neoplasia
Table of Contents
neoplasia / cancer / tumours
see also:
- specific tissue tumours:
benign neoplasia
epithelial:
- Papillomata (surface epithelia):
- sessile
- pedunculated (polyps)
- villous
- Squamous cell skin, tongue, larynx, anus (ie. where stratified sq. epith.)
- acanthosis: incr. thickness of prickle cell layer
- hyperkeratosis: incr. amt of adherent keratin
- parakeratosis: retention of nuclei of desq. keratinised cells;
- Transitional cell urinary passages, esp. bladder - usually villous;
- usually regarded as malignant & reported as so (recur, etc);
- Columnar cell colon (villous papilloma not the tubular adenoma), breast ducts;
- Adenomata (solid glandular tissue):
- dense masses of acini (except endocrine - solid groups of cells only)
- acini lined by either columnar or cuboidal shaped cells;
- if in glands that open to surface → pedunculated polyps;
- may secrete XS hormones (eg APUD-cell tumours, etc);
- Cystadenoma variant with elaborate cystic spaces - esp. ovary;
- Fibroadenoma variant with XS CT stroma (esp. breast)
- hard pericanalicular CT type
- soft intracanalicular CT type
- cystosarcoma phyllodes - myxoid stroma (breast)
connective tissue
- Fibroma many sites eg. skin, stomach, ovary;
- Myxoma uncommon, resembling Wharton's jelly: atrium, jaw;
- Myoma
- Leiomyoma sm. muscle (uterus, arrector pili, b.v) - commonest tumours!
- Rhabdomyoma striated muscle (incl. heart) - v.uncommon, esp. tub.sclerosis;
- Nerve Sheath:
- Neurofibroma
- Schwannoma (also called neurinoma or neurilemmoma);
- Meningioma
- Lipoma
- Giant-cell tumour of bone:
- Chondroma/Synovioma
- Osteoma
- Mesothelioma
- Carotid-body tumour
fetal/embryonic & germ cell
- Teratoma consists of multiple tissues foreign to part; ovary > testes;
- Hydatidiform mole trophoblastic;
- Ganglioneuroma
malignant neoplasia
types and characteristics
- usually indicated by pleomorphism, mitoses ± invasion b.memb;
epithelial (Carcinoma)
- stroma well formed usually; early lymph. spread; esp → liver;
- Squamous-cell from strat.squam. epith. (or from epith. undergone sqam. metaplasia);
- neo_dermal, oropharyngeal cancer, oesophageal cancer, anus, ectoCx, lung cancer, bladder cancer, GB, stomach cancer;
- if differentiation good → epithelial pearls form;
- Basal cell actually of intermediate behaviour;
- Transitional cell urinary passages; well-diff. → anaplastic; +/- squamous change;
- Glandular
- graded by:
- tubule formationn; regularity size/shape/stain nuclei, mitoses;
- stromal reactions alter appearance:
- scirrhous - hard, fibrotic (most breast Ca & many GIT);
- eg. linitus plastica; annular/purse-string of colon;
- medullary/encephaloid - little stroma → soft
- eg. breast Ca in lactation; cauliflower of caecum;
- adenocarcinoma - best differentiated - has tubules;
- carcinoma simplex - no attempt at central cavitation to produce acini (breast)
- anaplastic carcinoma - sheet of loosely attached cells
- giant cell carcinoma
- squamous metaplasia of adenocarcinoma
- signet-ring cell carcinoma - much mucus in cell
connective tissue malignant neoplasia(Sarcoma)
- more rapid growth; mainly blood-borne spread → lungs esp.
- poorly formed stroma; more radioresistant than Ca;
- Fibrosarcoma
- Neurofibrosarcoma
- Liposarcoma
- Leiomyosarcoma
- Rhabdomyosarcoma
- Chondrosarcoma
- Osteosarcoma
- Malig. mesothelioma
- Angiosarcoma
- Malig. meningioma
- Malig. melanoma - cutan.; mucosal; uveal; meningeal; adrenal;
lymphomata et al
- Hodgkin's
- Non-Hogkin's
- Multiple myeloma
- Leukaemia
fetal/embryonic & germ cell malignant neoplasia
- Choriocarcinoma trophoblastic, secreting HCG;
- Nephroblastoma (Wilm's) infancy/childhood;
- Retinoblastoma definite hered. incidence; infants;
- Malignant Teratoma young-middle age adults;
- Seminoma/Dysgerminoma older age gp than teratomas;
- Medulloblastoma 4th ventricle; mainly young children;
- Neuroblastoma adrenal medull or symp. ganglia; infancy;
- Hepatoblastoma very rare;
- Chordoma/Craniopharyngioma - rare
characteristics of malignant tumours
- invasiveness (eg. through basement membrane)
- metastasise - see neoplastic spread
- rapid increase in size usually more than benign tumours;
- cell cycling time usually N. but incr. no. of cells in mitosis & may be incr. time spent in mitosis;
- irregularity of size, shape & staining of nuclei due to:
- synthesis of DNA prior to division → nuclear enlargement & hyperchromatism;
- formation of aneuploid & polypoid cells as abnormal mitoses;
- less similarity with normal tissue than benign tumours as abn. differentiation;
- anaplasia is where little or no normal differentiation seen on microscopy;
- giant cells may be present in certain tumours, if anaplastic, or if adverse conditions;
effects of malignant tumours
- Mechanical pressure & obstruction
- Tissue Destruction:
- usual mode of death; infiltrate tissues;
- Haemorrhage:
- surface epith. Ca ulcerate; large arteries may be eroded;
- Secondary infection:
- ulcerative Ca; obstructed lumens;
- Starvation:
- direct by obstructing food intake; malabsorption;
- Pain:
- usually late;
- Haematological disorders:
- anaemia:
- bleed; malabs.; marrow replacement;
- neutrophil leukocytosis common;
- Cachexia:
- starvation; infection; liver involvement; serous effusions;
- Immunologic effects:
- esp. Hodgkin's, MM, CLL, & terminal cancers;
- Neuropathic effects:
- esp. lung, stomach, breast & ovary (without metast. effect!)
- Myopathic effects:
- esp. oat-cell lung; breast, colon; visceral → dermatomyositis;
- Dermatological effects:
- acanthosis nigrans - stomach, pancreas, lung;
- recurrent HZ - lymphoma due to decr. cell-med. immunity;
- Thrombotic complications:
- thrombophlebitis migrans - pancreas, lung, stomach;
- Afibrinoginaemia: rare: usually in prostate Ca;
- Hormonal:
- own hormones APUD-cell, endocrine tumours
- non-endo. tumour
- ACTH (-like) - oat cell; islet-cell; med.thyr.; breast;
- ADH - oat-cell
- insulin - mesothelioma, liver;
- TSH-like - hydat.mole, chorioCa,
- erythropoietin-like - renal Ca;
- Hypercalcaemia:
- extensive osteolytic mets; PGE2; PTH-like;
- Pulmonary osteoarthropathy:
- lung, fibrous mesothelioma; (& in ch.supp.dis. lung)
neoplasia.txt · Last modified: 2021/10/25 02:03 by gary1