neoplasia handout.docx

7/24/2019 neoplasia handout.docx

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NEOPLASIAAbnormal mass of tissue the growth ofwhich exceeds and is uncoordinated withthat of normal tissue and persists in thesame excessive manner after cessation ofstimuli which evoked the change].

NEO!A"# $ New %rowth&'((E)EN*A*'ON + normal parench,mal

ANA!A"'A + without di-erentiation#E*A!A"'A $ replaement&"!A"'A $ disordered growth#E*A"*A"'" $ spread of malignant tumor

ETIOLOGY

/irus factors

Overexposed cells

Environmental factors

'mmune actors

(ood factors %enetic factors

PATHOPHYSIOLOGY0 fundamental ph,siological changes1"A!'"E&2

$ "elf su3cienc, in growth signals$ Abilit, to invade and metastasi4e$ !imitless replicative potential$ 'nsensitivit, to growth$inhibitor,

signals$ "ustained angiogenesis

$ Evasion of AO*O"'"$ &efects in &NA repair

56$ *umor suppressor genes

(lowchart of pathoph,siolog, of 7A

SIGNS & SYMPTOMS OF CANCER(CAUTION)

8. 7hange in bowel or bladder habits9. A sore that doesn:t heal6. ;nusual bleeding or discharge


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Characteristic o !e"i#" a"$ %ai#"a"tt'%orsCHARACTERI

STICS

ENIGN MALIGNAN

Tcas'atio" cas'ate$ '"cas'at

e$DIFFERENTIA

TION*

ANAPLASIA

ell di-erentiated

"tructure sometimes

t,pical of tissue of

origin

$ "ome lack

di-erentiati

on with

anaplasia$

"tructure

often

at,picalRATE OF GRO

+TH

;suall, progressive an

d "!O

$#a, come to a

standstill or regress

$#itotic Bgures )A)E

and normal

Erratic and

ma, be slow

to rapid

#itotic

Bgures ma,

be

numerousand

abnormalLOCAL IN,AS

ION

;suall, 7OCE"'/E

expansile E!!$

&E#A)7A*E& masses

that do not invade or

inBltrate surrounding

normal tissues

!ocall,

invasive=

inBltrating

surrounding

tissue$

"ometimes

ma, be

seemingl,

cohesive

and

expansileMETASTASIS A?"EN* (reDuentl,

present$ *he

larger and

more

undi-erenti

ated

theprimar,=

the more

likel, are

metastases

*umor@ is a pathologic disturbance ofgrowth= characteri4ed b, excessiveand unnecessar, proliferation of cell.

9 *,pes of *umoro ?enigno #alignant

?enign tumors aren:t cancerous. *he, canoften be removed= and= in most cases= the,

do not come back. 7ells in benign tumoursdo not spread to other parts of the bod,.

#alignant tumors are cancerous and aremade up of cells that grow out of control.

o "ometimes cells move awa, from theoriginal 1primar,2 cancer site andspread to other organs and boneswhere the, can continue to grow and

form another tumour at that site. *hisis known as metastasis or secondarycancer.

o #etastases keep the name of theoriginal cancer location. e.g.pancreatic cancer that has spread tothe liver is still called pancreaticcancer.

NOMENCLATURE

e"i#" t'%ors

(or *umors of #esench,mal origin@ root word oma

(or *umors of epithelial origin $ cell oforigin= microscopic pattern= ormacroscopic architecture

7E!! O( O)'%'NAdenoma F derived from glands?enign tumors

#'7)O"7O'7 A**E)Napilloma F producing microscopall, 1ormacro2 visible Bnger$like proGection?enign tumors

#A7)O"7O'7 A)7C'*E7*;)E7,stadenomas F form large c,stic masses

Mai#"a"t t'%ors

(or *umors of #esench,mal origin

root word sarcomaExample@

OsteosarcomaEwing:s sarcoma)habdom,osarcoma

Osteosarco%a

Most co%%o" i"-(.)Lo/er e"$ o e%'r(0)Uer e"$ o ti!ia

usuall, a-ects the large bones of thearm or leg.


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occurs most commonl, in ,oungpeople and a-ects more males thanfemales.

Rha!$o%1osarco%a (RMS)

cancer made up of cells that normall,develop into skeletal muscles.

it is much more common in children=although it does sometimes occur inadults.

192 #ain *,pes of rhabdom,osarcoma@8. Embr,onal rhabdom,osarcoma9. Alveolar rhabdom,osarcoma

E/i"#2s sarco%a

rimar, bone cancer

most commonl, occurs in the longbones= ribs= pelvis and spine 1vertebralcolumn2

rimitive neuroectodermal tumor.

Askin tumor 1chest wall2. Extraosseous Ewing sarcoma 1tumor

growing in tissue other than bone2. Ra$ioo#ic 3"$i"#s- ONION S4IN

Mai#"a"t t'%ors

(or *umors of Epithelial origin

root word carcinomaExample@

?77

"77

#elanoma

CC

are abnormal= uncontrolled growths orlesions that arise in the skin:s basalcells= which line the deepest la,er ofthe epidermis.

"CC is an uncontrolled growth of abnormal

cells arising in the sDuamous cells=which compose most of the skin:s

upper la,ers 1the epidermis2.

MELANOMA

most dangerous form of skin cancerand have a high probabilit, ofmetastasi4ing and become lethal.

oo$*L1%h reate$

!eukemia

!,mphoma

Le'5e%ia

Abnormal proliferation and maturationof l,mphoc,tes and nonl,mphoc,ticcells H suppression of N cells

",mptoms@pain in the bones or Goints=

swollen l,mph nodes that usuall, donIt hurt=fevers or night sweats=feeling weak or tired=bleeding and bruising easil,=freDuent infections=discomfort or swelling in the abdomen=weight loss or loss of appetite

L1%ho%a

7ancer on the l,mphatic s,stem

't is often ver, treatable= and most

people live for a long time after beingdiagnosed. !,mphoma

.6 NON7HODG4IN8s

#ost common

?$cells and *$cells

skipping some nodes

7N" involvement

Average age 0J

Co"#e"ita e9cessi:e e9os're tora$iatio"

06 HODG4IN8s

#uch less common

)eed$"ternberg cells

in order

#ore locali4ed in cervical andsupraclavicular

?imodal incedence

)ed$"ternberg cells

7ause@ Epstein$?arr /irus

E;ects o" host

E-ects often are related to loss offunction= loss of nervous control= painand discomfort.

E-ects *umor impingement on nearb,

structures ;lcerationK bleeding 'nfection 1often due to obstruction2


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)upture or infraction

Ca"cer Cache9ia

rogressive weakness= loss ofappetite= anemia and profound weightloss.

C'shi" S1"$ro%e

7aused b, CORTISOL

A-ects adrenal cortex

Ma"iestatio"s-(.)Moo" ace(0)';ao h'% < on nape(=)Pe"$''% a!$o%e"(>)Si"$e1 ar% (striate$ ar%)

Para"eoastic s1"$ro%es

Endocrinopathies

Neurom,pathies

Osteochondral disorders

/ascular phenomena (ever

Nephrotic s,ndrome

E"$ocri"oathies

7ushing:s s,ndrome

adrenal carcinoma 1cortisol2

'nappropriate A&C s,ndrome1h,ponatremia2H1o"atre%ia

A"ti$i'retic hor%o"e

S1"$ro%e o I"aroriateA"ti$i'retic Hor%o"e(SIADH)

h,pothalamic tumors 1vasopressin2

small cell undi-erentiated lung cancer1vassopressin2 like hormone.

C,percalcemia

C,pogl,cemia$ caused b, tumor overproduction of insulin or insulin likeactivities

7arcinoid s,ndrome$ caused b,

serotonin= histamine produced b, thetumor. ol,c,themia$ caused b, tumor

production of er,thropoietins. &CA s,ndrome

Ne'ro%1oatheies

#,asthenia$ caused b, hostantibodies against the tumor cells that

cross react with neuronal cells orperhaps caused b, toxins.

7arcinomatous m,opath,$ immunemediated.

Osteocho"$ra Disor$ers

C,pertrophic osteoarthrop,$ clubbingperiosteal new bone= and arthritis.

araneoplastic s,ndromesvascular phenomena

Altered coagulabilit, + caused b,release of tumor products.

Fe:er

Associated with bacterial infectionscommon where blockage of drainageoccurs.

decreased immunit,.

Nehrotic s1"$ro%e Excessive loss of protein in the urine

$ 7aused b, damage to renalglomeruli b, tumor antigen$antibod, complexes.

Gra$i"# a"$ Sta#i"# o T'%or

Gra$i"#

&egree of maturit, or di-erentiation oftumor cells and other neoplasms1cancer2

Histoo#ic Gra$i"#

)esemblance between tumor andnormal cells

Ho/ is t'%or #ra$e $eter%i"e$?

T1e

?enign

#alignant

T'%or Gra$e %8 $ell &i-erentiated 1!ow %rade2

%9 $#oderatel, &i-erentiated1'ntermediate %rade2

%6$oorl, &i-erentiated 1Cigh %rade2

%


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Extentent of the primar, tumor andextent of spread in the bod, 1regionall,mph node2

?ase on the si4e and number ofprimar, lesion

resence or Absence of #etastases.

T'%or Sta#e

"tage 8 @ Earliest stage 1mostcurable2L

"tage 9 @ "pread to surrounding tissue=and nearb, l,mph node

"tage 6 @ "pread to a distant l,mphnode

"tage < @ "pread to a distant organ ofthe bod,

TNM Sta#i"# S1ste%

Pri%ar1 T'%or (T)

*J $used to indicate in situ lesion *8$*


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"upporative surger, + support forother 7A *x

&iagnostic surger,$ ?iops,

alliative surger, + used to relievepain onl,

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neoplasia handout.docx