Kris%neKra*s,M.D.NeoplasiaI:TumorNomenclature

•  Tounderstandpa%entsbe=er•  Tounderstandoralneoplasmsbe=er

•  Tonailtheneoplasiaques%onsonboards•  Thislecturecovers:

•  thenatureofbenignandmalignantneoplasms•  howneoplasmsstartandgrow

•  Laterlectureswillcover:•  thenatureofspecificneoplasms•  howtheseneoplasmsaffectthepa%ent

Whydoweneedalectureaboutneoplasia?

NeoplasiaOutline

•  Tumornomenclature

•  Tumorcharacteris%cs

•  Epidemiology

•  Cancerpathogenesis

NeoplasiaOutline

•  Tumornomenclature• Defini%ons•  Benigntumors• Malignanttumors• Mixedtumors•  Confusingterms

NeoplasiaOutline

•  Tumornomenclature• Defini%ons

Defini%ons

•  Neoplasm=massof%ssuethatgrowsexcessively,andkeepsgrowingevenifyouremovethes%mulusthatstarteditoff!

•  Tumor=neoplasm

•  Benigntumor=innocent-ac%ngtumor

•  Malignanttumor=evil-ac%ngtumor

Cancer=La%nfor“crab”

Defini%ons

•  Small

•  Slow-growing

•  Non-invasive•  Well-differen%ated

•  Staylocalized

•  Large•  Fast-growing

•  Invasive•  Poorly-differen%ated•  Metastasize

BenignTumors MalignantTumors

Defini%ons

•  Small

•  Slow-growing

•  Non-invasive•  Well-differen%ated

•  Staylocalized

•  Large•  Fast-growing

•  Invasive•  Poorly-differen%ated•  Metastasize

BenignTumors MalignantTumors

Defini%ons

Theonlyindisputablequalityofmalignancyis

BenigntumorsCANNOTmetastasize;malignanttumorsCAN.

metastasis!

Ifitismetasta%c,itMUSTBEmalignant.

Benignvs.Malignant

NeoplasiaOutline

•  Tumornomenclature• Defini%ons•  Benigntumors

Dr.Rosenpenis

Dr.Rosenpenis

“Hehasmelanoma…carcinoma…somekind

ofnoma.”

BenignTumors

Usuallydesignatedbyadding“-oma”tocelltype•  adenoma:benigntumorofglandularcells•  leiomyoma:benigntumorofsmoothmusclecells•  chondroma:benigntumorofchondrocytes

Otherbenigntumornames•  papilloma:hasfinger-likeprojec%ons•  polyp:projectsupward,formingalump•  cystadenoma:hashollowspaces(cysts)inside

Thyroidadenoma

Thyroidadenoma

Thyroidadenoma Normalthyroid

Leiomyoma

Chondroma

Oralpapilloma

Oralpapilloma

Colonpolyp

Stalk

Head

Colonpolyp

Colonpolyp

Ovariancystadenoma

Ovariancystadenoma

Ovariancystadenoma

NeoplasiaOutline

•  Tumornomenclature• Defini%ons•  Benigntumors• Malignanttumors

MalignantTumors

Carcinomasariseinepithelial%ssue•  adenocarcinoma:malignanttumorofglandularcells•  squamouscellcarcinoma:malignanttumorofsquamouscells

Sarcomasariseinmesenchymal%ssue•  chondrosarcoma:malignanttumorofchondrocytes•  angiosarcoma:malignanttumorofbloodvessels•  rhabdomyosarcoma:malignanttumorofskeletalmusclecells

Adenocarcinoma

Squamouscellcarcinoma

Chondrosarcoma

Angiosarcoma

Rhabdmyosarcoma

NeoplasiaOutline

•  Tumornomenclature• Defini%ons•  Benigntumors• Malignanttumors• Mixedtumors

MixedTumors

•  “Mixed”tumorsshowdivergentdifferen%a%on

•  Examples•  pleomorphicadenoma–glands+fibromyxoidstroma•  fibroadenoma–glands+fibrous%ssue

•  Nottobeconfusedwithteratomas

Pleomorphicadenoma

NeoplasiaOutline

•  Tumornomenclature• Defini%ons•  Benigntumors• Malignanttumors• Mixedtumors•  Confusingterms

ConfusingTermsMalignanttumorsthatsoundbenign

•  lymphoma•  mesothelioma•  melanoma•  seminoma

Non-tumorsthatsoundliketumors•  hamartoma:massofdisorganizedindigenous%ssue•  choristoma:heterotopicrestofcells

Namesthatseemtocomeoutofnowhere•  nevus•  leukemia•  hyda%diformmole

Neoplasm

Benign Malignant

Carcinoma Sarcoma

Nomenclature

Neoplasm

Benign Malignant

Carcinoma Sarcoma

adenomaangioma

rhabdomyoma

Nomenclature

Neoplasm

Benign Malignant

Carcinoma Sarcoma

squamouscellcarcinomaadenocarcinoma

Nomenclature

Neoplasm

Benign Malignant

Carcinoma Sarcoma

angiosarcomarhabdomyosarcoma

Nomenclature

Tissueoforigin Benign Malignant

Fibrous%ssue Fibroma Fibrosarcoma

Fat Lipoma Liposarcoma

Car%lage Chondroma Chondrosarcoma

Bone Osteoma Osteogenicsarcoma

Bloodvessels Hemangioma Angiosarcoma

Mesothelium Mesothelioma

Hematopoie%ccells Leukemia

Lymphoidcells Lymphoma

Squamousepithelium Squamouscellpapilloma Squamouscellcarcinoma

Glandularepithelium Adenoma Adenocarcinoma

Papilloma Papillaryadenocarcinoma

Cystadenoma Cystadenocarcinoma

Smoothmuscle Leiomyoma Leiomyosarcoma

Skeletalmuscle Rhabdomyoma Rhabdomyosarcoma

Melanocytes Nevus Melanoma

Knowthesenames!

Sampleboardques%on

Whichofthefollowingdescribesabenigntumorarisingfromskeletalmuscle?

A.Leiomyoma

B.Papilloma

C.Rhabdomyoma

D.Leiomyosarcoma

E.Rhabdomyosarcoma