- new growth from autonomous or uncontrolled proliferation as a result of genetic mutations

- resulting mass is neoplasm

Neoplasia

- originally result of swelling due to inflammation

- now used interchangeably with neoplasm

Tumor

- invade surrounding tissue, metastisize

Cancer

- associated with chronic irritation and explains cancers arising from cells not normally found in that site

Metaplasia

- one of the most common types of lung cancer

- results from smoking-related metaplasia from columnar to squamous cell, then dysplasia, carcinoma-in-situ, and invasive carcinoma

Invasive squamous cell carcinoma

- this infection changes endocervical columnar epithelium to squamous epithelium which can then progress to dysplasia, carcinoma-in-situ, and invasive squamous cell carcinoma

Human papilloma viral infection

- this can cause invasive adenocarcinoma following gastric glandular epithelium metaplasia in the esophagus

Chronic gastric reflux

- this allows neoplastic cells to experience additional mutations that can alter tumor's behavior

Genetic instability

- this characteristic of tumors allows for increasing mutational experimentation and survival

Large population of tumor cells

- refers to the degree of differentiation of neoplasms

- low-->intermediate-->high/well-->moderately-->poorly differentiated

- degree of malignancy usually predicted by this

Grade of neoplasms

- cellular and nuclear pleomorphism (size and shape)

- hyperchromatic staining or hyperchromasia (more DNA)

- increased nuclear/cytoplasmic ratio (larger nuclei)

- prominent nucleolus or nucleoli

- increased mitotic activity

- disorganized growth

Grade or anaplasia determinants

- tumor growth measured by this

Doubling time

- cancers grow faster not because of a shorter cell cycle, but because of this

- fewer cells lost to permanent terminal maturation

Cell production > Cell loss (apoptosis)

- description of the extent of spread of a neoplasm

- I-IV (low->high)

- TNM (size, number of lymph node, metastases)

Stage

- causes fewer bridges between cells which anchor through cells' plasma membranes

Down regulation of epithelial cadherin

- membrane attachment sites under the plasma membrane

- unbound or free can induce cellular proliferation

Catenins

- expression of these from the immunoglobulin supergene family correlates with aggressiveness of neoplasms

- associated with binding of malignant cells to ECM

ICAM (intercellular adhesion molecule) and VCAM (vascular cell adhesion molecule)

- bind to basement membrane and/or matrix proteins laminin and fibronectins

- in malignancy, transmembrane molecules for signal conduction are increased and initiate penetration of BM by secretion of proteolytic enzymes that degrade matrix

Integrins

- activates plasmin

- proteinase used to break through BM by malignant neoplasm

Serine proteinase

- Serine proteinase, collagenase (type IV-BM, type I-stroma), Cysteine proteinase (cathepsin B)

Proteinases released by malignant cells

- this is the result of fibroblast activation in malignant cells

- accompanied by type I collagenase production

- can create retraction in breast cancer

- deposition of abundant collagen

Desmoplastic reaction

- pseudopodia of tumor cells rich in receptors (laminin/fibrinectin) that assist in migration of tumor cells into the degraded zone of ECM are caused by this

Autocrine motile factor (AMF)

- invasion of blood or lymphatic vessels

- transport by embolization or mechanical means

- lodging and growth in new location (angiogenesis)

Steps in formation of metastases

- most important angiogenic factors

- produced by tumor cells directly or benign stromal cells in response to signals from tumor cells

VEGF (vascular endothelial growth factor) & bFGF (basic fibrobalst growth factor

- anti-angiogenic factor that is lost sometimes during metasteses

thrombospondin-1

- metastases utilize glucose (altered glycolysis) in a way that requires more glucose than normal cells

- 2:1 ATP: glucose ration instead of 20:1

- direct aerobic glycolysis

- can be used with CT/PET scan to detect increased uptake

Walburg effect

- proliferating malignant cells of the neoplasm

Parenchyma

- benign supporting framework of CT and blood vessels of neoplasms

- derived from non-neoplastic cells

Stroma

- histogenesis (cell of origin) or parenchymal component

- behavior (benign or malignant)

Classification of neoplasms

- primary suffix for benign neoplasms

-oma

- primary suffix for malignant neoplasms

-carcinoma or -sarcoma

- lymphoma, mesothelioma, melanoma, seminoma

Exceptions to benign/malignant suffix rule

- malignancies of epithelial cells (w/ BM)

- spread via lymphatic channels

- -in-situ is w/o invasion, invasive- has penetrated BM

- may be of ectodermal (skin/brain), mesodermal (kidney/endometrium), or endodermal (gut) origin

Carcinoma

- benign/malignant neoplasm of stratified squamous epithelium

Squamous papilloma/Squamous cell carcinoma

- malignant neoplasm of basal cells of skin

Basal cell carcinoma

- benign/malignant neoplasm of transitional epithelium

Transitional papilloma/Transitional cell carcinoma

- benign/malignant neoplasms of glandular or ductal cells

Adenoma/Adenocarcinoma

Papilloma/Papillary adenocarcinoma