Cancer, also known as a malignant tumor, is characterized by abnormal cell growth that exceeds normal limits and can invade surrounding tissues and spread to other parts of the body. Neoplasms, which include both benign and malignant tumors, originate from a single cell that has incurred genetic changes causing uncontrolled growth. Benign tumors are generally not life-threatening, remain localized, and do not spread, whereas malignant tumors can invade other tissues and metastasize to distant sites. The behavior and characteristics of tumors are determined by their parenchymal cells and surrounding stromal tissues.
MBBS 2nd Year Pathology - Neoplasia : IntroductionNida Us Sahr
Chapter 7 (Neoplasia) from Robbins and Cotran Pathologic Basis of Disease (9th Edition) for MBBS 2nd Year.
After going through this presentation, it will be easy to understand Neoplasia from Robbins.
Neoplasia
Overview
Characteristics of neoplasms compared to normal tissues
Types of neoplasms
Benign vs malignant
Cellular differentiation
Genetic basis for neoplasia
What is a “neoplasm”?
Lay term of “tumor” conveys usual connotations – ie a new growth or mass
Definition revolves around these features:
Monoclonal proliferation of cells with specific mutations
Excessive and unregulated growth of these cells, often at the expense of surrounding normal tissue
Terms to know about when discussing neoplasia
Metastasis - spread of a malignant tumor from one site to another via blood or lymph
Benign – typically refers to those tumors incapable of metastasis and having a good clinical outcome (prognosis)
Malignant – those tumors capable of invasive growth and/or metastasis, often fatal if not treated effectively
Parenchyma – these are the tumor cells themselves, usually referring to epithelial cells in organs.
Stroma – connective tissue cells that support the parenchymal cells – not actually tumor cells, but are stimulated to grow by the tumor via growth factors, eg angiogenesis
Cellular differentiation
Tumors are often “graded” as to how closely they resemble the normal parent tissue that they are derived from.
Well-differentiated means the cells are very similar in appearance and architectural arrangement to normal tissue of that organ
Differentiation
“Poorly-differentiated” refers to tumors that show only minimal resemblance to the normal parent tissue they are derived from.
“Anaplastic” means the tumor shows no obvious similarity to it’s parent tissue, usually associated with aggressive behavior
So what??????
Differentiation often provides clues as to the clinical aggressiveness of the tumor
Tumors often lose differentiation features over time as they become more “malignant” and as they acquire more cumulative genetic mutations
Differentiation often predicts responsiveness to certain therapies, eg estrogen receptors and Tamoxifen in breast cancers
Benign
– circumscribed, often encapsulated, pushes normal tissue aside
Malignant
– infiltrative growth, no capsule, destructive of normal tissues
Classification of neoplasms
Epithelial tumors
Benign forms – adenoma , papilloma
Malignant forms – carcinoma, eg adenocarcinoma, squamous cell carcinoma
Mesenchymal tumors
Benign forms – fibroma, leiomyoma,
Malignant forms – sarcoma, eg fibrosarcoma, leiomyosarcoma
Classification continued
Tumors of lymphocytes are always malignant – called lymphoma
Tumors of melanocytes
Benign – nevus
Malignant - melanoma
Precursors of neoplasia
Hyperplasia
Metaplasia
Chronic inflammation
dysplasia
Metaplasia, dysplasia, neoplasia
Neoplasia: Is the abnormal growth and proliferation of abnormal cells or abnormal amounts of cells due to a benign or malignant process. There can be benign tumors, or neoplasms, and malignant ones.
MBBS 2nd Year Pathology - Neoplasia : IntroductionNida Us Sahr
Chapter 7 (Neoplasia) from Robbins and Cotran Pathologic Basis of Disease (9th Edition) for MBBS 2nd Year.
After going through this presentation, it will be easy to understand Neoplasia from Robbins.
Neoplasia
Overview
Characteristics of neoplasms compared to normal tissues
Types of neoplasms
Benign vs malignant
Cellular differentiation
Genetic basis for neoplasia
What is a “neoplasm”?
Lay term of “tumor” conveys usual connotations – ie a new growth or mass
Definition revolves around these features:
Monoclonal proliferation of cells with specific mutations
Excessive and unregulated growth of these cells, often at the expense of surrounding normal tissue
Terms to know about when discussing neoplasia
Metastasis - spread of a malignant tumor from one site to another via blood or lymph
Benign – typically refers to those tumors incapable of metastasis and having a good clinical outcome (prognosis)
Malignant – those tumors capable of invasive growth and/or metastasis, often fatal if not treated effectively
Parenchyma – these are the tumor cells themselves, usually referring to epithelial cells in organs.
Stroma – connective tissue cells that support the parenchymal cells – not actually tumor cells, but are stimulated to grow by the tumor via growth factors, eg angiogenesis
Cellular differentiation
Tumors are often “graded” as to how closely they resemble the normal parent tissue that they are derived from.
Well-differentiated means the cells are very similar in appearance and architectural arrangement to normal tissue of that organ
Differentiation
“Poorly-differentiated” refers to tumors that show only minimal resemblance to the normal parent tissue they are derived from.
“Anaplastic” means the tumor shows no obvious similarity to it’s parent tissue, usually associated with aggressive behavior
So what??????
Differentiation often provides clues as to the clinical aggressiveness of the tumor
Tumors often lose differentiation features over time as they become more “malignant” and as they acquire more cumulative genetic mutations
Differentiation often predicts responsiveness to certain therapies, eg estrogen receptors and Tamoxifen in breast cancers
Benign
– circumscribed, often encapsulated, pushes normal tissue aside
Malignant
– infiltrative growth, no capsule, destructive of normal tissues
Classification of neoplasms
Epithelial tumors
Benign forms – adenoma , papilloma
Malignant forms – carcinoma, eg adenocarcinoma, squamous cell carcinoma
Mesenchymal tumors
Benign forms – fibroma, leiomyoma,
Malignant forms – sarcoma, eg fibrosarcoma, leiomyosarcoma
Classification continued
Tumors of lymphocytes are always malignant – called lymphoma
Tumors of melanocytes
Benign – nevus
Malignant - melanoma
Precursors of neoplasia
Hyperplasia
Metaplasia
Chronic inflammation
dysplasia
Metaplasia, dysplasia, neoplasia
Neoplasia: Is the abnormal growth and proliferation of abnormal cells or abnormal amounts of cells due to a benign or malignant process. There can be benign tumors, or neoplasms, and malignant ones.
Fraganvel
El delirio de tus sentidos ofrecerle lo mejor en calidad y diseño de velas decorativas, elaboradas con mano de obra calificada y experta en el arte.
about tumors:
Epithelial tumors are a type of tumor that originates from cells in the epithelium, which is a tissue that lines the surfaces and cavities of the body, such as the skin, organs, and glands. Epithelial tumors are also known as epithelial cell tumors or epitheliomas.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
2. Cancer is the second leading cause of death in the United States; only
cardiovascular diseases exact a higher toll.
Neoplasia means “new growth,” and a new growth is called a
neoplasm.
Tumor originally applied to the swelling caused by inflammation, but
the non-neoplastic usage of tumor has almost vanished; thus, the term
is now equated with neoplasm.
Oncology (Greek oncos = tumor) is the study of tumors or neoplasms.
A neoplasm is an abnormal mass of tissue, the growth of which exceeds
and is uncoordinated with that of the normal tissues and persists in
the same excessive manner after cessation of the stimuli which evoked
the change.
The entire population of neoplastic cells within an individual tumor
arises from a single cell that has incurred genetic change, and hence
tumors are said to be clonal.
3. • A tumor is said to be benign when its microscopic and gross
characteristics are considered relatively innocent, implying that
it will remain localized, it cannot spread to other sites, and it is
generally amenable to local surgical removal; the patient
generally survives.
• Malignant tumors are collectively referred to as cancers,
derived from the Latin word for crab, because they adhere to any
part that they seize on in an obstinate manner, similar to a crab.
Malignant, as applied to a neoplasm, implies that the lesion can
invade and destroy adjacent structures and spread to distant
sites (metastasize) to cause death. But the designation
malignant always raises a red flag.
4. All tumors, benign and malignant, have two basic components:
(1) clonal neoplastic cells that constitute their parenchyma and
(2) reactive stroma made up of connective tissue, blood vessels, and
variable numbers of macrophages and lymphocytes.
Although the neoplastic cells largely determine a tumor's
behavior and pathologic consequences, their growth and evolution is
critically dependent on their stroma.
An adequate stromal blood supply is requisite for the tumor cells to
live and divide, and the stromal connective tissue provides the
structural framework essential for the growing cells.
In addition, there is cross-talk between tumor cells and stromal cells
that directly influences the growth of tumors. In some tumors, the
stromal support is scant and so the neoplasm is soft and fleshy. In
other cases the parenchymal cells stimulate the formation of an
abundant collagenous stroma, referred to as desmoplasia. Some
demoplastic tumors—for example, some cancers of the
female breast—are stony hard or scirrhous.
The nomenclature of tumors and their biologic behavior are based
primarily on the parenchymal component.
5. Benign Tumors.
In general, benign tumors are designated by attaching the suffix
-oma to the cell of origin.
Tumors of mesenchymal cells generally follow this rule. For
example, a benign tumor arising in fibrous tisssue is called a
fibroma, whereas a benign cartilaginous tumor is a chondroma.
In contrast, the nomenclature of benign epithelial tumors is more
complex. These are variously classified, some based on their cells
of origin, others on microscopic pattern, and still others on their
macroscopic architecture.
6. • Adenoma is applied to a benign epithelial neoplasm derived from
glands, although they may or may not form glandular structures.
• Benign epithelial neoplasms producing microscopically or
macroscopically visible finger-like or warty projections from
epithelial surfaces are referred to as papillomas.
• Those that form , as in the ovary, are referred to as
cystadenomas.
• Some tumors produce papillary patterns that protrude into cystic
spaces and are called papillary cystadenomas.
• When a neoplasm, benign or malignant, produces a
macroscopically visible projection above a mucosal surface and
projects, for example, into the gastric or colonic lumen, it is
termed a polyp.
7. Colonic polyp. A, This benign glandular tumor (adenoma) is projecting into
the colonic lumen and is attached to the mucosa by a distinct stalk. B,
Gross appearance of several colonic polyps.
8. .
Malignant Tumors.
Malignant tumors arising in mesenchymal tissue are usually called
sarcomas (Greek sar = fleshy), because they have little connective tissue
stroma and so are fleshy (e.g., fibrosarcoma, chondrosarcoma,
leiomyosarcoma, and rhabdomyosarcoma).
Malignant neoplasms of epithelial cell origin, derived from any of the
three germ layers, are called carcinomas.
Carcinomas may be further qualified:
Squamous cell carcinoma would denote a cancer in which the tumor cells
resemble stratified squamous epithelium;
adenocarcinoma denotes a lesion in which the neoplastic epithelial cells
grow in glandular patterns.
Sometimes the tissue or organ of origin can be identified, as in the
designation of renal cell adenocarcinoma or bronchogenic squamous cell
carcinoma.
Not infrequently, however, a cancer is composed of undifferentiated cells
of unknown tissue origin, and must be designated merely as an
undifferentiated malignant tumor.
9. .
• In many benign and malignant neoplasms, the parenchymal cells
bear a close resemblance to each other, as though all were derived
from a single cell, are of monoclonal origin.
• Infrequently, divergent differentiation of a single neoplastic clone
along two lineages creates what are called mixed tumors. The best
example of this is the mixed tumor of salivary gland origin. These
tumors contain epithelial components scattered within a myxoid
stroma that sometimes contains islands of cartilage or bone. All these
elements, it is believed, arise from a single clone capable of giving
rise to epithelial and myoepithelial cells; thus, the preferred
designation of these neoplasms is pleomorphic adenoma.
Thismixed tumor of the
parotid gland contains
epithelial cellsforming ducts
and myxoid stromathat
resemblescartilage.
10. Teratoma contains recognizable mature or immature cells or tissues
representative of more than one germ cell layer and sometimes all three.
Teratomas originate from totipotential cells such as those normally present
in the ovary and testis and sometimes abnormally present in sequestered
midline embryonic rests.
Such cells have the capacity to differentiate into any of the cell types found
in the adult body and so, not surprisingly, may give rise to neoplasms that
mimic, in a helter-skelter fashion, bits of bone, epithelium, muscle, fat,
nerve, and other tissues.
When all the component parts are well differentiated, it is a benign (mature)
teratoma; when less well differentiated, it is an immature, potentially or
overtly, malignant teratoma.
A particularly common pattern is seen in the ovarian cystic teratoma
(dermoid cyst), which differentiates principally along ectodermal lines to
create a cystic tumor lined by skin replete with hair, sebaceous glands, and
tooth structures .
11. .
A, Grossappearanceof an opened cystic teratomaof theovary. Notethe
presenceof hair, sebaceousmaterial, and tooth. B, A microscopic view of a
similar tumor showsskin, sebaceousglands, fat cells, and atract of neural
tissue(arro w).
12. .
In general, benign and malignant tumors can be distinguished
on the basis of differentiation and anaplasia, rate of growth,
local invasion, and metastasis.
Differentiation refers to the extent to which neoplastic parenchymal
cells resemble the corresponding normal parenchymal cells, both
morphologically and functionally;
Lack of differentiation is called anaplasia.
In general, benign tumors are well differentiated.
The neoplastic cell in a benign adipocyte tumor—a lipoma—so closely
resembles the normal cell that it may be impossible to recognize it as
a tumor by microscopic examination of individual cells. Only the
growth of these cells into a discrete mass discloses the neoplastic
nature of the lesion.
In well-differentiated benign tumors, mitoses are extremely scant in
number and are of normal configuration.
13. .
Leiomyoma of the uterus. This
benign, well-differentiated tumor
contains interlacing bundles of
neoplastic smooth muscle cells
that are virtually identical in
appearance to normal smooth
muscle cells in the myometrium.
Benign tumor (adenoma) of the
thyroid. Notethenormal-looking
(well-differentiated), colloid-filled
thyroid follicles
14. .
Malignant neoplasms are characterized by a wide range of parenchymal cell
differentiation, from surprisingly well differentiated to completely
undifferentiated.
Certain well-differentiated adenocarcinomas of the thyroid, for example, may
form normal-appearing follicles, and some squamous cell carcinomas contain
cells that do not differ cytologically from normal squamous epithelial cells .
Thus, the morphologic diagnosis of malignancy in well-differentiated tumors
may sometimes be quite difficult.
In between the two extremes lie tumors that are loosely referred to as
moderately well differentiated.
Malignant neoplasms that are composed of poorly differentiated cells are said
to be anaplastic.
Lack of differentiation, or anaplasia, is considered a hallmark of malignancy.
In well-differentiated tumors , daughter cells derived from these “cancer stem
cells” retain the capacity for differentiation, whereas in poorly differentiated
tumors that capacity is lost.
15. .
Malignant tumor (adenocarcinoma) of
the colon. Note that compared with
the well-formed and normal-looking
glands characteristic of a benign
tumor (see Fig. 7-5 ), the cancerous
glands are irregular in shape and size
and do not resemble the normal
colonic glands. This tumor is
considered differentiated because
gland formation can be seen. The
malignant glands have invaded the
muscular layer of the colon.
Well-differentiated squamous cell
carcinoma of the skin. The tumor cells
are strikingly similar to normal
squamous epithelial cells, with
intercellular bridges and nests of
keratin pearls (arrow).