UTHSC Fall 2022 D2 Par 3 Pathology
Neoplasia
New growth
Neoplasm
An abnormal mass of tissue, the growth of which exceeds and is uncoordinated with
that of the normal tissues and persists in the same excessive manner after cessation of
the stimuli which evoked the change
Tumor and neoplasm are (antonym/synonym)
synonym
hyperplasia
increase in number of cells
Tumor
originally applied to the swelling caused by inflammation, now equated with neoplasm.
Oncology
study of tumors or neoplasms
Neoplasms origin
• Epithelial
• Mesenchymal
Neoplasms Biologic Behavior
• Benign
• Malignant
when is a tumor said to be benign?
when its gross and microscopic appearances are considered relatively innocent,
implying that it will remain localized, will not spread to other sites, and is amenable to
local surgical removal
how are benign tumors designated in vocabulary?
by attaching the suffix -oma to the name of the cell type from which the tumor originates
what do epithelial neoplasms arise from?
surface linings or glands
Adenoma
a benign tumor of glands
Polyp
a mass arising on an epithelial surface, not necessarily a neoplasm, such as nasal
polyp
Papilloma
a polyp with finger-like projections due to a benign neoplastic epithelial hyperplasia
Benign Mesenchymal Neoplasms Nomenclature
Suffix "-oma"
- Generally named for the neoplastic cell type
- Examples: lipoma, fibroma, leiomyoma
- Exceptions:
Malignant: Melanoma, lymphoma, multiple myeloma, mesothelioma, seminoma
- Inflammatory (benign): Granuloma, hematoma
T/F The following terms have specific definition and not all considered as a
benign neoplasm:
- Teratoma
,- Hamartoma
- Choristoma
True
Teratoma
A tumor containing recognizable mature or immature cell or tissues belonging to more
than one germ cell layer (and sometimes all three)
- Originates from totipotential germ cells
what germ layer does a teratoma originate from?
totipotential germ cells
Hamartoma
A focal malformation, composed of excessive and disorganized tissue elements
normally found at that site
Choristoma
- A heterotopic rest of cells or tissue
Examples: a small nodule of well-developed and normally organized pancreatic tissue
found in the stomach
Malignant Neoplasms
- Referred to as cancers
- Malignant tumors can invade and destroy adjacent structures and spread to distant
sites (metastasize) to cause death
Carcinoma
• Cancer arising from epithelial cells
• Squamous cell carcinoma, basal cell carcinoma
Sarcoma
• Cancer arising from connective tissue elements
• Osteosarcoma, fibrosarcoma
characteristics of a benign tumor
- intact skin surface
- expansile growth
- capsule
- homogenous cut surface
characteristics of a malignant tumor?
- ulceration of skin
- invasive growth
- inhomogeneous cut surface
- necrosis
- hemorrhage
- vessel invasion
- lymphatic invasion
what are the distinguishing features between benign and malignant tumors?
- Cell characteristics
- Rate of growth
- Local invasion
- Metastasis
tumor with cells that closely resemble normal cells designate a
(benign/malignant) tumor
,benign
a tumor with cells that are irregular in shape and size and do not completely
resemble normal cells designate a (benign/malignant) tumor
malignant
Differentiation
The extent to which neoplastic cells resemble the normal cells in the tissue of origin,
morphologically and functionally
Atypia
Structural abnormality in a cell
Anaplasia
lack of differentiation, a hallmark of malignancy
(Benign/Malignant) tumors, usually well-differentiated
Benign
(Benign/Malignant) tumors, showing cellular atypia and wider spectrum of
differentiation
Malignant
what is the spectrum of differentiation from least to most differentiated?
- Well differentiated
- Moderately differentiated
- Poorly differentiated
- Undifferentiated (Anaplastic)
Benign tumor characteristics
Intact skin surface
Expansile growth
Capsule
Homogenous Cut surface
malignant tumor characteristics
Invasive growth
Ulceration of skin
Lymphatic invasion
Inhomogenous cut surface
Necrosis
Hemorrhage
Vessel invasion
Histopathologically, malignant tumors demonstrate
cellular atypia
Features of Cellular Atypia
- Pleomorphism (variation in cell size and shape, tumor giant cells)
- Increased nucleus/cytoplasm ratio
- Abnormal nuclear morphology; nuclear hyperchromatism (darker in color)
- Prominent nucleoli
- Mitoses (increased number and presence of atypical mitotic figures)
- Loss of polarity
Dysplasia
- Literally means "disordered growth"
- Principally in epithelia
, - Constellation of changes including loss of uniformity of the individual cells and loss of
their architectural orientation
Metaplasia
One differentiated cell type (epithelial or mesenchymal) is replaced by another cell type.
The most common: columnar to squamous
what is the most common metaplasia?
columnar to squamous
T/F Epithelial metaplasia , double-edged sword and, in most circumstances
persistent epithelial metaplasia (columnar to squamous, seen in the lung), may
initiate malignant transformation (dysplastic changes).
True
Hyperkeratosis
Thickening of the skin caused by a mass of keratinocytes
Hyperplasia
increase in number of cells
dysplasia is a precursor of a (benign/malignant) process
malignant
Dysplasia is a "______________" lesion
premalignant
Mild Epithelial Dysplasia
Cellular atypia seen in the basal and parabasal cell layers of the epithelium
Moderate Epithelial Dysplasia
Cellular atypia seen from the basal layer to the midportion of the spinous layer
Severe Epithelial Dysplasia
Cellular atypia seen from the basal layer to a level above the midpoint of the epithelium
Carcinoma in Situ
Cellular atypia seen in the entire thickness of the epithelium
Invasive Carcinoma
Cells have invaded the basement membrane using collagenases and hydrolases
(metalloproteinases). Cell to cell contact is lost due to inactivation of E-cadherin.
Local Invasion of benign tumors
• Grow as cohesive expansile masses, remained localized to their site of origin
• Lack of capacity to infiltrate, invade, or metastasize to distant sites
Local Invasion of Malignant tumors
Infiltration, invasion, and destruction of the surrounding tissue
Metastasis
- The spread of a tumor to sites that are physically discontinuous with the primary tumor
(distant sites)
- As an unequivocal hallmark of a malignant tumor
- Benign neoplasms do not metastasize.
- Exceptions: glioma (malignant tumor in the CNS) and basal cell carcinoma (skin)
rarely metastasize
what is the unequivocal hallmark of a malignant tumor?
Metastasis
T/F benign neoplasms can metastasize
False
Neoplasia
New growth
Neoplasm
An abnormal mass of tissue, the growth of which exceeds and is uncoordinated with
that of the normal tissues and persists in the same excessive manner after cessation of
the stimuli which evoked the change
Tumor and neoplasm are (antonym/synonym)
synonym
hyperplasia
increase in number of cells
Tumor
originally applied to the swelling caused by inflammation, now equated with neoplasm.
Oncology
study of tumors or neoplasms
Neoplasms origin
• Epithelial
• Mesenchymal
Neoplasms Biologic Behavior
• Benign
• Malignant
when is a tumor said to be benign?
when its gross and microscopic appearances are considered relatively innocent,
implying that it will remain localized, will not spread to other sites, and is amenable to
local surgical removal
how are benign tumors designated in vocabulary?
by attaching the suffix -oma to the name of the cell type from which the tumor originates
what do epithelial neoplasms arise from?
surface linings or glands
Adenoma
a benign tumor of glands
Polyp
a mass arising on an epithelial surface, not necessarily a neoplasm, such as nasal
polyp
Papilloma
a polyp with finger-like projections due to a benign neoplastic epithelial hyperplasia
Benign Mesenchymal Neoplasms Nomenclature
Suffix "-oma"
- Generally named for the neoplastic cell type
- Examples: lipoma, fibroma, leiomyoma
- Exceptions:
Malignant: Melanoma, lymphoma, multiple myeloma, mesothelioma, seminoma
- Inflammatory (benign): Granuloma, hematoma
T/F The following terms have specific definition and not all considered as a
benign neoplasm:
- Teratoma
,- Hamartoma
- Choristoma
True
Teratoma
A tumor containing recognizable mature or immature cell or tissues belonging to more
than one germ cell layer (and sometimes all three)
- Originates from totipotential germ cells
what germ layer does a teratoma originate from?
totipotential germ cells
Hamartoma
A focal malformation, composed of excessive and disorganized tissue elements
normally found at that site
Choristoma
- A heterotopic rest of cells or tissue
Examples: a small nodule of well-developed and normally organized pancreatic tissue
found in the stomach
Malignant Neoplasms
- Referred to as cancers
- Malignant tumors can invade and destroy adjacent structures and spread to distant
sites (metastasize) to cause death
Carcinoma
• Cancer arising from epithelial cells
• Squamous cell carcinoma, basal cell carcinoma
Sarcoma
• Cancer arising from connective tissue elements
• Osteosarcoma, fibrosarcoma
characteristics of a benign tumor
- intact skin surface
- expansile growth
- capsule
- homogenous cut surface
characteristics of a malignant tumor?
- ulceration of skin
- invasive growth
- inhomogeneous cut surface
- necrosis
- hemorrhage
- vessel invasion
- lymphatic invasion
what are the distinguishing features between benign and malignant tumors?
- Cell characteristics
- Rate of growth
- Local invasion
- Metastasis
tumor with cells that closely resemble normal cells designate a
(benign/malignant) tumor
,benign
a tumor with cells that are irregular in shape and size and do not completely
resemble normal cells designate a (benign/malignant) tumor
malignant
Differentiation
The extent to which neoplastic cells resemble the normal cells in the tissue of origin,
morphologically and functionally
Atypia
Structural abnormality in a cell
Anaplasia
lack of differentiation, a hallmark of malignancy
(Benign/Malignant) tumors, usually well-differentiated
Benign
(Benign/Malignant) tumors, showing cellular atypia and wider spectrum of
differentiation
Malignant
what is the spectrum of differentiation from least to most differentiated?
- Well differentiated
- Moderately differentiated
- Poorly differentiated
- Undifferentiated (Anaplastic)
Benign tumor characteristics
Intact skin surface
Expansile growth
Capsule
Homogenous Cut surface
malignant tumor characteristics
Invasive growth
Ulceration of skin
Lymphatic invasion
Inhomogenous cut surface
Necrosis
Hemorrhage
Vessel invasion
Histopathologically, malignant tumors demonstrate
cellular atypia
Features of Cellular Atypia
- Pleomorphism (variation in cell size and shape, tumor giant cells)
- Increased nucleus/cytoplasm ratio
- Abnormal nuclear morphology; nuclear hyperchromatism (darker in color)
- Prominent nucleoli
- Mitoses (increased number and presence of atypical mitotic figures)
- Loss of polarity
Dysplasia
- Literally means "disordered growth"
- Principally in epithelia
, - Constellation of changes including loss of uniformity of the individual cells and loss of
their architectural orientation
Metaplasia
One differentiated cell type (epithelial or mesenchymal) is replaced by another cell type.
The most common: columnar to squamous
what is the most common metaplasia?
columnar to squamous
T/F Epithelial metaplasia , double-edged sword and, in most circumstances
persistent epithelial metaplasia (columnar to squamous, seen in the lung), may
initiate malignant transformation (dysplastic changes).
True
Hyperkeratosis
Thickening of the skin caused by a mass of keratinocytes
Hyperplasia
increase in number of cells
dysplasia is a precursor of a (benign/malignant) process
malignant
Dysplasia is a "______________" lesion
premalignant
Mild Epithelial Dysplasia
Cellular atypia seen in the basal and parabasal cell layers of the epithelium
Moderate Epithelial Dysplasia
Cellular atypia seen from the basal layer to the midportion of the spinous layer
Severe Epithelial Dysplasia
Cellular atypia seen from the basal layer to a level above the midpoint of the epithelium
Carcinoma in Situ
Cellular atypia seen in the entire thickness of the epithelium
Invasive Carcinoma
Cells have invaded the basement membrane using collagenases and hydrolases
(metalloproteinases). Cell to cell contact is lost due to inactivation of E-cadherin.
Local Invasion of benign tumors
• Grow as cohesive expansile masses, remained localized to their site of origin
• Lack of capacity to infiltrate, invade, or metastasize to distant sites
Local Invasion of Malignant tumors
Infiltration, invasion, and destruction of the surrounding tissue
Metastasis
- The spread of a tumor to sites that are physically discontinuous with the primary tumor
(distant sites)
- As an unequivocal hallmark of a malignant tumor
- Benign neoplasms do not metastasize.
- Exceptions: glioma (malignant tumor in the CNS) and basal cell carcinoma (skin)
rarely metastasize
what is the unequivocal hallmark of a malignant tumor?
Metastasis
T/F benign neoplasms can metastasize
False
