NEOPLASIA

GROUP-D

AIFA AFZAL 527135

SIDRA KHALIL 527161
MARYAM QAYYUM 527132
HAREERA HARAM 527139
SAJWAL NIGAR 527150
WAJEEHA AROOJ 527155
RIMSHA AMJAD 527153
 Definition
A neoplasm is an abnormal mass of tissues

 The growth of which exceeds and is uncoordinated with that of the

normal tissues
 Persists in the same excessive manner even after cessation of the
stimuli which evoked the change.
(old definition)

Neoplastic cells lose control and regulation of replication and form an

abnormal mass of tissue.
 Tumor
• Originaly applied to swelling caused by inflammation.

Tumor = Neoplasm

Oncology

The branch science deal with the study of neoplasms is called

oncology.
components
 Desmoplasia

 Desmoplasia is the term used for

production of abundant collagenous
stroma by the parenchymal cells.
• It leads to excessive fibrosis in the tumor
due to formation of an abundant
collagenous stroma.

e.g scirrhous carcinoma of breast.

 Benign Tumors

Benign tumors are designed by attaching the suffix “oma”

e.g
1. Tumor of fibroblasts (fibroma)
2. Tumor of cartilagenonous cells (chondroma)
3. Tumor of osteoblasts (osteoma)
• Adenoma
Benign epithelial tumor arising from glands or forming a glandular pattern
• Papilloma
Benign tumor with finger like projections
 Exceptions
( these are malignant tumors)
• Melanomas
• Seminoma
• Hepatoma
• Lymphoma
• Mesothelioma
 Malignant tumors

1. Malignant tumors arising in mesenchymal cell origin are usually

called sarcoma
e.g
fibrosarcoma, liposarcoma, leimyosarcoma, rhabdomyosarcoma

2. Malignant tumors of epithelial cells origin are called carcinoma

Carcinoma may be classified as:
 with glandular growth patterns i.e adenocarcinoma
 producing recognizable squamous cells of epithelium i.e
squamous cell carcinoma
 Malignant tumors

Mesenchymal cell origin Epithelial cell origin

Sarcoma Carcinoma

Squamous cell carcinoma Adenocarcinoma

 Mixed tumors

When two types of tumors are combined in the same

tumor, it is called a mixed tumor
Example
• Adenosquamous carcinoma
• Carcinosarcoma
 Teratoma

• Tumors are composed of cells representative of a signal germ

layer.
• Mixture from the three germ cell layers:
1. Ectoderm
2. Mesoderm
3. Endoderm known as teratoma

• Mainly present in Gonads (ovary, testes)

 Blastomas (embryomas)

• Arise from embryonal (primitive cell)

• These tumors occur more frequently in infants and children
(under 5 years of age)
e.g
1. Neuroblastoma
2. Nephroblastoma
3. Hepatoblastoma
4. Retinoblastoma
5. Pulmonaryblastoma
 Etiology of cancer :
• These factors may be involved :
1. Pre-disposing factors
2. Chronic neoplastic conditions (pre malignant )
3. Hormones
 Pre-disposing factors:

• Genetic Factors :
* Breast cancer : mutant BRCA1 and BRCA2 located at chromosome 17 and 13
respectively .
*Retinoblastoma : missing of RB gene in chromosome 13 .
• Racial and geographical factors :
* Black africans usually develop skin, penis, liver cancer .
*Indian people usually develop oral , breast, liver, colorectal .
• Environmental factors :
*Air pollutants : cause respiratory cancer .
*Radiatons : cause mostly skin cancer .
• Life style :
Smoking : oral , lung, pancrease, bladder cancer .
Alcohol: upper GIT , liver cancer .
Tobacco: oral, lung cancer .

2. Chronic neoplastic conditions (premalignant) :

• Carcinoma in situ :
Cancer in epithelium , common sites are skin, uterine, cervix, breast .
• Bening tumor :
Adenocarcinoma, neurofibrosarcoma .
• Other conditions :
Cirrohosis of liver ------- liver cancer
Chronic Bronchitis ------- cancer of bronchus
Ulcerative colitis ------ colorectal cancer
Infections -------- HIV, Hepatitis , Herpes simplex
3. Hormones:
• Oestrogen : excess of this hormone causes the endometrial
carcinoma .
• Anabolic steroids : benign and malignant tumors are formed due to
these steroids .
Pathogenesis
• Pathogenesis Of cancer is discussed under the 4 main
heading :
1. Molecular pathogenesis of cancer
2. Chemical carcinogen and chemical Carcinogenesis
3. Physical carcinogen and radiation carcinogenesis
4. Biological carcinogen and Viral oncogenesis
 Molecular pathogenesis of cancer
In normal cell growth
there are 4 main regulator
genes .
1. Proto oncogene(growth
promoting )
2. Anti oncogenes(growth
suppresors)
3. Apoptosis regulatory
gene
4. DNA repair gene
The corresponding
abnormalities in these 4
regulator gene are as under:
Activation of growth –
promoting oncogenes
• Inactivation of cancer
suppressor gene
Abnormal apoptosis
regulatory genes
Failure of DNA repair
genes
EGFR/HER2NEO receptor
• HER2 is a member of the
human epidermal growth factor
receptor (EGFR) family, which
induces the activation of
signalling pathways that
promote cell proliferation and
survival by dimerization with
other EGFR family members
Avoiding of apoptosis :
• In cancer cell the apoptosis is
compromised due to various
irregularities :
RB protein
TGF-Beta
BCl-2 family
BAX,BAK
. PTEN(phosphate and
TENSDN Homolog)
Chemical carcinogenesis
Chemical carcinogenesis/ mutagensTwo-
step/multistep process
• Initiation causes permanent DNA damage (Mutation)
• Promotion (Proliferation)
• INITIATORSDirect acting compounds
Direct acting carcinogens are bind covalently to
cellular macromolecules. E.g. nitrogen mustard, bis(chloro-
methyl) ether, benzyl chloride, Epoxides
• Indirect acting carcinogen (Procarcinogens):
Require metabolic conversion to form ultimate active
CELL PROMOTERS
. Can cause cellular proliferation & induce tumors in
initiated cells, e.g estrogen but they are non tumorigenic by
themselves.CANCER CELLSProliferation of a mutated cell may
lead to accumulation of additional mutations.
Physical carcinogenesis
• Physical agents in carcinogenesis are divided into 2 groups:
1. Radiation, both ultraviolet light and ionising radiation, is the most important
physical agent.
2. Non-radiation physical agents are the various forms of injury and are less
important.
• Mechanism. Radiation damages the DNA of the cell by one of the 2 possible
mechanisms:
a) It may directly alter the cellular DNA.
b) It may dislodge ions from water and other molecules of the cell and result in
formation of highly reactive free radicals that may bring about the damage.
• Damage to the DNA resulting in mutagenesis is the most important
action of ionising radiation. It may cause chromosomal breakage,
translocation, or point mutation.
• Non-radiation Physical Carcinogenesis
Mechanical injury to the tissues such as from stones in the gallbladder,
stones in the urinary tract, and healed scars following burns or trauma,
has been suggested as the cause of increased risk of carcinoma in these
tissues but the evidence is not convincing.
Biological carcinogenesis
• The epidemiological studies on
different types of cancers
indicate the involvement of
transmissible biologic agents in
their development, chiefly
viruses. Other biologic agents
implicated in carcinogenesis
are as follows:
• Parasites•
• Fungus
• Bacteria