NEOPLASIA Def.: persistent abnormal relatively autonomous proliferation of cells

NEOPLASIA – classification BEHAVIORAL benign borderline malignant

NEOPLASIA – growth benign expansive borderline - locally destructive malignant infiltrative METASTASES

Metastases Def.: development of secondary neoplastic foci in the distant places

Metastases - pathways seeding (body cavities) lymphatic spread hematogenous spread

General Oncology - 3 Precanceroses (& pseudotumours) Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

NEOPLASIA – classification HISTOGENETIC (cell of origin) mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma

General Oncology - 3 Precanceroses (& pseudotumours) Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

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

Tumour -Noduli-Metastases Malignant Tumour TYPING ICD-O GRADING G1 G2 G3 STAGING pT pN pM Tumour -Noduli-Metastases

General Oncology - 2 Precanceroses (& pseudotumours) Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

Typing Grading Staging represent the Most Important Prognostic Factors

Tumour -Noduli-Metastases Malignant Tumour TYPING ICD-O GRADING G1 G2 G3 STAGING pT pN pM Tumour -Noduli-Metastases

Additional Prognostic Factors proliferation markers (MIB 1…) cell cycle regulators (p53, bcl 2…) hormone receptors ER, PR growth factors receptors EGFR ---------------- angiogenesis others……… 1. Introduction The c-erbB-2 gene (HER-2/neu) is a member of the class of oncogene associated with tyrosine protein kinase [1 and 2]. The protein encoded by c-erbB-2 is a 185-kDa transmembrane receptor (p185); it is also a glycoprotein having intracellular, transmembrane and extracellular domains [3 and 4]. The tyrosine kinase activity of the protein is associated with the intracellular or cytosolic domain of the receptor, whereas the extracellular domain is responsible to react with extracellular growth factors. The c-erbB-2 protein shows structural and functional homology with the epidermal growth factor receptor (EGFR). The cytosolic tyrosine kinase domains of these two receptors are almost identical. They differ at the ectodomain of the molecule, therefore, a monoclonal antibody reacting with the extracellular domain of c-erbB-2 oncoprotein would not cross-react with the EGFR. This transmembrane receptor is presumably involved in the regulation of cell growth and cell transformation through signal transduction pathway.

NEOPLASIA – classification HISTOGENETIC (cell of origin) mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma

NEOPLASIA – architecture solid glandular papillary cystopapillary dissociated

Benign similar to nonneoplastic Malignant cellular pleomorphism NEOPLASIA – cytology Benign similar to nonneoplastic Malignant cellular pleomorphism NUCLEAR FEATURES: hyperchromasia (polyploidy, aneuploidy) rough chromatine structure irregular nuclear outline large and/or multiple nucleoli or undifferentiated monotonous cellularity

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 prevalAnce= výskyt, prevalence = převaha

Mesenchymal neoplasms Terminology Named after the cell of origin (Greek or Latin) benign - suffix -oma malignant – suffix -sarcoma

Mesenchymal neoplasms Benign fibroma lipoma leiomyoma rhabdomyoma hemangioma lymphangioma chondroma chordoma osteoma lymphoma Borderline -fibromatoses- -lipoblastoma- -hemangio endotelioma- - chondro blastoma- osteoblastoma Malignant fibrosarcoma liposarcoma leiomyosarcoma rhabdomyosarcoma hemangiosarcoma lymphangiosarcoma chondrosarcoma invasive chordoma osteosarcoma lymphosarcoma

Fibroma benign 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

Fibromatosis superficial – palms, soles of feet (Dupuytren), m. Peyronie – induratio penis plastica non-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

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

Myofibroblastic tumours benign myofibroblastic tumour myofibroblastic sarcoma solitary fibrous tumour (CD34+) hemangiopericytoma

Dermatofibrosarcoma protuberans Dermatofibroma cutaneous fibrous histiocytoma storiform architecture (myofibroblasts) Dermatofibrosarcoma protuberans borderline – ulceration & recurrences increased cellularity & atypiae

Fibrous Histiocytoma benign (pigmented villonodullar synovitis) Malignant Fibrous Histiocytoma – mostly local malignancy blood & lymph. spread possible increasing cellularity & atypiae