Definition:

 New growth
 Definitions:
 Oncology:
The study of neoplasm (tumor) is called oncology

 Differentiation:
The extent to which the neoplastic parenchymal cells
resemble their normal parent cells both morphologically
and functionally ;is called differentiation.
 Anaplasia:
Irreversible loss of differentiation is called anaplasia
ANAPLASIA
Tumor:
 It is often used synonymously with neoplasm,
but a "tumor" can mean any mass increasing
in size.
Cancer:
 Is the common term for malignant neoplasm.

N.B.:
 Once a neoplasm has started, it is not reversible.
Classification of Neoplasm

Benign Malignant
Cancer Cells Versus Normal Cells

Cancer Cells Versus Normal Cells

 Cancer may regarded as a group of diseases
characterized by an:
 Abnormal growth of cells

 Some of them can invade tissue and even distant

organs

 May cause death of the affected patient if the

tumor has progressed beyond the stage when it
can be successfully removed
Problem statement

 Worldwide
 Every year 10 million people are diagnosed
and more then 6 million die
 22.4 million peoples were living with
cancer in 2000
 Most common cancer worldwide are
 Lungs cancer (12.3%)
 Breast cancer (10.4%)
 Colorectal cancer (9.4%)
The Most common Caner in Egypt:
Benign Tumor
 Definition:
 is a mass of cells (tumor) that
lacks the ability to invade
neighboring tissue (donot
spread throughout the body)
or metastasize.
Benign tumors
 In general these are designated by
attaching the suffix “oma” to cell of origin

Example:
 Benign tumor arising from fibroblastic cells
is called fibro-oma (fibroma)
 Bengin tumor of fat cell (Lipoma)
 Benign tumor arising from meninges is
called meningi- oma (meningioma)
 Colonic polyp
A, This benign glandular tumor (adenoma) is projecting into the colonic lumen
and is attached to the mucosa by a distinct stalk. B, Gross appearance of several
colonic polyps.

CSBRP-July-2012
Here is a small hepatic adenoma, an uncommon benign
neoplasm, but one that shows how well-demarcated an
benign neoplasm is, because the adenoma is making bile
pigment, giving it a green color14.
benign nevus (pigmented mole) of the skin
15
COMPOUND NEVUS
Fibroma of eye lid:
• HAMARTOMA
• Hamartoma is a developmental abnormality, tumor-
like but non- neoplastic malformation consisting of a
mixture of tissues normally found at a particular site.

• The commonest forms are those composed of

blood vessels and those involving cells of the skin.
Leiomyoma

 Also called “myoma” or “fibroid”.

 Tumor is composed on intertwining bundles of smooth
muscle cells that more or less resemble of uninvolved
myometrium.
 They are sharply circumscribed, unencapsulated but
discrete, firm, gray-white masses with a characteristic
whorled appearance on cut surface.
 This tumor may have an increase of the CT with dense
hyalinization of the stroma
LEIOMYOMA-UTERUS
In contrast, this hepatocellular carcinoma is not as well circumscribed (note the
infiltration of tumor off to the lower right) nor as uniform in consistency. It is also
arising in a cirrhotic (nodular) liver. 23
Activity

Compare between
Benign and malignant
tumor
 Characteristics Benign Malignant
Differentiation/ Well differentiated; Some lack of differentiation
anaplasia structure sometimes typical with anaplasia; structure often
of tissue of origin atypical

Rate of growth Usually progressive and may be slow to rapid; mitotic

slow; may come to a
standstill or regress; mitotic
figures rare and normal
Local invasion Usually well-demarcated
masses that do not invade
or infiltrate surrounding
normal tissues
- Has capsule
Metastasis Absent
CSBRP-July-2012
figures may be numerous and
abnormal
- Hemorrhage and necrosis
present
Locally invasive, infiltrating
surrounding tissue
-no capsule
Frequently present; the larger
and more undifferentiated the
primary, the more likely are
metastases
 Pathogenesis of Tumour:

 The division (mitosis) of normal cells is

precisely controlled. New cells are only formed
for growth or to replace dead ones.
 Cancerous cells divide repeatedly out of
control even though they are not needed, they
crowd out other normal cells and function
abnormally.
 They can also destroy the correct functioning
of major organs.
 Cancer arises from the mutation of a normal gene.
 Mutated genes that cause cancer are called
oncogenes.
 It is thought that several mutations need to occur
to give rise to cancer.
 Cells that are old or not functioning properly.
 Normally self destruct and are replaced by new
cells.
 cancerous cells do not self destruct and continue
to divide rapidly producing millions of new
cancerous cells.
Genes involved in cancer development:
 The growth-promoting: proto-oncogenes
(oncogene)
 Growth-inhibiting: tumor suppressor genes,
 Genes that regulate programmed cell death
(apoptosis)
 Genes involved in DNA repair

Proto-oncogenes are considered dominant

HOW NEOPLASM
BEGINS
 Growth Disorders:
Non neoplastic Neoplastic
(Polyclonal) (Monoclonal)

Hyperplasia
Hypertrophy
Aplasia
Atrophy
Metaplasia
Dysplasia

Normal Adaptation Benign Malignant

 The clonal origin of Tumors

 Studies of human and experimental tumors have

proven that a tumor arises from single
transformed (changed ) cell.

A TUMOR IS MONOCONAL
Normal • Tumors are clonal (one parent)
cell
• But have different mutations → different
First
shapes & features.
First
mutation
mutation • Each new mutation adds a new feature.

Second
mutation

Third
mutation
Malignant cells
Fourth or
later mutation

More new mutations with time.

To Be Continued……