Oral Pathology 2 o Moveable

Introduction o Easily excisable by surgical enucleation

o Do not metastasize
I. Neoplasia
II. Benign  Add suffix -oma
III. Malignant  Followed by Tumors of Mesenchymal cells:
o Fibroma - fibrous tissues
I. NEOPLASIA o Chondroma - cartilage

 3rd most common cause of death =
MALIGNANT NEOPLASM (2009)
NEOPLASIA
 New growth
 Abnormal mass due cessation of stimuli.
 Disorder of cell growth that is triggered
by series of acquired mutations affecting
a single cell and its clonal progeny.
ONCOLOGY
 Study of tumors / neoplasms.
 Terminologies are followed by its origin,
pattern, or architecture.
o Adenoma - derived from glands.
o Papillomas - micro/macroscopically
visible fingerlike or warty projections
(cauliflower like) from epithelial
surfaces.
o Cystadenomas - forms large cystic
masses.
o Polyp - macroscopically projection
above a mucosal surface.

BENIGN VS. MALIGNANT TUMORS

Benign Malignant
Excessive Cancer; invade
proliferation; single surrounding tissue
mass
Classifications:
Carcinomas,
sarcomas, others

II. BENIGN TUMORS

 Innocent, localized, amenable to local

surgical removal.
 Slow growth thus no mitoses which rarely
happens, is observed.
 Has possibility to be malignant when
constantly triggered.
 Encapsulated
o Palpable
  Exceptions: leukemias & lymphomas -
arising from blood-forming cells
o Lymphoma

Squamous cell carcinoma

Pedunculated – raised (has neck)

Sessile – broad based. Likely to become  Has keratin pearls

cancerous simply by virtue of being missed.
Adenocarcinoma
III. MALIGNANT TUMORS

 Known as cancer.
 Borders are ill-defined and tumor itself is
infiltrative infiltrate or invade and destroy
adjacent structures then metastasize through
the blood vessels, lymphatics, body cavities.
 Characterized by widespread differentiation
(from poor to well-defined)
 "Psuedoencapsulated"

 Suffix -sarcoma, meaning arising in solid

mesenchymal tissue.
o Fibrosarcoma  Glands
o Chondrosarcoma  Columnar cells with lumen
o Leiomyosarcoma
o Rhabdomyosarcoma MIXED TUMORS
 Suffix -carcinoma, meaning it is epithelial  Tumor derived from more than one type
origin. of tissue.
Ectoderm – epidermis
Mesoderm - renal tubules PLEOMORPHIC ADENOMA
Endoderm - lining of gi tract  Epithelial component
 Myoepithelial cell component
 Stromal (mesenchymal) component
TERATOMA
 Has 3 germ layers.
 Also seen in fetus.
HAMARTOMAS
 Disorganized but are benign masses
composed of same tissues.
CHORISTOMA
 Heterotopic rest cells
 Normal pancreatic tissue found in
submucosa of stomach, duodenum, or
small intestine.
ANAPLASIA
 Lack of differentiation in neoplastic
cells.
 Hallmark of malignancy
 "to form backward"
 Anaplastic tumor showing cellular and
nuclear variation in size and shape. The
prominent cell in the cell field has an
abnormal tripolar spindle.
 Malignant cells usually have spindle cells.
MORPHOLOGIC CHANGES ASSOC.
WITH ANAPLASIA
 Pleomorphism
o Variation in size and shape.

Rhabdomyosarcoma

Pleomorphic tumor of skeletal
muscle
 Disproportionately large nuclei
 Abnormal nuclear morphology
o Morphology 1:1
 o Disproportion  Tumor cells breach the basement
 Abnormal mitoses membrane.
o High proliferative activity of
parenchymal cells. METASTASIS
 Spread of a tumor to sites that are
physically discontinuous with the
primary tumor.
 Marks a tumor as malignant.

PATHWAYS OF SPREAD
Direct seeding of body cavities or surfaces
Lymphatic spread - most common pathway
Hematogenous spread

 Loss of polarity
o Markedly disturbed orientation of
anaplastic cells from basal cell layer
to superficial layer

METAPLASIA
 Replacement of one type of cell with
another type in association with tissue
damage, repair, regeneration.
LAB DIAGNOSIS OF CANCER
Excisional biopsy
Incisional biopsy
 For large test
Fine-needle aspiration
 18-gauge needle
 To check if there is any fluid.
Cytologic smears

DYSPLASIA
 "Disordered growth"
 Exhibits pleomorphism.
 Contain large hyperchromatic nuclei.
 May be precursor to malignant
transformation, but does not always
progress to CA.

CARCINOMA IN SITU
 Pre-invasive neoplasm
 Dysplastic changes are marked and
involve the full thickness of epithelium
but does not penetrate the basement
membrane.

INVASIVE CARCINOMA
REFERENCES: