1. Definitions and Classifications in Neoplasia Folder: DefClass Updated: February 07, 2013

2. 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

3. 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

4. Reversible Squamous Metaplasia

5. Normal Secretory & Ciliated Epithelial Cells Illustrating functional effect of ciliated vs non-ciliated cells Figure 16-19, ECB, 1998, p. 528 RespCilia Ciliated Epithelium of Human Respiratory Tract

6. Progressive Steps in Neoplastic Cell Development: Hyperplasia and Dysplasia

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

8. 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 situ CIN = cervical intra-epithelial neoplasm DCIS = ductal carcinoma in situ PIN = prostatic intra-epithelial neoplasm

9. We have talked about “Hyperplasia”, “Metaplasia”, “Neoplasia”. What is the “plasia” part? What is “plasia” referring to? (One word!)

10. 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

11. 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

12. Classifications of Cancers

13. Sites of Origin for Primary Clinical Cancers Collection 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

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

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

16. Normal Proliferative Human Cells & Tissues Epithelial Linings Respiratory epithelium Gastro-intestinal linings Genito-urinary tract Glandular Linings Mammary gland Skin Ovary and Testis Bone Marrow Myoblasts Fetal Tissues Organ Hypertrophy Wound Healing Neurogenesis

17. 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.

18. Classification by Tissue Type for 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

19. Classification of Cancer by Histogenetic Site of Origin Part 1: Connective Tissue Neoplasms Tissue of Origin Fibrous tissue Cartilege Bone Fat Smooth Muscle Skeletal Muscle Blood Vessels Benign Neoplasm Fibroma Chondroma Osteoma Lipoma Leiomyoma Rhabdomyoma Hemangioma Malignant Neoplasm Fibrosarcoma Chondrosarcoma Osteogenic Sarcoma Liposarcoma Leiomyosarcoma Rhabdomyosarcoma Hemangiosarcoma Sarcomas (Sarcomata) are malignant neoplasms of connective tissue origin. About 5% of all cancers in humans

20. Classification of Cancer by Histogenetic Site of Origin Part 2: Epithelial Neoplasms Tissue of Origin Epidermis Stomach Adrenal cortex Surface Epithelium (Non-glandular) Glandular Epithelium Colon Breast Lung Benign Neoplasm Epidermal papilloma Gastric polyp Adrenocortical adenoma Papilloma Adenoma Colon adenoma Mammary adenoma Lung adenoma Malignant Neoplasm Epidermal carcinoma Gastric carcinoma Adrenocortical carcinoma Squamous carcinoma Adenocarcinoma Colon carcinoma Mammary carcinoma Lung carcinoma Carcinomas are malignant neoplasms of epithelial origin. About 85% of all cancers in humans!

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

22. Figure 2.4b Te Biology of Cancer Figure 2.4c The Biology of Cancer (© Garland Science 2007) Bronchiole of Lung Columnar Epithelium (Gall Bladder )

23. Figure 2.6c The Biology of Cancer (© Garland Science 2007)Figure 2.6a The Biology of Cancer (© Garland Science 2007) Squamous epithelium Uterine cervix Skin Glandular Epithelium (stomach) Columnar Epithelium, Small Intestine Goblet Cell (Mucous-secreting)

24. Figure 2.6d The Biology of Cancer (© Garland Science 2007) Adenocarcinoma(Stomach) Adenocarcinoma (Colon) Glandular Epithelium Stomach

25. Classification of Cancer by Histogenetic Site of Origin Part 4: Neoplasms of the Nervous System Tissue of Origin Brain glial cells Meninges Neurons Adrenal medulla Retina Benign Neoplasm Astrocytoma Oligodendroglioma Meningioma Ganglioneuroma Pheochromocytoma --- Malignant Neoplasm Glioblastoma multiforme Meningeal sarcoma Neuroblastoma Pheochromocytoma 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

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

27. 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

28. Neuroblastoma in a Little Boy (Viewed in Class in 501Intro) William Bunn: 8-Year-old Police Officer July, 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

30. Classification of Cancer by Histogenetic Site of Origin Part 3: Hematopoietic and immune system neoplasms Tissue of Origin Lymphoid tissue and Lymphocytes Thymus Granulocytes Plasma Cells Erythrocytes Benign Neoplasm Infectious mononucleosis and other lymphoproliferative diseases Thymoma Granulocytosis --- Polycythemia vera Malignant Neoplasm Lymphoma (lymphosarcoma) Lymphocytic leukemia (B and T Cell Leukemias) Reticulum cell sarcoma Hodgkin's Disease Thymoma Myelogenous leukemia (Granulocytic leukemia) Multiple Myeloma Erythroleukemia Leukemias and Lymphomas (Lymphosarcomas) are malignant neoplasms of hematopoietic (blood cell forming) tissue origin About 5% of all cancers in humans

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

32. Different Forms of Leukemias Acute (A) and Chronic (C) 3.4% of all forms of human cancers Lymphocytic54% (32% CLL; 22% ALL) Also called "lymphoblastic" Myelocytic 37% (26% CML; 11% AML) Also called "granulocytic" or "myelocytic" Monocytic 9% (All acute) ErythroleukemiaRare

33. Morphology & Staining of Blood Cells Kuby, 3rd Ed. Figure 3-1

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

35. 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? _ _ _ _ _ _ _ _ _ _ _ _ _ 0 of 5

36. If a stem cell divides but does not self-renew, what will happen to the stem cell compartment for that cell lineage? 0 of 5

37. Pluripotent Stem Cell and Lymphoid and Myeloid Lineages (Fig 2-1, Kuby 4th Ed. p. 28 Myeloid Stem Cell

38. Lymphoid Lineage Fig 2-1 Kuby 4th Ed p. 28

39. Myeloid Lineage (Kuby, Fig 2-1, 4th Ed., p. 28)

42. Figure 8.32 The Biology of Cancer (© Garland Science 2007) Disease Progression in Chronic Myelogenous Leukemia p. 293

44. AgeEffct

45. Diagnostic Pathobiology of Hodgkins Disease vs 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; 2 nd age-related risk later in life

46. A neoplasm (or cancer) that is localized and encapsulated is defined as being _ _ _ _ _ _ 0 of 103

47. A neoplasm (or cancer) that is invasive and metastatic is defined as being _ _ _ _ _ _ _ _ _ 0 of 103

48. First-hand experiences with cancer incidence (This question is anonymous. You can respond with more than one number) 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. 0 of 103

49. 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. 0 of 103

51. http://abcnews.go.com/Health/BreastCancerCenter/early- stage-breast-cancer-care/story?id=12870356abcnews.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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53. A carcinoma is a neoplasm (cancer) that arises from ___ ___ ___ ___ ___ ___ ___ ___ ___ ___ tissue. 0 of 5