epithelial surfaces
referred asreferred as papillomaspapillomas
Forming large cystic masses- asForming large cystic masses- as cystadenomascystadenomas

11. Malignant NeoplasmMalignant Neoplasm
Epithelial origin- CarcinomaEpithelial origin- Carcinoma
 Squamous cell carcinoma-Squamous cellsSquamous cell carcinoma-Squamous cells
 Adenocarcinoma-glandular growthAdenocarcinoma-glandular growth
Mesenchymal origin- SarcomaMesenchymal origin- Sarcoma
Mixed Epithelial & MesenchymalMixed Epithelial & Mesenchymal
Pleomorphic adenoma, CarcinosarcomaPleomorphic adenoma, Carcinosarcoma
Exceptions to the rule:Exceptions to the rule:
Melanomas , Seminomas, Hepatomas,Melanomas , Seminomas, Hepatomas,
Retinoblastoma, Medulloblastoma, MesotheliomaRetinoblastoma, Medulloblastoma, Mesothelioma
are malignant neoplasm although suffix oma isare malignant neoplasm although suffix oma is
attachedattached

12. Retinoblastoma

13. Retinblastoma

14. ChoristomaChoristoma
Ectopic rest of normal tissue e.g pancreatic rest inEctopic rest of normal tissue e.g pancreatic rest in
small intestinesmall intestine
HamartomaHamartoma
Tumor like malformation composed of disorganizedTumor like malformation composed of disorganized
but mature specialized cells or tissue normally foundbut mature specialized cells or tissue normally found
in an organ (indigenous to particular site) e.gin an organ (indigenous to particular site) e.g
Juvenile rectal polypJuvenile rectal polyp
PolypPolyp
Macroscopically visible mass above mucosal surface,Macroscopically visible mass above mucosal surface,
may be neoplastic or non-neoplasticmay be neoplastic or non-neoplastic
PolypoidPolypoid
Malignant polypsMalignant polyps

15. Benign TumorsBenign Tumors
 Cell of origin + OMACell of origin + OMA
 Fibroma, chondroma, osteomaFibroma, chondroma, osteoma
 Adenoma: derived from glands/Adenoma: derived from glands/
glandular patternglandular pattern
Tubular adenoma, colon

16.  Polyp: macroscopicPolyp: macroscopic  projection ofprojection of
mucosal surfacemucosal surface

17.  Papillomas: architecturePapillomas: architecture  fingerfinger
like projectionslike projections

19. Nomenclature of neoplasmsNomenclature of neoplasms
Tissue of OriginTissue of Origin BenignBenign MalignantMalignant
Composed of One Parenchymal Cell TypeComposed of One Parenchymal Cell Type
 Tumors of mesenchymal origin connective tissue andTumors of mesenchymal origin connective tissue and
derivativesderivatives
Fibroma FibrosarcomaFibroma Fibrosarcoma
Lipoma LiposarcomaLipoma Liposarcoma
Chondroma ChondrosarcomaChondroma Chondrosarcoma
Osteoma Osteogenic sarcomaOsteoma Osteogenic sarcoma
 Endothelial and related tissuesEndothelial and related tissues
Blood vessels Hemangioma AngiosarcomaBlood vessels Hemangioma Angiosarcoma
Lymph vessels Lymphangioma LymphangiosarcomaLymph vessels Lymphangioma Lymphangiosarcoma
•• Synovium Synovial sarcomaSynovium Synovial sarcoma
•• Mesothelium MesotheliomaMesothelium Mesothelioma
•• Brain coverings Meningioma Invasive meningiomaBrain coverings Meningioma Invasive meningioma

20. Nomenclature of NeoplasmNomenclature of Neoplasm
•• Hematopoietic cells LeukemiasHematopoietic cells Leukemias
•• Lymphoid tissue LymphomasLymphoid tissue Lymphomas
 MuscleMuscle
Smooth Leiomyoma LeiomyosarcomaSmooth Leiomyoma Leiomyosarcoma
Striated Rhabdomyoma RhabdomyosarcomaStriated Rhabdomyoma Rhabdomyosarcoma
Tumors of epithelial originTumors of epithelial origin
 Stratified squamous cellStratified squamous cell
papilloma Epidermoidpapilloma Epidermoid
carcinomacarcinoma
 Basal cells of skin or adnexa Basal cell carcinomaBasal cells of skin or adnexa Basal cell carcinoma
 Epithelial lining of glands or ductsEpithelial lining of glands or ducts
Adenoma AdenocarcinomaAdenoma Adenocarcinoma
Papilloma Papillary carcinomasPapilloma Papillary carcinomas
Cystadenoma CystadenocarcinomaCystadenoma Cystadenocarcinoma

22. Nomenclature of tumorsNomenclature of tumors
 Respiratory passagesRespiratory passages
Bronchial adenoma Bronchogenic carcinomaBronchial adenoma Bronchogenic carcinoma
 Renal epitheliumRenal epithelium
Renal tubular adenoma Renal cell carcinomaRenal tubular adenoma Renal cell carcinoma
 Liver cellsLiver cells
Liver cell adenoma Hepatocellular carcinomaLiver cell adenoma Hepatocellular carcinoma
 Urinary tract epitheliumUrinary tract epithelium
Papilloma Transitional cell carcinomaPapilloma Transitional cell carcinoma
 Placental epitheliumPlacental epithelium
Hydatidiform mole ChoriocarcinomaHydatidiform mole Choriocarcinoma
 Testicular epithelium (germ cells) SeminomaTesticular epithelium (germ cells) Seminoma
Embryonal carcinomaEmbryonal carcinoma
 Tumors of melanocytesTumors of melanocytes
Nevus Malignant melanomaNevus Malignant melanoma

24. Nomenclature of tumorsNomenclature of tumors
More Than One Neoplastic Cell Type—Mixed Tumors,More Than One Neoplastic Cell Type—Mixed Tumors,
Usually Derived from One Germ Cell LayerUsually Derived from One Germ Cell Layer
Salivary glands Pleomorphic adenomaSalivary glands Pleomorphic adenoma
Malignant mixed tumorMalignant mixed tumor
Renal Wilms tumorRenal Wilms tumor
More Than One Neoplastic Cell Type Derived fromMore Than One Neoplastic Cell Type Derived from
More Than One Germ Cell Layer—TeratogenousMore Than One Germ Cell Layer—Teratogenous
Totipotential cells in gonads or in embryonic restsTotipotential cells in gonads or in embryonic rests
Mature teratomaMature teratoma
Dermoid cystDermoid cyst
Immature teratomaImmature teratoma
TeratocarcinomaTeratocarcinoma

27. Differences- Benign & MalignantDifferences- Benign & Malignant
Characteristics Benign Malignant
Differentiation/anaplasia: Well-differentiated Some lack of differentiation
with anaplasia
Rate of growth: Usually progressive & slow; Erratic & may be slow to rapid
may standstill or regress; Mitotic figures may be
numerous
mitotic figures rare & normal and abnormal
Local invasion: Usually cohesive and expansile Locally invasive, infiltrating
well-demarcated masses that Surrounding normal tissue
do not invade or infiltrate Sometimes seemingly
cohesive
surrounding normal tissues and expensile
Metastasis: Absent Frequently present; the larger
and more undifferentiated the
primary, likely are metastase
e.g bone, lung, brain ,liver.

28. Comparison between Benign &Comparison between Benign &
Malignant TumorMalignant Tumor

30. *Basal cell carcinoma and CNS*Basal cell carcinoma and CNS
tumours -no metastasestumours -no metastases
Medulloblastoma involve spinal canalMedulloblastoma involve spinal canal
and meningesand meninges
*Primary tumour regress or disappear*Primary tumour regress or disappear
in Choriocarcinoma and Malignantin Choriocarcinoma and Malignant
melanomamelanoma
*Sarcoma- vascular metastases*Sarcoma- vascular metastases
*Carcinoma- lymphatic metastases*Carcinoma- lymphatic metastases
except HCC, RCC, FC of thyroidexcept HCC, RCC, FC of thyroid