2. Neoplasia
Fatima Obeidat, MD

3. - Neoplasia literally means "new growth“
- In medicine it is referred to as a tumor,
- The study of tumors is called oncology

4. Neoplasms are either :
a. benign or
b. malignant:

5. 1. The neoplastic cells which determines its biologic behavior,
- All tumors, benign and malignant, have two basic components
1. The neoplastic cells which determines its biologic behavior,
2. The non-neoplastic connective tissue, is important to the growth of the neoplasm

6. - designated by attaching the suffix -oma to the cell origin
NOMIMNCLATURE
Benign mesenchymal Tumors :
- designated by attaching the suffix -oma to the cell origin
a. A benign bone tumor is called osteoma
b. A benign smooth muscle tumor is leiomyoma
c. Benign tumor of cartilage is chondroma
d. Benign tumor of smooth muscles-leiomyoma

7. II. The nomenclature of benign epithelial tumors
Adenomas :
- Are benign epithelial neoplasms producing glands or derived from glands such as colonic adenoma

8. 2. A polyp :
Is a mass projects above a mucosal surface, as in gut,
3. Cystadenomas
Are cystic tumors that arise in the ovary

9. Teratoma :
Is a tumor contains tissues from more than one germ cell layer and present in ovaries and testes
Contain bone, epithelium, muscle, fat, nerve

10. III. Malignant mesenchymal neoplasms called sarcomas
-.Malignant bone tumor is osteosarcoma
Malignant tumor of cartilage called chondrosarcoma
Malignant tumor of skeletal muscles is called rhabdomyosarcoma

11. - Malignant tumor of smooth muscles called leiomyosarcoma

12. IV. Malignant tumors of epithelium are carcinomas
- Those arise from glands adenocarcinomas
- Those produce squamous cells called squamous cell carcinomas

13. Choristoma - Called hetrotopia- - Is a congenital anomaly not a neoplasm - Means presence of normal tissue in an abnormal location such as presence of normal pancreatic tissue in stomach

14. EXCEPTIONS OF NOMENCLATURE a
EXCEPTIONS OF NOMENCLATURE a. Lymphoma :Malignant tumor of lymphocytes, b. Melanoma,: Malignant tumor of melanocytes c.Seminoma :malignant tumor of testis D.Astrocytoma:Malignant tumor of brain

15. CHARACTERISTICS OF NEOPLASMS A
CHARACTERISTICS OF NEOPLASMS A. Differentiation - It means how much neoplastic cells resemble the normal cells

16. 1. Benign neoplasms :
- Composed of well-differentiated cells that resemble their normal counterparts
2. Malignant neoplasms :
= Characterized by a wide range of differentiation, from well differentiated to poorly differentiated

17. B. Rate of Growth - Most benign tumors grow slowly and most cancers grow faster - The rate of growth of malignant tumors correlates with their level of differentiation - Poorly differentiated tumors grow more rapidly than well-differentiated tumors.

18. C. Local Invasion
A benign neoplasm
- does not have the capacity to invade the normal tissue

19. 2- Cancers
- grow by progressive invasion, and penetration of the surrounding tissue
- It necessary to remove a wide margin of surrounding normal tissue after excision of a malignant tumor -

20. - The pathologists carefully examine the margins of resected tumors to ensure that they have (clean margins)

21. Metastasis :
- Are secondary implants of a tumor, discontinuous from the primary tumor and located in remote tissues -

22. NOTE
Not all cancers have able to metastasize such as basal cell carcinomas of the skin and the majority of malignant central nervous tumors
- Dissemination strongly may prevent, the possibility of curing the disease,

23. - Metastasis occurs by: 1
- Metastasis occurs by: 1. Spread by seeding : - Occurs when neoplasms invade a natural body cavity and example is cancer of the ovary, which cover the peritoneal surfaces

24. 2.Lymphatic spread :
- Is more typical of carcinomas, and although enlargement of nodes near primary neoplasm should arouse concern for metastatic spread, it does not always imply metastasis

25. 3. Hematogenous spread : Is the favored pathway for sarcomas
- Arteries are penetrated less than veins.
- Liver and lungs are the most common site of hematogenous metastasis -

26. prostate cancer metastazize to the vertebra - The skeletal muscles are rarely the site of metastatic deposits -

27. Cancer Epidemiology:
It contribute to knowledge about the origin of cancer. For example the association between smoking and lung cancer arose from epidemiologic studies
- There is association between high dietry fat and low fiber with colon cancer

28. The cancer frequency increases with age. -
Age:
The cancer frequency increases with age.
- This is due to accumulation of somatic mutations and the decline in immune competence with age
- Cancer occurs among children
- The major lethal cancers in children are leukemias, tumors of the central nervous system, and bone sarcomas..

29. Heredity : - About 10% of cancer are familial Acquired Preneoplastic Lesions - Increase the likelihood of malignancy, but most do not progress to cancer and their removal may prevent the development of a cancer.: Examples.
&

30. a. Endometrial hyperplasia
B. Cirrhosis & villous adenoma of clon

31. -Are benign tumors precancerous
-Are benign tumors precancerous?" - In general the answer is no, but there are exceptions, and it is better to say that each benign tumor is associated with a particular risk, ranging from high to virtually nonexistent. - For example, large colon villous adenoma can undergo malignant transformation - Leiomyoma of uterus does not transform to malignany

32. 1. Chemical Carcinogens form of cancer
ETIOLOGY OF CANCER:
1. Chemical Carcinogens form of cancer
a. Direct-Acting Agents: weak carcinogens
- Are important because some are cancer chemotherapy drugs used to cure certain lymphoma but can evoke a subsequent, second form of cancer, usually leukemia

33. b. Indirect-Acting Agents:
Benzo[a]pyrene present in cigarette smoking cause lung cancer
2. Polycyclic hydrocarbons are produced from smoked meats and fish .
3. Aflatoxin B1 produced by Aspergillus, that grows on improperly stored grains and can cause hepatocellular carcinoma

34. II. Radiation Carcinogenesis a
II. Radiation Carcinogenesis a. Therapeutic irradiation of the neck can give rise to thyroid cancers years later

35. III. Oncogenic DNA Viruses: 1. Human Papillomavirus a. Skin warts b
III. Oncogenic DNA Viruses: 1. Human Papillomavirus a. Skin warts b. Genital warts caused byHPV-6 and 11 c. Squamous cell carcinoma of the cervix caused by high-risk HPVs (16 and 18)

36. 2. Epstein-Barr Virus : associated with a. Burkitt lymphoma b
2. Epstein-Barr Virus : associated with a. Burkitt lymphoma b. Lymphomas in patients with AIDS c. Nasopharyngeal carcinoma, 3. HBV and HCV : Liver carcinoma IV H. pylori may cause 1. Adenocarcinoma of stomach

37. 2. Gastric lymphoma and early eradication of H
2. Gastric lymphoma and early eradication of H. pylori "cures" the lymphoma .

38. CLINICAL ASPECTS OF NEOPLASIA
1- Location is crucial in both benign and malignant tumors,
a.Aa small pituitary adenoma can destroy the surrounding normal gland, giving rise to hypopituitarism.

39. b. Benign and malignant colon tumors can ulcerate and cause hemorrhage and in addition can cause obstruction

40. 2. Cancer Cachexia
- Progressive loss of body fat and lean body mass, accompanied by weakness, anorexia, and anemia

41. = . Cachexia is not caused by the nutritional demands of the tumor.
- Although patients with cancer are anorexic, but cachexia results from the action of soluble factors than reduced food intake;