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Tumors

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Chemical
Physical
Viruses
Heritable genetic damage
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Viral-genetic
Physico-chemical
Dysontogenetic (result of
embryonic primordia
dytopia during
embryogenesis
Polyetiological
Онкоген –
Протоонкоген – нормальный ген, который
ген стимулирующий
при условиях мутации может
злокачественный рост трансформироваться в онкоген
Антионкоген – ген блокатор онкогена
«De novo»
Without previous
damage
Staging development of tumor
Facultative
Degeneration
Atrophy
Chronic inflammation
Obligate
Dysplasia
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Autonomous growth– lack of control over proliferation and differentiation of
cells
Macroscopical changes
Microscopical changes
Atypism
Secondary changes in tumors
Metastasis
Infiltrative (invasive)
Expansive
 Grows from itself,
pushing the
surrounding tissues
 Formation of
pseudocapsule
 Mostly benign tumors
 Growth into
surrounding tissues
with destroing
 Fast growth
 Malignant tumors
Apposition
 Neoplastic
transformation of
normal cells into the
the tumor cells
 Desmoid tumors
Depending from the lumen of organ
Exophytic
 Expansive growth of
tumor in the lumen of
organ
Unicentral
Endophytic
 Infiltrative growth of
tumor in the wall of
organ
Multycentral
Depending from the amount of tumor primary foci
Parenchyma of tumor
Stroma of tumor
Desmoplastic reaction
Organoid tumors
(look like organ due to presence of
parenchyma and stroma)
Hystioid tumors
(undifferentiated tumors) – prevalence
of parenchyma, stroma contain thin
walls vessels and capillaries
Morphological
• tissue
•cellular
Histological
investigation
Biochemical
Metabolic
changes of cell
Histochemical
investigation
Antigen
Changes of
surface active
antigens
IHC
investigation
Functional
Changes of
functional activity
of tissue or organ
Clinical
diagnosis
Polymorphism (different shape and size) or monomorphism
of cells and nucleus
Necrosis, hemorrhages, ulceration, petrification, sliming etc.
The formation of secondary foci of tumor growth (metastasis) as a result
of spreading neoplastic cells from primary tumor to other tissues
Metastasis
Hematogenous
Intracanalicular
Implantation
Lymphogenous
Mix
Benign
Tumors with local destructive growth
(Bordeline tumors)
Malignant
Benign tumors=name of tissue in latin or greek +
suffix “oma”.
Excluding: lymphoma, seminoma, melanoma.
 Malignant epithelial tumors = name of tissue in
latin or greek + «carcinoma».
 Malignant mesenchymal = name of tissue +
«sarcoma».
 Tumor arising from the germ cells– «teratoma».
 Tumor arising from fetal tissue or their
derivates– «blastoma»
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 Small size incapsulated well demarcated
formation compressing surrounding tissues
 Expansive slow growth without invasion
 Secondary changes rare, more often
petrification, sliming
 Mature cells and very similar to normal
tissue cells
 Organoid
 Tissue atypism
 Possible malignization
 Rare metastasis
 Do not recur
 Large size due to invasive growth with
unclear borders
 Destructive fast growth
 Secondary changes are common, more
often necrosis, bleeding
 The degree of differentiation of cells
may be different, but the cells do not
reach full maturity
 Cellular atypism
 Metastasis
 Recur
Local
 Local effect of the primary
tumor or metastases
(compression, destruction
of the surrounding tissues
and organs)
General
Cachexia
Paraneoplastic
syndrom
 Nonspecific reactions from the
various organs and systems, or
ectopic production of biologically
active substances by tumor
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Endocrinopathy (producing
of different hormones by the
tumor)
Neurological manifestations
Skin manifestations –
acanthosis nigricans
(hyperpigmentation of
armpits, neck, anal area)
Hematological apperances
(hypercoagulation, anemia,
thrombocytopenia)
Epithelial tumors without
specific localization
(non-organic specific)
Tumors of exo- and
endocrine glands and
epithelial integument
Tumors of melaninproducing tumors
Tumors of the nervous
system and brain
membranes
Tumors of the blood system
Mesenchymal tumors
Teratomas
The degree of
malignancy
G1 – low-grade tumors – usually
well-differentiated tumors with
minimally pronounced;
G2 – intermediate grade tumors–
moderately differentiated;
G3 – high-grade– poorly
differentiated tumors with
pronounced signs of cellular
atypism
Stage of the tumors
process
Determined by:
 Degree of intergrowth (invasion)
of the primary tumor node in the
organ and the surrounding
tissues;
 Severity of the metastatic
process.
Used classification TNM (tumor –
опухоль, nodulus – узел,
methastases – метастазы)
Т – size and spreading;
N – metastasis in regional
lymphnodes;
M – di8stant metastases
Non-organospecific
tumors
Benign
 Papilloma
 Adenoma
Malignant
 Carcinoma in situ
 Squamous cell carcinoma
with keratinization or
nonkeratinizing
 Adenocarcinoma
 Mucinous (colloid)
 Solid (trabecular)
 Smallcell (scirrous)
 Largecell
 Ringcell
 Medullar(adenogenic)
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Macro: round shape formation, hard or soft on consistency. Papillary
surface located on wide or narrow base.
Micro: constructed from cells, expanding cover epithelium, the
number of its layers is increased. Tissue atypism - uneven
development of the epithelium and stroma and excessive formation
of small vessels. Cellular atypism is absent..
Location: skin and mucous membranes covered by transitional or
squamous nonkeratinizing epithelium.
Outcomes: inflammation, bleeding, malignization.
Prognosis: favorable in case of adequate surgical removal.
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Macro: well demarcated nodule soft on consistency. On cut surface
– white-pink, with formation of cyst in some cases.
Micro: consists of cells prismatic or cubic epithelium, forming
glandular formations, sometimes with papillary outgrowths. The
relationship between glandular structures and the tumor stroma is
different. There is no cellular atypism.
Location: parenchymatous organs (liver, kidney, endocrine
organs).
Outcomes: inflammation, bleeding, malignization.
Prognosis: favorable in case of adequate surgical removal.
Fibroadenoma
Adenomatous polyp
Tubular adenoma
Acinar adenoma
Papillary adenoma
Carcinoma in situ
 The form of cancer without
invasive growth, but with
marked atypism and cell
proliferation with
pathological mitoses
 Tumor growth within the
epithelial bed without
transition to the underlying
tissue
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It consists of strands of atypical epithelial cells, growing into the
underlying tissues, destroying them and forming clusters in them.
It subdevided into keratinizing (formation of “carcinomatous
pearls” and nonkeratinizing squamous-cell carcinoma.
Location: skin and mucous membranes covered by transitional or
squamous epithelium.
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Adenogenous tumor (tumor cells form a glandular formation,
growing into surrounding tissues), but has a pronounced cellular
atypism.
Adenocarcinoma subdevided into three types: acinar (prevalence
of acinar structures), tubular (tubular structures) and papillary.
Location: prismatic epithelium of mucous membranes and
glandular organs.
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Adenogenic carcinoma, whose cells have signs of
morphological and functional atypism - perverted
formation of mucus.
The tumor has the slimy appearance or colloidal mass
with single atypical cells
Undifferentiated cancer
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Undifferentiated cancer or anaplastic tumor
It consists of monomorphic lymphocyte-like cells that do not form
any structures with a large number of pathological mitoses;
stroma is extremely scarce.
Common necrotic changes
It is used IHC to determine immunophenotype of tumor
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Undifferentiated cancer which consist from polymorphous
hyperchromic cells with numerous mitosis.
High-grade tumor with early metastasis.
Location: common in stomach, lungs.
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Undifferentiated carcinoma, which consist from cell containing
mucus, and nucleus pushed to cellular membrane.
Cytoplasm of these cells stain in crimson color in PAS-reaction.
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Undifferentiated cancer with extremely atypical hyperchromic cells
located among strata and strands of coarse-fiber connective
tissue.
High-grade tumor with early metastasis.
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Undifferentiated cancer with a significant predominance of the
parenchyma over the stroma.
The tumor is soft, pale pink, resembles brain tissue (cerebral
cancer)
It consists of layers of atypical epithelial cells, contains numerous
mitoses
Location: mammary and thyroid glands.
Follicular
Papillary
Anaplastic
Medullary
Anaplastic
Small-cell carcinoma
13%
Non-Small-cell carcinoma
87%
Squamous cell
carcinoma
Carcinoid
Adenocarcinoma
Large-cell
carcinoma
Adeno-squamous
carcinoma
Cancer of
bronchial glands
Immunophenotype of
metastase of
adenocarcinoma of lungs
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