2. terminology
• oncology: the study of tumors
• neoplasia: new growth (indicates autonomy
with a loss of response to growth controls)
3. types of neoplasms
• benign: localized and amenable to surgical
removal; patient usually survives
• malignant: invasive tumor capable of
destroying structures and spread to distant
sites (metastasis); may result in early death
of the patient
4. examples of benign tumors
• Fibroma: benign tumor of fibrous tissue
• Lipoma: benign tumor of fat
• Adenoma: benign glandular tumor
• Chondroma: benign cartilaginous tumor
• Myoma: benign in muscle tissue
10. • The terms “benign” and “malignant”
describe the biologic behavior of a tumor
• the biologic behavior is characterized by
degree of differentiation of the tumor and
by the rate of growth (and rate of cell death)
11. differentiation
• Well-differentiated tumors contain cells that
resemble the normal cells of origin
• poorly-differentiated or undifferentiated
tumors contain cells that do not resemble
their normal counterparts (ancillary studies
may be needed to determine the cell of
origin)
14. • Benign tumors are co mposed of well-differentiated
cells.
• Malignant tumors are characterized by a
wide range of cellular differentiation.
• Anaplasia (cellular pleomorphism,
hyperchromatic nuclei, high N:C ratio, giant
cells, bizarre nuclei) is a feature of
malignant tumors.
16. dysplasia
• denotes a loss of architectural organization
and a loss of cell uniformity in epithelium
• pleomorphism and mitoses are more
prominent than in the normal
• usually graded: mild, moderate, severe, and
carcinoma-in-situ
• mild to moderate dysplasia is potentially
reversible
19. dysplasia
• Dysplasia is a non-neoplastic proliferation.
• Dysplasia may or may not progress to
cancer.
20. rate of growth
• In general, benign and well-differentiated
malignant tumors have a slower rate of
growth than moderately-differentiated and
poorly-differentiated malignant tumors.
• There are exceptions. Blood supply, site,
and hormonal stimulation are factors that
can affect the growth rate of tumors.
21. invasion
• Benign tumors usually grow by slow
expansion.
• Malignant tumors usually infiltrate and may
destroy surrounding tissue (cell surface and
the extracellular matrix play an important
role).
22. metastasis
• indicates malignancy
• a discontinuous spread of the tumor
• Methods of metastasis include: (1)seeding
of body cavities, (2) lymphatic spread, and
(3) hematogenous spread.
26. grading and staging
• Grading is based on the microscopic
features of the cells which compose a tumor
and is specific for the tumor type.
• Staging is based on clinical, radiological,
and surgical criteria, such as, tumor size,
involvement of regional lymph nodes, and
presence of metastases. Staging usually has
prognostic value.
27. morbidity and mortality
• metastases
• rupture into major vessels
• compression of vital organs
• organ failure
• infection
41. biochemical assays
• tumor markers: sometimes diagnostic or
prognostic
• can be helpful in monitoring effectiveness
of therapy or in detecting
relapses/recurrences
42. some serological markers
associated with malignant tumors
hCG choriocarcinoma
AFP hepatocellular ca
calcitonin thyroid medullary ca
prolactin pituitary adenomas
CA 125 ovarian carcinoma
PSA prostate carcinoma
chromogranin A endocrine neoplasias
43. summary
• neoplasia- an abnormal mass of tissue
which has lost its responsiveness to growth
controls
• benign neoplasms tend to be slow-growing,
well-differentiated tumors which lack the
ability to metastasize
• benign neoplasms, in general, remain
localized and are amenable to surgery
44. summary
• malignant neoplasms tend to be fast-growing
lesions which invade normal
structures
• malignant neoplasms vary in the degree of
differentiation and some show anaplasia
• malignant neoplasms are capable of
metastasis
45. summary
• The prognosis of a patient with any type of
neoplasm depends on a number of factors
including: the rate of growth of the tumor,
the size of the tumor, the tumor site, the cell
type and degree of differentiation, the
presence of metastasis, responsiveness to
therapy, and the general health of the
patient.
