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L36 - Pathology Growth DisordersGrowth disorder = tissue/cell growing…
L36 - Pathology Growth Disorders
Growth disorder = tissue/cell growing beyond the size which it is supposed to grow
- Understand common terminology of the various growth disorders and how this relates to biological behaviour
- Understand principles of how tumours are classified based on macroscopic, microscopic and genetic features
- Understand how tumours may spread throughout the body
- Understand general principles of diagnosis and treatment of neoplasms
- Understand principles of diagnostic techniques that might be used in clinical management
- Understand the principles behind development of neoplastic disease
- Describe how tumours may transform from benign to malignant
- Understand interactions between genetic and environmental factors in the development of neoplasms
- More details of pharmacological treatment of neoplasms
Dysplasia
"Disordered growth"
- Demonstrates nuclear atypia, nuclear lesion which is atypical and architectural abnormalities
- Often an endpoint of chronic stress
- Associated with embryology (abnormal development of a organ)
- May arise in normal, hyperplastic or metaplastic epithelium
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Neoplasia
A type of abnormal and excessive growth of tissue, arising from a clonal proliferation of cells, reflecting underlying cellular and genetic abnormalities.
Normal growth = poly-clonal prolif. abnormal = mono-clonal
Benign
Latin = "well formed"
Typically na,ed after tissue type
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Generally these are not fatal - but may cause harm through mass effect (benign tumours in the brain)
They themselves do not have capacity to be fatal, but their size might obstruct usual processes
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Malignant
"tending to cause death"
Cancer is actually latin for crab, and cancers are referred to as malignant tumours
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Nomeclature
Mass - An Aggregate of Tissue
- Names often end in -oma
- Naming usually reflects the cells making up the mass
- All neoplasms are masses, but not all masses are neoplasms
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Tumour - Latin for "swelling"
- Almost always means a neoplasm
- Yet not all swellings are neoplasms.
E.g. Hydrocoele, hernia, lymphoedema, inflammatory pseudotumour, abscess
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Components of a neoplasm
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Reactive Stroma (Connective tissue)
- Desmoplasia = formation of abundant fibrous stroma by invasive tumour
- Angiogenesis = New blood vessels, critical in formation of aid growing factors and metastases
Core Cancer Concepts
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Tumours that can be benign in some patients but malignant in others
E.g. Teratomas (mutations in pluripotent germline cells. Malig. in men, Benign in women)
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Pathways of Spread
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Transcoelomic
Direct seeding through body cavities (peritoneum)
- Commonly seenwith gastric, ovarian etc.
Nomeclature
Malignant Tumours of Epithelial Origin
- Tissue + carcinoma
Fibrosarcoma
Malignant Tumours of Mesenchymal Origin
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Recognising Malignancy
Nuclear Features
1. Atypia
- Pleomorphism (Variation in shape)
- Nuclear hyperchromasia
- Nucleoli
- Nucleo/cyto-megaly
- Anisonucleosis (Irregular nuclear outlines)
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Tissue
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Abnormal architecture
(polyps, lost polarity)
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Organism Features
Local Effects
Shorness of breath, pathological fracture
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Paraneoplastic syndromes
(hormonal substances produced when features of endocrine tissue are grown by tumours)
Molecular Features
Presence or absence of genetic fingerprints
I.e. Identifiable genetic mutations (often nowadays these are defining the type of tumour
Diagnosis
- Clinical signs& symptoms
- Histopathology
- Imaging
- Immunopathology
- Cancer markers (biopsy)
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Differentiation and Anaplasia
Differentiation = extent to which neoplasms resemble normal cells from which they proliferated
Anaplasia = Total loss of differentiation
- Poorly differentiated => tend to behave worse
- Lose differentiation over time
Hernia, this is displaced intestines which may be retunred back to their approximate place
Accessory Spleen
Lipoma (benign)
Keratosis
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Adenoma with Low Grade Dysplasia
Adenoma with High Grade Dysplasia
Appeared as though a crab had clawed at the breast
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