Definition Neoplasia Process of new growth Neoplasm A

Definition of Neoplasm § "A neoplasm is an abnormal mass of tissue, the growth

Nomenclature - Benign Tumor § Suffix -oma to the parenchymal cell of origin §

Nomenclature - Malignant Tumor § Sarcomas (Greek sar = fleshy): arising in mesenchymal tissue

Nomenclature – Mixed Tumor § Composed of more than one neoplastic cell type §

Nomenclature – Teratoma § Composed of more than one neoplastic cell type § Derived

Objectives of Cancer Staging § To aid the clinician in planning treatment § To

TNM System of Cancer Staging § AJCC/UICC § Regular update § T Primary tumor

Tumor Grade § G 1 Well differentiated § G 2 Moderately differentiated § G

Differentiation § Extent to which neoplastic cells resemble comparable normal cells, both morphologically and

Laboratory Diagnosis of Cancer § Histologic and cytologic methods § Immunohistochemistry § Molecular diagnosis

Histologic Methods § Benign/malignant vs gray zone § Clinical data Mucinous adenoca. vs postchemoradiation

Cytologic Method § Less invasive, more rapidly performed § Lowered cohesiveness and anaplasia of

§ George Papanicolaou, Greek physician and anatomist in the United States (1883 - 1962)

Immunohistochemistry § Categorization of undifferentiated malignant tumors § Categorization of leukemias & lymphomas §

Molecular Diagnosis § Diagnosis of malignant neoplasms § Prognosis of malignant neoplasms § Amplification

Diagnosis of Malignant Neoplasms § TCR gene and Ig heavy chain gene rearrangement in

Flow Cytometry § Identification of cell-surface antigens § Classification of leukemias and lymphomas §

Tumor Markers § Not primary modalities for the diagnosis of cancer but § §

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Definition § Neoplasia : Process of "new growth" § Neoplasm : A new growth § Tumor = Neoplasm § Oncology (Greek oncos = tumor): Study of tumors or neoplasia § Cancer : Common term for all malignant tumors § Originated from Latin for crab

Definition of Neoplasm § "A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change. " British oncologist Willis § Clonality § Heritable genetic alterations Autonomous growth

Nomenclature - Benign Tumor § Suffix -oma to the parenchymal cell of origin § Fibroma, chondroma, osteoma etc. § Adenoma § Benign epithelial neoplasm forming glandular patterns § Tumors derived from glands § Papilloma, cystadenoma, papillary cystadenomas § Polyp: Macroscopically visible projection above a mucosal surface

Nomenclature - Malignant Tumor § Sarcomas (Greek sar = fleshy): arising in mesenchymal tissue § fibrosarcoma, liposarcoma, leiomyosarcoma § Carcinoma: epithelial cell origin § adenocarcinoma, squamous cell carcinoma § According the organ of origin (renal cell carcinoma) § Poorly differentiated or undifferentiated malignant tumor

Nomenclature – Mixed Tumor § Composed of more than one neoplastic cell type § Derived from one germ cell layer § Mixed tumor in salivary gland Pleomorphic adenoma § Wilms tumor from renal anlage

Nomenclature – Teratoma § Composed of more than one neoplastic cell type § Derived from more than one germ cell layer

Objectives of Cancer Staging § To aid the clinician in planning treatment § To give some indication of prognosis § To assist in evaluating the results of treatment § To facilitate the exchange of information § To contribute to the continuing investigation of human cancer

TNM System of Cancer Staging § AJCC/UICC § Regular update § T Primary tumor size/extent § N Regional lymph node involvement § M Distant metastasis absent/present § p. TNM, c. TNM, yp. TNM

Tumor Grade § G 1 Well differentiated § G 2 Moderately differentiated § G 3 Poorly differentiated § G 4 Undifferentiated § Low grade (G 1 and G 2) § High grade (G 3 and G 4)

Differentiation § Extent to which neoplastic cells resemble comparable normal cells, both morphologically and functionally § Anaplasia § Pleomorphism § Abnormal nuclear morphology: hyperchromasia, high N/C ratio § Mitosis and abnormal mitosis § Loss of polarity

Laboratory Diagnosis of Cancer § Histologic and cytologic methods § Immunohistochemistry § Molecular diagnosis § Flow cytometry § Tumor markers

Histologic Methods § Benign/malignant vs gray zone § Clinical data Mucinous adenoca. vs postchemoradiation status

Cytologic Method § Less invasive, more rapidly performed § Lowered cohesiveness and anaplasia of the cancer cells § Fine needle aspiration § Breast, LN, thyroid § Exfoliative cytology § Pap smear § Body fluid, bronchial brushing, sputum, urine

§ George Papanicolaou, Greek physician and anatomist in the United States (1883 - 1962)

Immunohistochemistry § Categorization of undifferentiated malignant tumors § Categorization of leukemias & lymphomas § Determination of site of origin of metastatic tumors § Detection of molecules that have prognostic or therapeutic significance

Molecular Diagnosis § Diagnosis of malignant neoplasms § Prognosis of malignant neoplasms § Amplification of the N-MYC gene & del(1 p) in neuroblastoma § Detection of minimal residual disease § Diagnosis of hereditary predisposition to cancer § MSI, BRCA 1, BRCA 2, RET § DNA microarray analysis and proteomics

Diagnosis of Malignant Neoplasms § TCR gene and Ig heavy chain gene rearrangement in lymphoma § BCR-ABL transcripts in CML § Round blue cell tumors in children § t(11; 22)(q 24; q 12) in Ewing sarcoma

Flow Cytometry § Identification of cell-surface antigens § Classification of leukemias and lymphomas § Aneuploidy § Poorer prognosis in early-stage breast cancer, carcinoma of the urinary bladder, lung cancer, colorectal cancer, and prostate cancer

Tumor Markers § Not primary modalities for the diagnosis of cancer but § § § § support of diagnosis Response to therapy and indicator to relapse CEA in colorectal (60 -90%), pancreatic (50 -80%), gastric and breast (25 -50%) ca. AFP in HCC, NSGCT, colon, pancreas, lung & stomach PSA, PSMA in prostate cancer CA-125 in ovarian cancer CA 19 -9 in colon and pancreatic ca. APC, RAS & p 53 in stool with colorectal ca. P 53 in urine with bladder ca.