CLASSIFICATION OF TUMOURS

• BEHAVIOURAL: BENIGN OR MALIGNANT

• HISTOGENETIC: CELL OF ORIGIN

• SHAPES:
– SESSILE
– PEDUNCULATED
– PAPILLARY
– FUNGATING
– ULCERATED
– ANNULAR
NEOPLASTIC FEATURES
• LOSS OF DIFFERENTIATION

• LOSS OF CELLULAR COHESION

• NUCLEAR ENLARGEMENT (↑NUCLEAR :CYTOPLASMIC RATIO)

• INCREASED MITOTIC ACTIVITY INCLUDING TRI-,TETRAPOLAR OR BIZARRE

FIGURES
BEHAVIOURAL CHARACTERISTICS
• BENIGN
– Slow growth rate
– Low mitotic activity
– Good likeness to normal tissue
– Often normal nuclear morphology
– No invasion
– Never metastasise
– Often circumscribed or encapsulated border
– Rare necrosis & ulceration
– Often exophytic
• MALIGNANT
– Rapid growth rate
– High mitotic activity
– Variable often poor likeness to normal tissue
– Pleomorphic, prominent nucleoli, hyperchromatic
– Invasive
– Frequent metastases
– Irregular & often poorly defined border
– Ulceration and necrosis common on skin/mucosa
– Often endophytic
CHARACTERISTICS OF CARCINOMAS & SARCOMAS
• CARCINOMA
– Epithelial
– Common
– Lymphatic route for metastasis
– In-situ phase present
– Usually over 50 years
• SARCOMA
– Connective tissue
– Rare
– Haematogenous route for metastasis
– No in-situ phase
– Usually below 50 years
PREDISPOSITION TO MALIGNANCIES

• GEOGRAPHIC FACTORS

• ENVIRONMENTAL (UV LIGHT, ASBESTOS, SMOKING TOBACCO)

• AGE ACUTE LEUKAIMIA <15 YEARS & SARCOMAS >55 YEARS

• HEREDITY

• ACQUUIRED PRENEOPLASTIC DISORDERS

OCCUPATIONAL CANCERS

• ARSENIC – LUNG, SKIN HAEMANGIOSARCOMA

• ASBESTOS – LUNG MESOTHELIOMA & GIT

• BENZENE – LEUKAIMIA, HODGKIN DISEASE

• VINYL CHLORIDE – ANGIOSARCOMA, LIVER

• BERYLLIUM – LUNG

• CHROMIUM – LUNG

• CADMIUM – PROSTATE

• NICKEL – NOSE, LUNG

• ETHYLENE OXIDE - LEUKAIMIA

GENETIC PREDISPOSITIONS
AUTOSOMAL DOMINANT
– FAMILIAL RETINOBLASTOMA
– FAMILIAL ADENOMATOUS POLYPOSIS
– MULTIPLE ENDOCRINE NEOPLASIA SYNDROMES
– NEUROFIBROMATOSIS TYPES 1 & 2
– VON HIPPEL-LINDAU SYNDROME
FAMILIAL CANCERS

• BREAST CANCER

• OVARIAN CANCER

• COLON CANCERS OTHER THAN FAMILIAL ADENOMATOUS POLYPOSIS

AUTOSOMAL RECESSIVE SYNDROMES WITH DEFECTIVE DNA REPAIR

• XERODERMA PIGMENTOSUM

• ATAXIA TELANGIECTASIA

• BLOOM SYNDROME

• FANCONI ANEMIA
ACQUIRED PRENEOPLASTIC DISORDERS

• CHRONIC ATROPHIC GASTRITIS OF PERNICIOUS ANAEMIA

• SOLAR KERATOSIS OF THE SKIN

• CHRONIC ULCERATIVE COLITIS

• LEUKOPLAKIA OF THE ORAL CAVITY, VULVA & PENIS