General Pathology

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General Pathology

• Basic Principles of Cellular and Organ Pathology
• Oncology - II

Jaroslava Dušková Inst. Pathol. ,1st Med.
Faculty, Charles Univ. Prague
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General Oncology - I

• Disorders of the cell proliferation and growth
  (hypertrophy, hyperplasia, metaplasia)
• Neoplasms disorders of cell proliferation and
  differentiation
• Molecular biology of neoplasia - oncogenesis
• Host - neoplasm interactions

General Oncology - II

• Biology of the neoplastic growth
• Precanceroses ( pseudotumours)
• Classification of the neoplasms
• Methods of tumour diagnostics
• Neoplasm prognostification

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General Oncology - II

• Biology of the neoplastic growth
• Precanceroses ( pseudotumours)
• Classification of the neoplasms
• Methods of tumour diagnostics
• Neoplasm prognostification

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NEOPLASIA classification

• BEHAVIORAL
• benign
• borderline
• malignant

histological vs. clinical behaviour
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NEOPLASIA growth

• benign expansive
• borderline - locally destructive
• malignant infiltrative
• METASTASES

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Clinical manifestation of neoplasms

• Benign
• no
• mass (palpable or visible on imaging)
• compression
• obstruction
• pressure
• bleeding
• hormonal production

• Malignant
• no
• mass
• pressure
• bleeding
• hormonal production
• destruction
• inflammatory response
• distant metastases

• Borderline

combined!
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Metastasis

• Def.
• development of secondary tumour foci in the
  distant places

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Metastases - pathways

• seeding (body cavities)
• lymphatic spread
• hematogenous spread cellular embolism!!!

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Invasion Metastasis - steps

• Invasion into the extracellular matrix - ECM
• dyscohesion of cells loss of E-cadherine
• ECM degradation proteolytic enzymes
• migration
• epithelio-mesenchymal conversion
• ameboid migration or
• groups
• Angioinvasion esp. into newly formed vessels
• Extravasation local factors promoting or
  inhibiting the subsequent growth
• tropism
• late metastases

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NEOPLASIA macroscopy

• whittish/grayish mass
• yellow nodule lipoma, clear cell kidney
  carcinoma, adrenocortical adenoma
• red nodule hemangioma
• brown nodule nevocellular nevus, melanoma, pigm.
  basalioma
• organ enlargement leukemia
• organ consolidation ( superficial ulceration)
  tongue carcinoma
• organ softening necrosis glioblastoma
• branched outgrowth papilloma, villous
  adenoma
• cystic (cystopapillary) cystadenoma, ca

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NEOPLASIA histological architecture

• solid
• glandular
• papillary cystopapillary
• dissociated

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NEOPLASIA cytology

• Benign similar to nonneoplastic
• Malignant cellular pleomorphism
• NUCLEAR FEATURES
• hyperchromasia (polyploidy, aneuploidy)
• rough chromatine structure
• irregular nuclear outline
• large and/or multiple nucleoli
• !or undifferentiated monotonous cellularity!

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General Oncology - 2

• Biology of the neoplastic growth
• Precanceroses ( pseudotumours)
• Classification of the neoplasms
• Methods of tumour diagnostics
• Neoplasm prognostification

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Pseudotumors

• Definition
• - pathological lesions of different
  etiology masquerading real neoplasms

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Pseudotumors

• cysts
• pseudocysts
• deposits of pathol. material
• (gout, ganglion, amyloid)
• inflammatory pseudotumors (tuberculoma)
• hyperplasia (esp. nodular)
• embryonal development disturbance
  (choristia, hamarcia)

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Precanceroses (preblastomatoses)

• most pseudotumorous processes with
  dysplasia features
• dysplastic lesions looking not like tumours
  (SIL, intest. metaplasia with dysplasia)

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Nonneoplastic Growth Disturbances II

• repair
• hypertrophy / atrophy
• hyperplasia
• metaplasia
• dysplasia
• anaplasia undifferentiation

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Dysplasia

• Definition
• - disturbance of cell growth, maturation,
  architecture
• (frequently, but not always preneoplastic
  condition)

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PSEUDOTUMORS and PRECANCEROSES
(preblastomatoses)

• precanceroses

• pseudotumors

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Diagnosis early less complicated therapy

• pseudotumors
• clinical
• morphological

• precanceroses
• screening
• morphological

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General Oncology - II

• Biology of the neoplastic growth
• Precanceroses ( pseudotumours)
• Classification of the neoplasms
• Methods of tumour diagnostics
• Neoplasm prognostification

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NEOPLASIA classification

• HISTOGENETIC
• mesenchymal
• epithelial
• neuroectodermal
• mixed
• germ cell, teratoma, choriocarcinoma
• mesothelioma

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General Oncology - I

• Disorders of the cell proliferation and growth
  (hypertrophy, hyperplasia, metaplasia)
• Neoplasms disorders of cell proliferation and
  differentiation
• Molecular biology of neoplasia - oncogenesis
• Host - neoplasm interactions

General Oncology - II

• Biology of the neoplastic growth
• Precanceroses ( pseudotumours)
• Classification of the neoplasms

• General Oncology - III
• Methods of tumour diagnostics
• Neoplasm prognostification
• Prediction of the response to the therapy