Transcript Definitions and Classifications in Neoplasia

Definitions and Classifications
in Neoplasia
Folder: DefClass(NoTP)
Updated: February 11, 2015
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
To Here Presentation 7, Feb. 3, 2015
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
Classifications of Cancers
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
Sites of Origin for Primary Clinical Cancers
Collection of 200 Different Clinical Diseases
(See Diversity of Cancers in Folder Title:"Clinical" and
Two 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
Bronchiole of
Lung
Figure 2.4b Te Biology of Cancer
Columnar Epithelium (Gall Bladder)
Figure 2.4c The Biology of Cancer (© Garland Science 2007)
Squamous epithelium
Uterine cervix
Skin
Figure 2.6a The Biology of Cancer (© Garland Science 2007)
Glandular Epithelium (stomach)
Goblet Cell
(Mucous-secreting)
Columnar Epithelium, Small Intestine
Figure 2.6c The Biology of Cancer (© Garland Science 2007)
Adenocarcinoma(Stomach)
Adenocarcinoma (Colon)
Glandular Epithelium Stomach
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
Pheochromocytoma
---
Malignant Neoplasm
Glioblastoma multiforme
Meningeal sarcoma
Neuroblastoma
Pheochromocytoma
Retinoblastoma
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)
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
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)
Classification of Cancers based on Tissue Type or Cell Type
Source of Origin (Histogenic Classification)
Classification by Site of Origin
Slides 20 to 48
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
Sites of Origin for Primary Clinical Cancers
Collection of 200 Different Clinical Diseases
(See Diversity of Cancers in Folder Title:"Clinical" and
Two Graphics Following)
•
•
•
•
•
•
Different Symptoms
Different Cell Type of Origin
Different Histology
Different Cell Products and Cell Markers
Different Prognoses
Different Therapy
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
See Slides 14, 16, 20 for Benign vs
Malignant
Diagnostic Pathobiology of Hodgkins Disease
vs
Non-Hodgkins Lymphoma
http://www.med-ed.virginia.edu/courses/path/innes/wcd/hodgkin.cfm
(Right Click. Click on Open Hyperlink)
University of Virginia, School of Medicine;Pathology Trends
Derived from Lymphocyte, usually a B cell,
Characterized by being binuclear.
Presents “owl-like” appearance
Incidence
Early onset; 2nd age-related risk
later in life
PBS Series: secondopinion-tv.org
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Highlight. Right Click. Open Hyperlink
Surgical Excision of Regional Lymph Nodes in Breast Cancer
(ABC News: February 8, 2011
http://abcnews.go.com/Health/BreastCancerCenter/earlystage-breast-cancer-care/story?id=12870356
http://abcnews.go.com/Health/BreastCancerCenter/early-stage-breast-cancer-care/story?id=12870356
(Copy & paste to Mozilla Firefox)
Neuroblastoma in a Little Boy
(Viewed in Class in 501Intro)
William Bunn: 8-Year-old Police Officer
July, 2010
http://abclocal.go.com/wtvd/story?section=news/local&id=7531763
- 2 minutes and 32 seconds
http://www.msnbc.msn.com/id/26184891/vp/38084943#38084943
1 1/2 minutes - actual funeral
Refers to Stem Cell Transplants and Chemotherapy
for Neuroblastoma in final 5 seconds of clip
Also viewed story of Kuyler Van Nocker and Neuroblastoma
First-hand experiences with cancer incidence
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a step-brother or sister) has been or is a
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I have a child or a niece or nephew who is
or has been a cancer patient.
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