neoplasia advance
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(Neoplasia)
.. , .., .. ()
Non-neoplastic proliferation
Versus
Neoplastic proliferaton.
Cellular Proliferation and Growth ( )
Enlargement of Tissue and Organ
Non-neoplastic proliferation Neoplastic proliferation
Non-neoplastic proliferation
Cellular adaptation
(Stimulus)
(Stimulus)
Pathological process Physiological change
Hormonal change
Exercise
Non-neoplastic proliferation Cellular Adaptation
Hypertrophy.
Hyperplasia.
Metaplasia.
Hamartomas and Choristomas
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Hamartomas
(Developmental abnormality) (Neoplasia)
Chondroid hamartoma of Lung
Picture pathhsw5m54.ucsf.edu
Chondroid hamartoma of Lung
Picture pathhsw5m54.ucsf.edu
Choristomas
(Developmental abnormality)
Preneoplastic process
Dysplasia
Adaptation
Neoplasia
Dysplasia
(Cytological feature of malignancy) Premalignancy
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Mild cervical dysplasia with HPV infection
Severe cervical dysplasia with HPV infection
Neoplastic proliferation
Tumor, Cancer and Neoplasm.
Benign neoplasm.
Malignant neoplasm.
Neoplastic Proliferation
Tumor, Cancer and Neoplasm Tumor
(Tissue Swelling)
Neoplasia
Tumor, Cancer and Neoplasm Cancer
Cancer Crab
Benign NeoplasmTumor (Well differentiation)
Benign tumor Salivary gland
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Malignant NeoplasmTumor Cancer Invasion
Lung carcinoma
Benign neoplasm versus
Malignant neoplasm
(Characteristic of Benign and Malignant neoplasms)
Differentiation
Anaplasia
Rate of growth
Local invasion
Metastasis
Differentiation Differentiation
(Function)
Well differentiation -
Poorly differentiation -
Moderately differentiation - 2
Well differentiated neoplasm
Leiomyoma
Adenoma
(Benign neoplasm)
Leiomyomas
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(Malignant neoplasm)
Well differentiation Poorly differentiation Lack of differentiation, Anaplasia
Anaplasia Lack of differentiation Anaplasia
Pleomorphism DNA
Nuclear hyperchromatism
Cytoplasm (Nuclear-to-Cytoplasmic ratio) 1:1 1:4 1:6
Malignant melanoma
Mitoses (Higher proliferative activity) Mitoses Mitoses Mitoses ( Atypical, bizarre mitotic figures) tripolar, quadripolar,
Abnormal mitosis
( Rate of Growth )
Poor differentiation
Leiomyoma
( Inadequate blood supply )
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( Local Invasion )
( Local Invasion )
Benign tumors Fibrous capsules Connective tissue Benign tumors Fibrous capsules Hemangioma
Leiomyomas
Hemangioma
Cancers Cancers Crabs Cancers Fibrous capsules Cancers ( Vascular invasion ) ( Neural invasion )
Breast carcinoma (Invasive ductal carcinoma)
Metastasis Cancers
3 Body cavities
( Ovary ) Peritoneal cavity Pseudomyxoma peritonei.
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( Lymphatic Spread ) Cancers Upper Outer quadrant Inner quadrant Internal mammary arteries
Lymphatic Spread
( Hematologic Spread ) Mesenchymal cells Sarcomas Glandular epithelium Carcinomas Pulmonary arteriovenous shunts Tumor emboli
; ( Benign Tumors ) ( Malignant Tumors or Cancer )
( Cell or Tissue of Origin)
Benign Tumors
oma Mesenchym ( Epithelium )
Mesenchyme
Fibroma ( Fibroblastic
cells or tissue )
Lipoma ( Fatty or Adipose cells or tissue)
Leiomyoma ( Smooth muscle )
Rhabdomyoma ( Striated muscle )
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Mesenchyme
Chondroma
( Chondroblasts or Cartilage )
Osteoma ( Osteoblasts or Bone )
Hemangioma or Angioma (Blood vessels)
Lymphangioma (Lymphatic vessels)
( Epithelium )
Adenoma ( Gland or Tubule )
( Epithelium )
Papilloma (Finger-like or warty projections from epithelial surfaces)
Cystadenoma (Cystic mass) Mucinous cystadenoma Papillary cystadenoma Mucinous cystadenoma
Malignant Tumors or Cancer
Mesenchym sarcoma
( Epithelium ) carcinoma
Mesenchym
Fibrosarcoma ( Fibroblastic cells or tissue )
Liposarcoma ( Fatty or Adipose cells or tissue)
Leiomyosarcoma ( Smooth muscle )
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Mesenchym
Rhabdomyosarcoma ( Striated muscle )
Chondrosarcoma ( Chondroblasts or Cartilage )
Osteosarcoma ( Osteoblasts or Bone )
Angiosarcoma (Blood vessels)
( Epithelium )
Ectoderm Squamous cell carcinoma Squamous epithelium Squamous cell.
Mesoderm Renal cell carcinoma Renal tubule
Endoderm Adenocarcinoma
Adenocarcinoma
1 1 1 2
Mixed tumor Pleomorphic adenoma
2 Myxoid stroma Epithelial sheets glands Myoepithelial cells
Teratoma Totopotential cells or Germ
cells Ectoderm, Mesoderm and Endoderm Ectoderm, Mesoderm and Endoderm Dermoid cyst
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Mature cystic teratomaor
Dermoid cyst
Melanoma Melanocytes Carcinoma of melanocytes Melanocarcinoma
Seminoma Germ cell
Lymphoma Lymphocyte
Melanoma
Melanocytes
(Cancer incidence)
2
(National incidence)
(Mortality rate)
6
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(Geographic and Environmental Factors)
(Age)
(Hereditary)
(Preneoplastic lesions)
(Geographic and Environmental Factors)
6 7
Melanoma 6
(Geographic and Environmental Factors)
(Age)
55 (Leukemia)
Osteosarcoma 2 10-20 60
(Hereditary)
3 Inherited Cancer Syndromes
Familial Cancers
Autosomal Recessive Syndromes of Defective DNA Repair.
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Inherited Cancer Syndromes
Autosomal dominant pattern 40% Retinoblastoma
10,000
Familial adenomatous polyposis (FAP) 100% 50
Familial Cancers
(Multifactors) BRCA 1 BRCA 2
Autosomal Recessive Syndromes of Defective DNA Repair
Autosomal recessive DNA (DNA repair) Xeroderma pigmentosum
(Preneoplastic lesions)
(Cancerous transformation)
(Regeneration)
(Hyperplastic proliferation) (Dysplastic proliferation)
Endometrial hyperplasia Endometrial carcinoma
Cervical dysplasia Cervical carcinoma
Squamous metaplasia and dysplasia Bronchogenic carcinoma
Molecular basis of cancer Oncogenes
Protooncogenes
OncogenesProtooncogenes
:
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3 Chemical carcinogens Radiant energy Oncogenic microbes
Viral carcinogenesis
(Chemical Carcinogens)
(The initiation-promotion sequence)
( Initiation) Promotion
(Promotion) Promoter
Initiation Promotion
Initiator 2 Direct-acting
compound
Indirect-acting compound (Procarcinogen)
(Detoxification)
(Early menarche) (Late menopause) (A later age of first pregnancy)
Polycyclic aromatic hydrocarbons benzopyrene 3-methylcholanthrene dibenzanthracene
Aflatoxin Aflatoxin B1 Aspergillus flavus
Aromatic Amines Azo Dyes
Nitrosamines
Asbestos Bronchogenic carcinoma, Mesothelioma Vinyl chloride Angiosarcoma Arsenic
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( Radiant energy) (Ultraviolet Radiation)
Basal cell carcinoma, Squamous cell carcinoma Melanoma Melanoma
(Ionizing radiation) Leukemia
(Oncogenic microbes)
Viral carcinogenesis Helicobacter pylori Lymphoma DNA DNA virus RNA RNA virus
DNA virus
Human papilloma virus (HPV) 70 HPV type 1, 2, 4 7 Squamous papilloma Wart HPV type 16, 18, 31, 33, 35 51 Squamous cell carcinoma HPV type 6 11 Squamous dysplasia
DNA virus
Epstein-Barr virus (EBV) B Infectious mononucleosis Burkitt lymphoma B ( ) Nasopharynx Squamous cell carcinoma
Hepatitis B virus (HBV) Hepatocellular carcinoma
RNA virus
Human T-Cell Leukemia Viruses I (HTLV I) T T T cell leukemia lymphoma
CLINICAL FEATURES OF TUMORS
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Effects of Tumor on Host
Pituitary adenoma
Intussusception
Beta-cell adenoma Beta ()
Melena Hematemesis
(Hematuria)
Hepatic capsule
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CANCER CACHEXIA
Cytokines
PARANEOPLASTIC SYNDROMES
( ) 10%
Paraneoplastic syndromes (Ectopic hormone production)
Cushing syndrome Adrenocorticotropic hormone (ACTH) ACTH 50% Cushing syndrome Small cell carcinoma
(Hypercalcemia) Calcium humeral substances Parathyroid hormone-related protein Multiple myeloma Paraneoplastic syndrome Paraneoplastic syndromes Squamous cell carcinoma
Neuromyopathic paraneoplastic syndromes A myasthenic syndrome Myasthenia gravis
Acanthosis nigricans - (Gray-black patches of verrucous hyperkeratosis)
Hypertrophic osteoarthropathy Distal ends of long bones, Metatarsals, Metacarpals Proximal phalanges Periosteum Clubbing of Fingers
Migratory thrombophlebitis (Trousseau syndrome) Thrombi
Disseminated intravascular coagulation Acute promyelocytic leukemia
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Grading and Staging of TumorsGrade Stage
Grading
Differentiation Mitoses 4 Grade Grade Differentiation (Function) Well differentiation Mitoses Grade I Mitoses Grade IV Grading Staging
Staging
3 (T)
(N)
(M)
The Union International Centre Cancer (UICC) 3
4 5 (T0-T3 or 4) T0
3-4 (N0-N2 or 3) N0
3 (M0-M2) M0
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Laboratory Diagnosis of Cancer
Histologic and Cytologic Methods
Molecular Diagnosis
Flow Cytometry DNA
Tumor Markers.
Tumor Markers.
Tumor markers cell surface antigens cytoplasmic proteins enzymes hormones.
hormones Human chorionic gonadotropin Trophoblastic tumors
nonseminomatous testicular tumors
Calcitonin Medullary carcinoma of thyroid
Catecholamine and metabolites Pheochromocytoma
cell surface antigens
alpha-fetoprotein Liver cell cancer nonseminomatous germ cell tumors of testis
Carcinoembryonic antigen Carcinomas of the colon, pancreas, lung, stomach, and breast
cytoplasmic proteins
Immunoglobulins Multiple myeloma
Prostate-specific antigen Prostate cancer CA-125 Ovarian cancer
CA-19-9 Colon cancer, pancreatic cancer
CA-15-3 Breast cancer
enzymes
Prostatic acid phosphatase Prostate cancer
Neuron-specific enolase Small cell cancer of lung Neuroblastoma
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