General Pathology Basic Principles

of Cellular and Organ Pathology

Oncology - II

Jaroslava Dušková

Inst. Pathol. ,1st Med. Faculty, Charles Univ. Prague

General Oncology - I

Disorders of the cell proliferation and growth (hypertrophy, hyperplasia,

metaplasia) Neoplasms – disorders of cell proliferation and differentiation Molecular biology of neoplasia - oncogenesis Host - neoplasm interactions

General Oncology - II

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

General Oncology - II

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

NEOPLASIA – classification

BEHAVIORAL

benign borderline malignant

histological vs. clinical behaviour

NEOPLASIA – growth

benign expansive

borderline - locally destructive

malignant infiltrative

METASTASES

Clinical manifestation of neoplasms Benign

nomass (palpable or visible on

imaging) compression obstruction

pressurebleedinghormonal production

Malignantnomasspressurebleeding hormonal production

destructioninflammatory

responsedistant metastases

Borderline

combined…!

Metastasis

Def.: development of secondary tumour foci in the distant places

Metastases - pathways

seeding (body cavities) lymphatic spread hematogenous spread

cellular embolism!!!

Invasion & Metastasis - steps Invasion into the extracellular matrix - ECM

– dyscohesion of cells – loss of – E-cadherine– ECM degradation – proteolytic enzymes– migration

epithelio-mesenchymal conversion ameboid migration or groups

Angioinvasion – esp. into newly formed vessels Extravasation – local factors promoting or

inhibiting the subsequent growth tropism late metastases

NEOPLASIA – macroscopy whittish/grayish mass yellow nodule lipoma, clear cell kidney carcinoma,

adrenocortical adenoma red nodule hemangioma brown nodule nevocellular nevus, melanoma, pigm.

basalioma organ enlargement leukemia organ consolidation (& superficial ulceration)

tongue carcinoma organ softening – necrosis glioblastoma branched outgrowth papilloma, villous adenoma cystic (cystopapillary) cystadenoma, ca

NEOPLASIA – histological architecture

solidglandularpapillary

cystopapillarydissociated

NEOPLASIA – cytology

Benign similar to nonneoplastic

Malignant cellular pleomorphismNUCLEAR FEATURES:

hyperchromasia (polyploidy, aneuploidy)

rough chromatine structureirregular nuclear outlinelarge and/or multiple nucleoli

!or undifferentiated monotonous cellularity!

General Oncology - 2

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

Pseudotumors

Definition:

- pathological lesions of different etiology masquerading real neoplasms

Pseudotumors cysts pseudocysts deposits of pathol. material

(gout, ganglion, amyloid) inflammatory pseudotumors

(tuberculoma) hyperplasia (esp. nodular) embryonal development disturbance

(choristia, hamarcia)

Precanceroses (preblastomatoses)

most pseudotumorous processes with dysplasia features

dysplastic lesions looking not like tumours (SIL, intest. metaplasia

with dysplasia)

Nonneoplastic Growth Disturbances – II

repair hypertrophy / atrophy hyperplasia metaplasia dysplasia anaplasia – undifferentiation

Dysplasia

Definition:

- disturbance of cell growth, maturation, architecture

(frequently, but not always preneoplastic condition)

PSEUDOTUMORS and PRECANCEROSES (preblastomatoses)

pseudotumors

precanceroses

Diagnosis early less complicated therapy

pseudotumors – clinical– morphological

precanceroses– screening

– morphological

precanceroses– screening

– morphological

General Oncology - II

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms Methods of tumour diagnostics Neoplasm prognostification

NEOPLASIA – classification

HISTOGENETIC mesenchymal epithelial neuroectodermal mixed germ cell, teratoma, choriocarcinoma mesothelioma

General Oncology - I

Disorders of the cell proliferation and growth (hypertrophy, hyperplasia,

metaplasia) Neoplasms – disorders of cell proliferation and differentiation Molecular biology of neoplasia - oncogenesis Host - neoplasm interactionsGeneral Oncology - II

Biology of the neoplastic growth Precanceroses (& pseudotumours) Classification of the neoplasms

General Oncology - III Methods of tumour diagnostics Neoplasm prognostification Prediction of the response to the therapy