1. Grading And Staging
Grading is based on the microscopic features of the cells which compose a tumor and is specific for the tumor type.
Staging is based on clinical, radiological, and surgical criteria, such as, tumor size, involvement of regional lymph nodes, and presence of metastases. Staging usually has prognostic value. 1

2. Staging and Grading Gradin g
In the diagram below utilizing an adenocarcinoma as an example, the principles of grading are illustrated: 2

3. Staging Anatomical spread of tumor based on -size of tumor
-spread to regional L.N
-presence or absence of metastasis
TNM staging system & AJC 3

4. 4

5. Staging and Grading
In this diagram utilizing a lung carcinoma as an example, the principles of staging are illustrated: 5

6. Diagnostic Methods for Neoplasia
History and Physical Examination
learning from :
talking to the patient direct examination clues to the presence of a neoplasm Signs and symptoms such as weight loss, fatigue, and pain may be present. A mass may be palpable or visible. 6

7. Diagnostic Methods for Neoplasia
Radiographic Techniques The use of plain films (x-rays), computed tomography (CT), magnetic resonance imaging (MRI), mammography, and ultrasonography (US) may be very helpful to detect the presence and location of mass lesions. The findings from these methods may aid in staging and determination of therapy. 7

8. biochemical assays tumor markers: sometimes diagnostic or prognostic
can be helpful in monitoring effectiveness of therapy or in detecting relapses/recurrences
Serum tumor markers: prostate specific antigen,CEA ,β-HCG ,α-FETOPROTEIN...etc )may help to determine the presence of specific neoplasms . not perfect screening tools in a general population. 8

9. Pathological Diagnostic Procedures
FNA (fine needle aspiration)
cytological smears
biopsy
frozen sections 9

10. Diagnostic Methods for Neoplasia
Cytology
sample cells
simple
cost-effective
minimally invasive.
e.g : Pap smear for the diagnosis of cervical dysplasias and neoplasms.
Cells exfoliated into body fluids can be examined.
Fine needle aspiration (FNA) can be used also. 10

11. Diagnostic Methods for Neoplasia
Tissue Biopsy and Surgery Methods that sample small pieces of tissue (biopsy) from a particular site, often via endoscopic techniques (such as colonoscopy, upper endoscopy, or bronchoscopy) can often yield a specific diagnosis of malignancy. At surgery, portions of an organ or tissue can be sampled, or the diseased tissue(s) removed and examined in surgical pathology to determine the stage and grade of the neoplasm. 11

12. frozen section 12

13. staining a frozen section13

14. ancillary studies Imunohistochemistry electron microscopy cytogenetics
flow cytometry 14

15. cytokeratin stain on a carcinoma15

16. EM: neurosecretory granules16

17. Molecular studies
PCR
FISH
Molecular profiling of tumor 17