Definitions and Classificationsin Neoplasia

Folder: DefClass

Updated: February 07, 2013

Definitions in Oncology. (Part 1)Neoplasia: (“Plasia = Cells)Abnormal new cell proliferation of altered cells• Heritably Altered• Relative autonomous growth• Can be benign or malignant (See later)

Hyperplasia:• Abnormal proliferation of otherwise normal cells

Tumor:Solid mass, usually cellular (but not necessarily)• Can be neoplastic, non-neoplastic, or even non-cellular• "Tumor" usually means a neoplasm in common usage• Some free cell neoplasms can be non-tumorous

Definitions in Oncology. (part 2)Metaplasia:• Replacement of one type of normal adult

differentiated cell type that is normally present,• by another normal adult differentiated type that

belongs somewhere else. Usually in response to injury or irritation Reversible upon removal of the stimulus

See “Reversible squamous metaplasia”, next slide)

Dysplasia• Abnormal interaction of cells giving abnormal

tissue development• Can be pre-neoplastic

Reversible Squamous Metaplasia

Normal Secretory & Ciliated Epithelial CellsIllustrating functional effect of ciliated vs non-ciliated cells

Figure 16-19, ECB, 1998, p. 528RespCilia

Ciliated Epithelium ofHuman Respiratory Tract

Progressive Steps in Neoplastic Cell Development:Hyperplasia and Dysplasia

Progressive Steps in Neoplastic Cell Development:Cancer In situ and Invasive Cancer

Figure 11.7 The Biology of Cancer (© Garland Science 2007)

Progression in Neoplastic Development: Weinberg, Chapter 11 on Multistep Tumorigenesis. Figure 11.7

CIS = carcinoma in situCIN = cervical intra-epithelial neoplasmDCIS = ductal carcinoma in situPIN = prostatic intra-epithelial neoplasm

We have talked about “Hyperplasia”, “Metaplasia”,

“Neoplasia”. What is the “plasia” part? What is “plasia” referring to? (One word!)

Definitions in Oncology. (part 3)Anaplasia:Irreversible loss of normal cell structure and function• Positional Anaplasia: Size, shape, arrangement, and

overall organization of cells in a tissue are altered• Cytological Anaplasia: Intra-cellular structures

(mitochondria, cytoskeletal elements, nuclear size and morphology) are altered

Cancer:• Mass of cells with potentially unlimited growth,• serves no useful function for the host,• deprives the host of nutrients necessary for survival,• expands locally by invasion and systemically by• lymphatic and hematogenous pathways,• untreated progresses to lethal condition in the host

Benign and Malignant Neoplasia

Benign Neoplasm Generally Encapsulated Non-invasive Highly Differentiated Few Mitotic Figures Slow Growth or No Net Growth Little Anaplasia Non-Metastatic (by definition)

Malignant Neoplasm Non-encapsulated Invasive Poorly Differentatied Mitotic Figures Common Can have rapid growth Relatively Anaplastic Metastatic or Capable of

becoming so

Classifications of Cancers

Sites of Origin for Primary Clinical CancersCollection of 200 Different Clinical Diseases

(See Diversity of Cancers in Folder Title:"Clinical" and Two Graphics Following)

• Different Symptoms• Different Cell Type of Origin• Different Histology• Different Cell Products and Cell Markers• Different Prognoses• Different Therapy

Cancer Incidence 2002: 1,285,000. Cancer Deaths 555,000. 43% Death RateCancer Incidence 2009: 1,479,000. Cancer Deaths 562,000. 38% Death Rate

Why do we get cancers in these tissues and organs with these distributions?

Normal Proliferative Human Cells & TissuesEpithelial Linings• Respiratory epithelium• Gastro-intestinal linings• Genito-urinary tract

Glandular Linings• Mammary gland

SkinOvary and TestisBone MarrowMyoblastsFetal TissuesOrgan HypertrophyWound HealingNeurogenesis

90% of cancers in humans are carcinomas or hematological malignancies (leukemia-lymphoma).

This is largely because normal epithelial cells that can generate carcinomas, and normal hematological stem cells that can generate hematological malignancies are

cells that normally have to _ _ _ _ _ _ in order to carry out their functions in vivo.

Classification by Tissue Typefor Cell Type of Origin

(Histogenetic Classification)Connective Tissue

Hematopoietic Tissue

Nervous tissue

Germinal Tissue & Mixed Tissue Types

Epithelial Tissue

Sarcoma

Leukemia & Lymphoma

Neuroectodermal malignancies

Carcinoma

Classification of Cancer by Histogenetic Site of OriginPart 1: Connective Tissue Neoplasms

Tissue of OriginFibrous tissueCartilegeBoneFatSmooth MuscleSkeletal MuscleBlood Vessels

Benign NeoplasmFibromaChondromaOsteomaLipomaLeiomyomaRhabdomyomaHemangioma

Malignant NeoplasmFibrosarcomaChondrosarcomaOsteogenic SarcomaLiposarcomaLeiomyosarcomaRhabdomyosarcomaHemangiosarcoma

Sarcomas (Sarcomata) are malignant neoplasms of connective tissue origin.About 5% of all cancers in humans

Classification of Cancer by Histogenetic Site of OriginPart 2: Epithelial Neoplasms

Tissue of OriginEpidermisStomachAdrenal cortexSurface Epithelium(Non-glandular)Glandular EpitheliumColonBreastLung

Benign NeoplasmEpidermal papillomaGastric polypAdrenocortical adenomaPapilloma

Adenoma Colon adenoma Mammary adenoma Lung adenoma

Malignant NeoplasmEpidermal carcinomaGastric carcinomaAdrenocortical carcinomaSquamous carcinoma

Adenocarcinoma Colon carcinoma Mammary carcinoma Lung carcinoma

Carcinomas are malignant neoplasms of epithelial origin.About 85% of all cancers in humans!

Table 2.1 The Biology of Cancer (© Garland Science 2007) p. 30

Figure 2.4b Te Biology of Cancer

Figure 2.4c The Biology of Cancer (© Garland Science 2007)

Bronchiole of Lung

Columnar Epithelium (Gall Bladder)

Figure 2.6c The Biology of Cancer (© Garland Science 2007)Figure 2.6a The Biology of Cancer (© Garland Science 2007)

Squamous epitheliumUterine cervix

Skin

Glandular Epithelium (stomach)

Columnar Epithelium, Small Intestine

Goblet Cell(Mucous-secreting)

Figure 2.6d The Biology of Cancer (© Garland Science 2007)

Adenocarcinoma(Stomach)

Adenocarcinoma (Colon)

Glandular Epithelium Stomach

Classification of Cancer by Histogenetic Site of OriginPart 4: Neoplasms of the Nervous System

Tissue of OriginBrain glial cells

MeningesNeuronsAdrenal

medullaRetina

Benign NeoplasmAstrocytomaOligodendrogliomaMeningiomaGanglioneuromaPheochromocytoma---

Malignant NeoplasmGlioblastoma multiforme

Meningeal sarcomaNeuroblastomaPheochromocytoma

Retinoblastoma

Neoplasms of the nervous system are generalized as Neuroectodermal malignancies comparable to carcinoma, sarcoma,

or leukemia groupings.Part of the remaining 5% of all cancers in humans

Table 2.4 The Biology of Cancer (© Garland Science 2007)p. 34

Figure 2.9a The Biology of Cancer (© Garland Science 2007)p. 35

Astrocytes (Glial Cells) Astrocytoma (Glioblastoma),Glioblastoma Multiforme

Neuroectodermal Neoplasm of Non-Neuronal Supporting Cells of Brain

Neuroblastoma in a Little Boy(Viewed in Class in 501Intro)

William Bunn: 8-Year-old Police OfficerJuly, 2010 http://abclocal.go.com/wtvd/story?section=news/local&id=7531763  -  2 minutes and 32 seconds     http://www.msnbc.msn.com/id/26184891/vp/38084943#38084943   1 1/2 minutes - actual funeral Refers to Stem Cell Transplants and Chemotherapy for Neuroblastoma in final 5 seconds of clip

Also viewed story of Kuyler Van Nocker and Neuroblastoma

Classification of Cancer by Histogenetic Site of OriginPart 3: Hematopoietic and immune system neoplasms

Tissue of OriginLymphoid tissueand Lymphocytes

ThymusGranulocytes

Plasma CellsErythrocytes

Benign NeoplasmInfectious mononucleosisand other lymphoproliferative diseases

ThymomaGranulocytosis

---Polycythemia vera

Malignant NeoplasmLymphoma (lymphosarcoma)Lymphocytic leukemia(B and T Cell Leukemias)Reticulum cell sarcomaHodgkin's DiseaseThymomaMyelogenous leukemia(Granulocytic leukemia)Multiple MyelomaErythroleukemia

Leukemias and Lymphomas (Lymphosarcomas) are malignant neoplasms of hematopoietic (blood cell forming) tissue originAbout 5% of all cancers in humans

Table 2.3 The Biology of Cancer (© Garland Science 2007)p. 33

Different Forms of LeukemiasAcute (A) and Chronic (C)

3.4% of all forms of human cancers

Lymphocytic 54% (32% CLL; 22% ALL)Also called "lymphoblastic"

Myelocytic 37% (26% CML; 11% AML)Also called "granulocytic" or "myelocytic"

Monocytic 9% (All acute) Erythroleukemia Rare

Morphology &Staining ofBlood Cells

Kuby, 3rd Ed.Figure 3-1

Hematopoiesis (formation of blood cells)Fig 2-1, Kuby 4th Ed. p. 28

A normal stem cell when it divides to form two cells has to do two things. It has to self-renew. What else does it

have to do to carry out is normal function?

_ _ _ _ _ _ _ _ _ _ _ _ _

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If a stem cell divides but does not self-renew, what will happen to the stem cell compartment for that cell

lineage?

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Pluripotent Stem Celland Lymphoid andMyeloid Lineages

(Fig 2-1, Kuby 4th Ed. p. 28

Myeloid Stem Cell

Lymphoid Lineage

Fig 2-1 Kuby 4th Ed

p. 28

MyeloidLineage(Kuby, Fig 2-1,4th Ed., p. 28)

Figure 8.32 The Biology of Cancer (© Garland Science 2007)

Disease Progression in Chronic Myelogenous Leukemia

p. 293

AgeEffct

Diagnostic Pathobiology of Hodgkins Diseasevs

Non-Hodgkins Lymphoma

http://www.med-ed.virginia.edu/courses/path/innes/wcd/hodgkin.cfm(Right Click. Click on Open Hyperlink)

University of Virginia, School of Medicine;Pathology Trends

Derived from Lymphocyte, usually a B cell,Characterized by being binuclear.Presents “owl-like” appearance

Incidence

Early onset; 2nd age-related risk later in life

A neoplasm (or cancer) that is localized and encapsulated is defined as being

_ _ _ _ _ _

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A neoplasm (or cancer) that is invasive and metastatic is defined as being

_ _ _ _ _ _ _ _ _

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First-hand experiences with cancer incidence(This question is anonymous. You can respond with more than one number)

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1. I myself have been treated for a cancer.

2. One (or more) of my parents or step parents has been or is a cancer patient.

3. One (or more) of my grandparents has been or is a cancer patient.

4. One (or more) of my brothers or sisters (or a step-brother or sister) has been or is a cancer patient.

5. I have a child or a niece or nephew who is or has been a cancer patient.

6. At least one of my close friends has been or is a cancer patient.

7. I have not experienced cancer first-hand.

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First-hand experiences with cancer Mortality(This question is anonymous. You can respond with more than one number)

1. One of my parents or step parents has died from cancer.

2. One (or more) of my grandparents has died from cancer.

3. One or more of my grandparents has passed away but not from Cancer.

4. One of my brothers or sisters (or a step-brother or sister) has died from cancer.

5. I have lost a child or a niece or nephew to cancer.

6. I have lost a close friend to cancer.

7. No one close to me has died of cancer.

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http://abcnews.go.com/Health/BreastCancerCenter/early-stage-breast-cancer-care/story?id=12870356

http://abcnews.go.com/Health/BreastCancerCenter/early-stage-breast-cancer-care/story?id=12870356

Surgical Excision of Regional Lymph Nodes in Breast Cancer(ABC News: February 8, 2011

(Copy & paste to Mozilla Firefox)

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PBS Series: secondopinion-tv.org

CML and Patient #9 in Gleevec Trial 1995Highlight. Right Click. Open Hyperlink

See episode 607

A carcinoma is a neoplasm (cancer) that arises from ___ ___ ___ ___ ___ ___ ___ ___ ___ ___

tissue.

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