Pathology

Lecture 9: Neoplasia
Dr. Abdul Baset Abbas
Assistant Prof. of Microbiological and Biochemical Pharmacy

讲 师

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 Neoplasia
Neoplasia: literally means the process of "new growth and characterized by
unceasing abnormal and excessive proliferation of cells "without control".
Tumor or neoplasm: A mass of tissue in which the growth rate is excessive and
uncoordinated when compared with normal tissues. The neoplasm is an abnormal
mass of tissue, the growth of which exceeds and is uncoordinated with that of the
normal tissues, and persists in the same excessive manner after cessation of the
stimuli which evoked the change. British oncologist Willis.
Oncology: the branch of pathology that study of tumors or neoplasms.
Cancer: is a disease that results from abnormal growth and differentiation of tissues.
In other word, is the common term for all malignant tumors.

Components of neoplasm
All tumors, benign and malignant, have two basic components:
(1) Parenchyma: it constitutes the proliferating part of the neoplastic cells.
(2) Stroma: it is made up of connective tissue and blood vessels and lymphatics. It
provides support for growth of parenchymal cells.
In some tumors, the stromal support is scant and so the neoplasm is soft and fleshy.
Sometimes the parenchymal cells stimulate the formation of an abundant
collagenous stroma referred to as desmoplasia. Some tumors as cancers of the
female breast are stony hard or scirrhous. 2
Nomenclature for general categories of neoplasms
Adenoma: Benign neoplasm derived from glandular cells.
Carcinoma: Malignant neoplasm derived from epithelial cells.
Sarcoma: Malignant neoplasm derived from mesenchymal cells (e.g., fat, muscle).
Lymphoma: Malignant neoplasm derived from lymphocytes.
Melanoma: Malignant neoplasm derived from melanocytes.
Germ cell tumor: Malignant neoplasm derived from germ cells.

Type of neoplasm
1. Benign tumors: Benign tumors are designated by attaching the suffix "oma" to
the cell of origin. In general, the name of a benign neoplasm often ends with –
oma.
Characteristics:
a. It will remain localized.
b. It cannot spread to other sites.
c. Amenable to local surgical removal.
d. Patient survives.
e. Benign tumors of mesenchymal cells generally follow this rule. For example, a
benign tumor arising from fibroblastic cells is called a fibroma, a cartilaginous
tumor is a chondroma, and a tumor of osteoblasts is an osteoma. 3
In contrast, nomenclature of benign epithelial tumors is more complex. They are
variously classified, some based on their cells of origin, others on microscopic
architecture, and macroscopic patterns. For example:
1. Adenoma: is benign epithelial neoplasm that forms glandular patterns.
2. Papillomas: is benign epithelial neoplasm that producing microscopically or
macroscopically visible finger-like or warty projections from epithelial
surfaces.
3. Cystadenomas: is benign epithelial neoplasm that form large cystic masses,
as in the ovary.
Some exceptions: Hepatoma* (malignant neoplasm of liver), melanoma
(malignant neoplasm of melanocytes), mesothelioma (malignant neoplasm of
mesothelial cells), and seminoma (malignant germ cell neoplasm of testis).
* in some reference hepatoma benign neoplasm.

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2. Malignant tumors:
In malignant neoplasm, the suffix carcinoma, if the growth arises from the
epithelium or sarcoma when it is of mesenchymal origin. It is also called cancer.
In general, the name of a malignant neoplasm often ends with –carcinoma or
sarcoma.
The malignant tumor is destructive and dangerous, having characteristics such
as: a. It can invade and destroy adjacent structures.
b. It spreads to distant sites (metastasis).
c. Patient dies.

There are two types of malignant tumors:-

1. Carcinoma: is the malignant tumors of epithelial cell origin. The word
carcinoma is attached to the type of tissue, for example: malignant epithelial
tumor of renal cell is called renal cell carcinoma, adenocarcinoma: carcinoma
of gland or squamous cell carcinoma: carcinoma of stratified squamous cell.
2. Sarcomas: the malignant tumors arising in mesenchymal tissues. The word
sarcoma is attached to the type of tissue for example: malignant tumor of
fibroblastic cells is called fibrosarcoma, (cartilage) chondrosarcoma, (bone)
osteogenic sarcoma and (fat) liposarcoma.

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Spread of tumor: malignant tumors spread by two ways:
a. Invasion, or the infiltration of tumor cells into surrounding organs.
b. Metastasis: The ability of tumor cells to spread to other parts of the body
and establish secondary tumors. Metastases, or the spread of tumor cells to
distant organs through the blood, which is characteristic of sarcomas, or
through the lymphatics, which is characteristic of carcinomas.

Mixed tumor:
Tumor containing more than of one cell type (mesenchymal or epithelial). For
example pleomorphic adenoma of salivary gland as benign, and teratomas in
ovary as malignant.
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Changes in cell due to malignancy:
1- Changes in growth property (regulatory control) .
2- Morphological changes (in size and shape).
3- Karyotypic changes (in genes).
4- Antigenic changes.
5- Metabolic changes.
6- Cell membrane changes (loss adhesiveness to other cells).
7- Tumor cell products (tumor markers):
Tumor markers are proteins secreted into the blood by neoplasms, allowing for
diagnosis of the tumor or for monitoring of the tumor following treatment. In another define substances
produced by or found on the surface of tumor cells.
Carcinogens: are substance that are known to cause cancer or at least produce an
increased incidence of cancer.
Types of carcinogens:
1. Chemicals as aflatoxin (liver cancer), tobacco chewing (oral cavity cancer),
cigarette smoking (lung, larynx and esophageal cancer) etc.
2. Radiations as UV and X ray.
3. Viruses as herpes simplex virus, human papilloma virus and HIV, etc.
4. Hormones as estrogen in high level cause breast and endometrial carcinoma.
5. Hereditary factors.
6. Nutritional factors as low fiber diet cause colon cancer.

Treatment
1. Surgery. 2. Radiation. 3. Chemotherapy.
4. Hormonal therapy: sex hormones are routinely used to inhibit tumor growth in
breast, prostate and uterine cancer. 5. Immune-based therapies. 8
Qs?
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THANKS

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