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Definitions and Classifications in Neoplasia Folder: DefClass(NoTP) Updated: February 8, 2017 Definitions in Oncology. (Part 1) Neoplasia: (“Plasia = Cells) Abnormal new cell proliferation of altered cells • Heritably Altered • Relative autonomous growth • Can be benign or malignant (See later) Hyperplasia: • Abnormal proliferation of otherwise normal cells Tumor: Solid mass, usually cellular (but not necessarily) • Can be neoplastic, non-neoplastic, or even non-cellular • "Tumor" usually means a neoplasm in common usage • Some free cell neoplasms can be non-tumorous Definitions in Oncology. (part 2) Metaplasia: • Replacement of one type of normal adult differentiated cell type that is normally present, • by another normal adult differentiated type that belongs somewhere else. Usually in response to injury or irritation Reversible upon removal of the stimulus See “Reversible squamous metaplasia”, next slide) Dysplasia • Abnormal interaction of cells giving abnormal tissue development • Can be pre-neoplastic Reversible Squamous Metaplasia Normal Secretory & Ciliated Epithelial Cells Illustrating functional effect of ciliated vs non-ciliated cells Figure 16-19, ECB, 1998, p. 528 Ciliated Epithelium of Human Respiratory Tract RespCilia Progressive Steps in Neoplastic Cell Development: Hyperplasia and Dysplasia Progressive Steps in Neoplastic Cell Development: Cancer In situ and Invasive Cancer Progression in Neoplastic Development: Weinberg, Chapter 11 on Multistep Tumorigenesis. Figure 11.7 Figure 11.7 The Biology of Cancer (© Garland Science 2007) CIS = carcinoma in situ CIN = cervical intra-epithelial neoplasm DCIS = ductal carcinoma in situ PIN = prostatic intra-epithelial neoplasm The Next 3 Slides are Turning Point Quiz Questions You may not use any notes or electronic devices other than your NXT transmitter. No computers. No phones. No talking or consulting. Make sure that your desk is clear. These are graded quizzes that make up 40% of the overall course grade. They are designed for both you and me to determine whether you are paying attention and following what is going on. Response Counter Response Counter Classifications of Cancers 1. By Cellular Properties, and Histological Degree of Progression (Slides 14 – 16) 2. By Tissue Type and Site of Origin (Slides 17 to 21) Benign and Malignant Neoplasia Benign Neoplasm Generally Encapsulated Non-invasive Highly Differentiated Few Mitotic Figures Slow Growth or No Net Growth Little Anaplasia Non-Metastatic (by definition) Malignant Neoplasm Non-encapsulated Invasive Poorly Differentatied Mitotic Figures Common Can have rapid growth Relatively Anaplastic Metastatic or Capable of becoming so Definitions in Oncology. (part 3) Anaplasia: Irreversible loss of normal cell structure and function • Positional Anaplasia: Size, shape, arrangement, and overall organization of cells in a tissue are altered • Cytological Anaplasia: Intra-cellular structures (mitochondria, cytoskeletal elements, nuclear size and morphology) are altered Cancer: • Mass of cells with potentially unlimited growth, • serves no useful function for the host, • deprives the host of nutrients necessary for survival, • expands locally by invasion and systemically by • lymphatic and hematogenous pathways, • untreated progresses to lethal condition in the host See Slides 14, 16, 20 for Benign vs Malignant Sites of Origin for Primary Clinical Cancers Collection of 200 Different Clinical Diseases (See Diversity of Cancers in Folder Title:"Clinical" and Three Graphics Following) • • • • • • Different Symptoms Different Cell Type of Origin Different Histology Different Cell Products and Cell Markers Different Prognoses Different Therapy Cancer Incidence 2002: 1,285,000. Cancer Deaths 555,000. 43% Death Rate Cancer Incidence 2009: 1,479,000. Cancer Deaths 562,000 38% Death Rate Cancer Incidence 2014: 1,665,540. Cancer Deaths 585,720 35% Death Rate Why do we get cancers in these tissues & organs with these distributions? Why are cancers of some sites more deadly than cancers at other sites? Normal Proliferative Human Cells & Tissues Hematopoietic Pluripotent Stem Cells and Progenitor Cells Form Blood Cells: Red Blood Cells, Leucocytes, Megacaryocytes/Platelets Epithelial Linings • • • Respiratory epithelium Gastro-intestinal linings Genito-urinary tract Glandular Linings • Mammary gland Skin Ovary and Testis Bone Marrow Myoblasts Fetal Tissues Organ Hypertrophy Wound Healing Neurogenesis Brain Astrocytes/Glial Cells Classification by Tissue Type for Cell Type of Origin (Histogenetic Classification) Connective Tissue Sarcoma Hematopoietic Tissue Leukemia & Lymphoma Nervous tissue Neuroectodermal malignancies Germinal Tissue & Mixed Tissue Types Epithelial Tissue Carcinoma Classification of Cancer by Histogenetic Site of Origin Part 1: Connective Tissue Neoplasms Tissue of Origin Fibrous tissue Cartilege Bone Fat Smooth Muscle Skeletal Muscle Blood Vessels Benign Neoplasm Fibroma Chondroma Osteoma Lipoma Leiomyoma Rhabdomyoma Hemangioma Malignant Neoplasm Fibrosarcoma Chondrosarcoma Osteogenic Sarcoma Liposarcoma Leiomyosarcoma Rhabdomyosarcoma Hemangiosarcoma Sarcomas (Sarcomata) are malignant neoplasms of connective tissue origin. About 5% of all cancers in humans Carcinomas: Cancers of Epithelial Origin Classification of Cancer by Histogenetic Site of Origin Part 2: Epithelial Neoplasms Tissue of Origin Epidermis Stomach Adrenal cortex Surface Epithelium (Non-glandular) Glandular Epithelium Colon Breast Lung Benign Neoplasm Epidermal papilloma Gastric polyp Adrenocortical adenoma Papilloma Malignant Neoplasm Epidermal carcinoma Gastric carcinoma Adrenocortical carcinoma Squamous carcinoma Adenoma Adenocarcinoma Colon adenoma Mammary adenoma Lung adenoma Colon carcinoma Mammary carcinoma Lung carcinoma Carcinomas are malignant neoplasms of epithelial origin. About 85% of all cancers in humans! Table 2.1 The Biology of Cancer (© Garland Science 2007) p. 30 Histology of Normal Epithelial Tissue (1) Bronchiole of Lung Columnar Epithelium (Gall Bladder) Figure 2.4b The Biology of Cancer Figure 2.4c The Biology of Cancer (© Garland Science 2007) Histology of Normal Epithelial Tissue (2) Squamous epithelium Glandular Epithelium (stomach) Uterine cervix Skin Goblet Cell (Mucous-secreting) Columnar Epithelium, Small Intestine Figure 2.6a The Biology of Cancer (© Garland Science 2007) Figure 2.6c The Biology of Cancer (© Garland Science 2007) Adenocarcinoma(Stomach) Adenocarcinoma (Colon) Normal Glandular Epithelium Stomach Normal Columnar Epithelium, Small Intestine Figure 2.6d The Biology of Cancer (© Garland Science 2007) Neuroectodermal Malignancies Cancers of the nervous system Classification of Cancer by Histogenetic Site of Origin Part 4: Neoplasms of the Nervous System Tissue of Origin Brain glial cells Meninges Neurons Adrenal medulla Retina Benign Neoplasm Astrocytoma Oligodendroglioma Meningioma Ganglioneuroma Malignant Neoplasm Glioblastoma multiforme Pheochromocytoma Pheochromocytoma --- Retinoblastoma Meningeal sarcoma Neuroblastoma Neoplasms of the nervous system are generalized as Neuroectodermal malignancies comparable to carcinoma, sarcoma, or leukemia groupings. Part of the remaining 5% of all cancers in humans p. 34 Table 2.4 The Biology of Cancer (© Garland Science 2007) Neuroectodermal Neoplasm of Non-Neuronal Supporting Cells of Brain Astrocytes (Glial Cells) Astrocytoma (Glioblastoma), Glioblastoma Multiforme p. 35 Figure 2.9a The Biology of Cancer (© Garland Science 2007) To Here: Presentation 7, Tuesday, February 9, 2016 Cancers of Hematopoietic Origin Blood Cell Cancers; Leukemia, Lymphoma Classification of Cancer by Histogenetic Site of Origin Part 3: Hematopoietic and immune system neoplasms Benign Neoplasm Tissue of Origin Lymphoid tissue Infectious mononucleosis and Lymphocytes and other lymphoproliferative diseases Thymus Granulocytes Thymoma Granulocytosis Plasma Cells1 Erythrocytes Plasmacytoma (localized) Polycythemia vera 1 Antibody Malignant Neoplasm Lymphoma (lymphosarcoma) Lymphocytic leukemia (B and T Cell Leukemias) Reticulum cell sarcoma Hodgkin's Disease Thymoma Myelogenous leukemia (Granulocytic leukemia) Multiple Myeloma (dispersed) Erythroleukemia secreting B-cell. Neoplastic plasma cell secretes monoclonal antibodies or parts of monoclonal antibodies (BenceJones proteins) Leukemias and Lymphomas (Lymphosarcomas) About 5% of all cancers in humans Table 2.3 The Biology of Cancer (© Garland Science 2007) p. 33 Different Forms of Leukemias Acute (A) and Chronic (C) 3.4% of all forms of human cancers Lymphocytic 54% (32% CLL; 22% ALL) Also called "lymphoblastic" Myelocytic 37% (26% CML; 11% AML) Also called "granulocytic" or "myelocytic" Monocytic 9% (All acute) Erythroleukemia Rare (Red-Blood Cell Lineage) Morphology & Staining of Blood Cells Kuby, 3rd Ed. Figure 3-1 Hematopoiesis (formation of blood cells) Fig 2-1, Kuby 4th Ed. p. 28 Pluripotent Stem Cell and Lymphoid and Myeloid Lineages (Fig 2-1, Kuby 4th Ed. p. 28 Myeloid Stem Cell Lymphoid Lineage Fig 2-1 Kuby 4th Ed p. 28 Myeloid Lineage (Kuby, Fig 2-1, 4th Ed., p. 28) Disease Progression in Chronic Myelogenous Leukemia p. 293 Figure 8.32 The Biology of Cancer (© Garland Science 2007) Diagnostic Pathobiology of Hodgkins Disease vs Non-Hodgkins Lymphoma http://www.med-ed.virginia.edu/courses/path/innes/wcd/hodgkin.cfm (Double Click. Opens to Lymphoma) “Pathology” Link Opens to All of University of Virginia School of Medicine Clinical Pathology Pathology > Basic Hematology > White Cell Disorders > Lymphoma: Hodgkin Lymphoma (Part 1) Can Access Other Pathologies and Other Hematological Diseases University of Virginia, School of Medicine;Pathology Trends Non-Hodgkins Lymphoma Cells Derived from Lymphocyte, usually a B cell, Characterized by being binuclear. Presents “owl-like” appearance Non-Hodgkin’s Lymphoma Hodgkin’s Disease Hodgkin’s Disease, Early Onset The Next Three Slides are Turning Point Quiz Questions You may not use any notes or electronic devices other than your NXT transmitter. No computers. No phones. No talking or consulting. Make sure that your desk is clear. These are graded quizzes that make up 40% of the overall course grade. They are designed for both you and me to determine whether you are paying attention and following what is going on. Response Counter Response Counter Response Counter End of DefClass Presentation In the PBS Series of Cancer Videos that Follow on the next slide: View Leukemia View Non-Hodgkins Lymphoma PBS Series: secondopinion-tv.org Cancer Breast Reconstruction Treatment for breast cancer can be overwhelming, both physically and emotionally. While... Mammography The recent controversy over when—and how often—women should begin having mammograms has left a... 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While breast cancer in young women accounts for a... The Future of Cancer Treatment CML and Patient #9 in Gleevec Trial 1995 Cancer is the second leading cause of death in the United States. About one-half of all men and... Highlight. Right Click. Open Hyperlink The Next Slides are Turning Point Quiz Question Slides You may not use any notes or electronic devices other than your NXT transmitter. No computers. No phones. No talking or consulting. Make sure that your desk is clear. These are graded quizzes that make up 40% of the overall course grade. They are designed for both you and me to determine whether you are paying attention and following what is going on. Rank 1 Responses 2 3 4 5 6 0% 0% 1 2 0% 3 0% 4 0% 5 0% 6 Rank 1 Responses 2 3 4 5 6 0% 0% 1 2 0% 0% 3 4 0% 0% 5 6 Rank 1 2 Responses 3 4 5 6 0% 0% 1 2 0% 0% 3 4 0% 0% 5 6 Rank 1 2 3 4 5 6 Responses 0% 1 0% 2 0% 3 0% 4 0% 5 0% 6 Response Counter