Transfusion Pathology

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Neoplasia I Tumor Nomenclature
Kristine Krafts, M.D. October 5, 2009
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Why do we need a lecture about neoplasia?

• To understand patients better
• To understand oral neoplasms better
• To nail the neoplasia questions on boards
• This lecture covers
• the nature of benign and malignant neoplasms
• how neoplasms start and grow
• Later lectures will cover
• the nature of specific neoplasms
• how these neoplasms affect the patient

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Neoplasia Outline

• Tumor nomenclature
• Tumor characteristics
• Epidemiology
• Cancer pathogenesis

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Neoplasia Outline

• Tumor nomenclature
• Definitions
• Benign tumors
• Malignant tumors
• Mixed tumors
• Confusing terms

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Neoplasia Outline

• Tumor nomenclature
• Definitions

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Definitions

• Neoplasm mass of tissue that grows excessively,
  and keeps growing even if you remove the stimulus
  that started it off!
• Tumor neoplasm
• Benign tumor innocent-acting tumor
• Malignant tumor evil-acting tumor

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Cancer Latin for crab
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Definitions
Benign Tumors
Malignant Tumors

• Small
• Slow-growing
• Non-invasive
• Well-differentiated
• Stay localized

• Large
• Fast-growing
• Invasive
• Poorly-differentiated
• Metastasize

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Definitions
Benign Tumors
Malignant Tumors

• Small
• Slow-growing
• Non-invasive
• Well-differentiated
• Stay localized

• Large
• Fast-growing
• Invasive
• Poorly-differentiated
• Metastasize

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Definitions
The only indisputable quality of malignancy is
metastasis!
Benign tumors CANNOT metastasize malignant
tumors CAN.
If it is metastatic, it MUST BE malignant.
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Benign vs. Malignant
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Neoplasia Outline

• Tumor nomenclature
• Definitions
• Benign tumors

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Benign Tumors

• Usually designated by adding -oma to cell type
• adenoma benign tumor arising from glandular
  cells
• leiomyoma benign tumor arising from smooth
  muscle cells
• chondroma benign tumor arising from
  chondrocytes
• Other benign tumor names
• papilloma has finger-like projections
• polyp projects upward, forming a lump
• cystadenoma has hollow spaces (cysts) inside

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Thyroid adenoma
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Thyroid adenoma
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Thyroid adenoma
Normal thyroid
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Leiomyoma
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Chondroma
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Oral papilloma
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Oral papilloma
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Head
Stalk
Colon polyp
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Colon polyp
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Colon polyp
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Ovarian cystadenoma
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Ovarian cystadenoma
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Ovarian cystadenoma
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Neoplasia Outline

• Tumor nomenclature
• Definitions
• Benign tumors
• Malignant tumors

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Malignant Tumors

• Carcinomas arise in epithelial tissue
• adenocarcinoma malignant tumor of glandular
  cells
• squamous cell carcinoma malignant tumor of
  squamous cells
• Sarcomas arise in mesenchymal tissue
• chondrosarcoma malignant tumor of chondrocytes
• angiosarcoma malignant tumor of blood vessels
• rhabdomyosarcoma malignant tumor of skeletal
  muscle cells

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Adenocarcinoma
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Squamous cell carcinoma
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Chondrosarcoma
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Angiosarcoma
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Rhabdmyosarcoma
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Neoplasia Outline

• Tumor nomenclature
• Definitions
• Benign tumors
• Malignant tumors
• Mixed tumors

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Mixed Tumors

• Mixed tumors show divergent differentiation
• Examples
• pleomorphic adenoma glands fibromyxoid stroma
  
• fibroadenoma glands fibrous tissue
• Not to be confused with teratomas

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Pleomorphic adenoma
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Neoplasia Outline

• Tumor nomenclature
• Definitions
• Benign tumors
• Malignant tumors
• Mixed tumors
• Confusing terms

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Confusing Terms

• Malignant tumors that sound benign
• lymphoma
• mesothelioma
• melanoma
• seminoma
• Non-tumors that sound like tumors
• hamartoma mass of disorganized indigenous
  tissue
• choristoma heterotopic rest of cells
• Names that seem to come out of nowhere
• nevus
• leukemia
• hydatidiform mole

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Nomenclature
Neoplasm
Benign
Malignant
Carcinoma
Sarcoma
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Nomenclature
Neoplasm
Benign
Malignant
adenoma angioma rhabdomyoma
Carcinoma
Sarcoma
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Nomenclature
Neoplasm
Benign
Malignant
Carcinoma
Sarcoma
squamous cell carcinoma adenocarcinoma
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Nomenclature
Neoplasm
Benign
Malignant
Carcinoma
Sarcoma
angiosarcoma rhabdomyosarcoma
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Know these names!
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Sample board question

• Which of the following describes a benign
  tumor arising from skeletal muscle?
• A. Leiomyoma
• B. Papilloma
• C. Rhabdomyoma
• D. Leiomyosarcoma
• E. Rhabdomyosarcoma

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Sample board question

• Which of the following describes a benign
  tumor arising from skeletal muscle?
• A. Leiomyoma
• B. Papilloma
• C. Rhabdomyoma
• D. Leiomyosarcoma
• E. Rhabdomyosarcoma