1. General Pathology Basic Principles of Cellular and Organ Pathology Oncology - II Jaroslava Dušková Inst. Pathol.,1st Med. Faculty, Charles Univ. Prague

2. General Oncology - I u Disorders of the cell proliferation and growth (hypertrophy, hyperplasia, metaplasia) u Neoplasms – disorders of cell proliferation and differentiation u Molecular biology of neoplasia - oncogenesis u Host - neoplasm interactions General Oncology - II u Biology of the neoplastic growth u Precanceroses (& pseudotumours) u Classification of the neoplasms u Methods of tumour diagnostics u Neoplasm prognostification

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

4. NEOPLASIA – classification BEHAVIORAL v benign v borderline v malignant histological vs. clinical behaviour

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

6. Clinical manifestation of neoplasms u Benign no mass (palpable or visible on imaging) compression obstruction pressure bleeding hormonal production u Malignant no mass pressure bleeding hormonal production destruction inflammatory response distant metastases u Borderline combined…!

7. Metastasis Def.: development of secondary tumour foci in the distant places

8. Metastases - pathways v seeding (body cavities) v lymphatic spread v hematogenous spread cellular embolism!!!

9. Invasion & Metastasis - steps u Invasion into the extracellular matrix - ECM –dyscohesion of cells – loss of – E-cadherine –ECM degradation – proteolytic enzymes –migration v epithelio-mesenchymal conversion v ameboid migration or v groups u Angioinvasion – esp. into newly formed vessels u Extravasation – local factors promoting or inhibiting the subsequent growth v tropism v late metastases

12. NEOPLASIA – macroscopy v whittish/grayish mass v yellow nodule lipoma, clear cell kidney carcinoma, adrenocortical adenoma v red nodule hemangioma v brown nodule nevocellular nevus, melanoma, pigm. basalioma v organ enlargement leukemia v organ consolidation (& superficial ulceration) tongue carcinoma v organ softening – necrosis glioblastoma v branched outgrowth papilloma, villous adenoma v cystic (cystopapillary) cystadenoma, ca

13. NEOPLASIA – histological architecture solid glandular papillary cystopapillary dissociated

14. 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!

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

16. Pseudotumors Definition: - pathological lesions of different etiology masquerading real neoplasms

17. Pseudotumors v cysts v pseudocysts v deposits of pathol. material (gout, ganglion, amyloid) v inflammatory pseudotumors (tuberculoma) v hyperplasia (esp. nodular) v embryonal development disturbance (choristia, hamarcia)

18. Precanceroses (preblastomatoses) v most pseudotumorous processes with dysplasia features v dysplastic lesions looking not like tumours (SIL, intest. metaplasia with dysplasia)

19. Nonneoplastic Growth Disturbances – II v repair v hypertrophy / atrophy v hyperplasia v metaplasia v dysplasia v anaplasia – undifferentiation

20. Dysplasia Definition: - disturbance of cell growth, maturation, architecture (frequently, but not always preneoplastic condition)

21. PSEUDOTUMORS and PRECANCEROSES (preblastomatoses) pseudotumors precanceroses

22. Diagnosis early less complicated therapy pseudotumors – clinical – morphological precanceroses – screening –morphological precanceroses – screening –morphological

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

24. NEOPLASIA – classification HISTOGENETIC v mesenchymal v epithelial v neuroectodermal v mixed v germ cell, teratoma, choriocarcinoma v mesothelioma

25. General Oncology - I u Disorders of the cell proliferation and growth (hypertrophy, hyperplasia, metaplasia) u Neoplasms – disorders of cell proliferation and differentiation u Molecular biology of neoplasia - oncogenesis u Host - neoplasm interactions General Oncology - II u Biology of the neoplastic growth u Precanceroses (& pseudotumours) u Classification of the neoplasms General Oncology - III  Methods of tumour diagnostics  Neoplasm prognostification  Prediction of the response to the therapy