细胞增殖、凋亡异常与疾病 Abnormal Cell Proliferation,Differentiation Apoptosis and Related of Disease
NEOPLASIA Def.: persistent abnormal relatively autonomous proliferation of cells.
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Transcript of NEOPLASIA Def.: persistent abnormal relatively autonomous proliferation of cells.
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NEOPLASIA
Def.: persistent abnormal relatively autonomous
proliferation of cells
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NEOPLASIA – classification
BEHAVIORAL
benign borderline malignant
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NEOPLASIA – growth
benign expansive
borderline - locally destructive
malignant infiltrative
METASTASES
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Metastases
Def.: development of secondary neoplastic foci in the distant places
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Metastases - pathways
seeding (body cavities) lymphatic spread hematogenous spread
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General Oncology - 3
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
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NEOPLASIA – classification
HISTOGENETIC (cell of origin) mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma
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General Oncology - 3
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
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Methods of Tumour Diagnostics
Clinical symptoms – history imaging techniques (X-ray, CT, endoscopy,
PET…. laboratory tests morphology - pathology
– cytology & histology & autopsy
Symptomles precanceroses / tumours – screening – e.g. Hemocult, Pap-test– histology incl. special staining methods – immunohistochemistry, electron microscopy– genetic analysis
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Malignant Tumour
TYPING ICD-OGRADING G1 G2 G3STAGING pT pN pM
Tumour -Noduli-Metastases
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General Oncology - 2
Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification
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Typing Grading Staging
represent
the Most Important Prognostic
Factors
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Malignant Tumour
TYPING ICD-OGRADING G1 G2 G3STAGING pT pN pM
Tumour -Noduli-Metastases
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Additional Prognostic Factors
proliferation markers (MIB 1…) cell cycle regulators (p53, bcl 2…) hormone receptors ER, PR growth factors receptors EGFR
---------------- angiogenesis others………
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NEOPLASIA – classification
HISTOGENETIC (cell of origin) mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma
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NEOPLASIA – architecture
solidglandularpapillary
cystopapillary
dissociated
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NEOPLASIA – cytology
Benign similar to nonneoplastic
Malignant cellular pleomorphismNUCLEAR FEATURES:
hyperchromasia (polyploidy, aneuploidy)
rough chromatine structureirregular nuclear outlinelarge and/or multiple nucleoli
or undifferentiated monotonous cellularity
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NEOPLASIA – Nosology-Typing definition & ICD-O code prevalance age/sex predisposition (if any) typical locations clinical symptoms gross level view histopathology / cytopathology
(incl. special diagnostic tools) ultrastructure (esp. if useful for the diagnosis) possible complications, prognosis
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Mesenchymal neoplasms
Terminology
Named after the cell of origin (Greek or
Latin) benign - suffix -oma malignant – suffix -sarcoma
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Mesenchymal neoplasmsBenign fibroma lipoma leiomyoma rhabdomyoma hemangioma lymphangioma chondroma chordoma osteoma lymphoma
Malignant fibrosarcoma liposarcoma
leiomyosarcoma rhabdomyosarcoma
hemangiosarcoma lymphangiosarcoma
chondrosarcoma invasive chordoma
osteosarcoma lymphosarcoma
Borderline
-fibromatoses-
-lipoblastoma-
-hemangio
endotelioma-
- chondro
blastoma-
osteoblastoma
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Fibromabenign tumour derived from fibroblasts rare age/sex predisposition no typical locations ovary, oral cavity solid white mass gross level: circumscribed, soft-firm,
whittish fibroblast like fusiform cells (vimentin) pressure, dif. dg
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Fibromatosis superficial – palms, soles of feet (Dupuytren),
m. Peyronie – induratio penis plasticanon-neoplastic tumour like lesion
deep: borderline between tumour like lesions and fibrosarcoma – local recidives common
rare age/sex predisposition F, middle age gross level: strictures/large infiltrative masses fibroblast like fusiform cells
(vimentin) mass
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Fibrosarcoma derived from fibroblasts age/sex predisposition M soft tissue clinical symptoms: mass gross level view: fish flesh look fusiform cells, mitoses
(vimentin+) hematogenous spread
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Myofibroblastic tumours
benign myofibroblastic tumour myofibroblastic sarcoma solitary fibrous tumour (CD34+)
– hemangiopericytoma
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Dermatofibroma cutaneous fibrous histiocytoma storiform architecture (myofibroblasts)
Dermatofibrosarcoma protuberans
borderline – ulceration & recurrences increased cellularity & atypiae
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Fibrous Histiocytoma
benign (pigmented villonodullar synovitis)
Malignant Fibrous Histiocytoma – mostly local malignancy blood & lymph. spread possible
increasing cellularity & atypiae