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PULSE: Unraveling Neoplasia

Emma Matosyan

Created on April 6, 2024

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Unraveling Neoplasia: Growth, Diagnosis, and Treatment

PATHOLOGY 3500Team 33

Diagnosis

Staging & Grading

Neoplasia

New and abnormal growth of tissue → malignant or benign

Imaging: Reveales inernal structures with a visual image.

Grading

Based on mitotic index and cellular differentiation.

  • How similar does it look to the normal tissue?
  • Low-grade and well-differentiated tumors look like normal cells

CT

Computed Tomography

MRI

Magnetic Resonance Imaging

PET

Position Emission Tomogtaphy

Biopsy: Used for histological confirmation

  • This is a procedure where a sample of tissue (or tumor) is removed from the body for examination under the microscope.

VS

Malignant Neoplasia

Benign Neoplasia

Staging

Uncontrolled cellular proliferation and have the ability to metastasize. Malignant tumors are considered invasive, cancerous and can be life-threatening.

Tend to be localized, well-differentiated, and are unable to invade surrounding tissues or metastasize to distant sites

Describes the extent of disease using the TNM system (Tumor, Node, Metastasis)

Blood Tests: Look for tumor markers

  • Some blood tests are designed to identify certain tumor markers, which are substances that might be present within the blood in higher quantities when cancer is present.
  • One example of this is the prostate-specific antigen (PSA) test for prostate cancer

Quiz

TNM System

Types of Malignancies

Types of Benign Tumors

Predisposing Factors

Treatment

Radiation

Chemotherapy Drugs

Surgical Intervention

Genetics

Radiation will target and destroy a cancer cells DNA in order to prevent the cells from dividing, thus “killing” the tumor.

Age

Chemotherapy is the administration of drugs, either on their own or in combination, which aims to kill cancer cells.

Geographic Factors

The main goal with surgical treatment of cancer is to remove the tumor at an early stage before it has spread to other parts of the body

Envoronmental Factors

TNM Staging

  • T1 invades superficial vs T4 invades all the way through (worst)
  • N stage increases as lymph node invasion occurs
    • N0 = no invasion
  • M0-M1
    • M0 = no spread, and M1 = spread to other sites
  • T, N,M together gives us a stage
Explanation

A) Leiomyosarcoma: Leiomyosarcoma is a subtype of sarcoma arising from smooth muscle cells, not glandular epithelial tissue.B) Squamous cell carcinoma: Squamous cell carcinoma originates from squamous epithelium and does not involve glandular epithelial tissue. C) Adenocarcinoma (Correct): Adenocarcinoma is a subtype of carcinoma that arises from glandular epithelial tissue, such as the colon, lung, or breast. It retains some functional aspects of the glandular cells it originates from, as indicated in the provided information. D) Papilloma: Papilloma is a benign epithelial tumor with frond-like or papillary structures, unrelated to glandular epithelial tissue.

Also a malignant tumor but comes from epithelial cells → able to invade surrounding tissues and metastasize

Carcinoma

Malignant tumor from mesenchymal cells such as connective tissues e.g. bones, cartilage, and muscle

Sarcoma

Leiomyosarcoma

Adenocarcinoma

Subtype of sarcoma from smooth muscle cells → found where smooth muscle is present e.g. blood vessels, uterus, gastrointestinal tract.

Subtype of carcinoma that comes from glandular epithelial tissue → seen in organs like the colon, lung and breast. Keeps some functional aspects of the glandular cells it originates from

Eyelid, Kaposi sarcoma

Lung primary small cell carcinoma

Bile duct, Adenocarcinoma

Squamous Cell Carcinoma

Subtype of carcinoma from squamous epithelium that can be found in the skin, esophagus, and other organs. Will see keratinization and the presence of intercellular bridges

Uterus, Leiomyosarcoma

Cervix, squamous cell carcinoma

  • Less common than carcinomas but highly malignant

Think of "Sarcoma" starting with "S," which you can associate with "S" for "Soft tissues" or "Supporting tissues" like bones, cartilage, and muscle (mesenchymal cells). You can remember that sarcomas are less common but highly malignant, so you might associate the "S" in "Sarcoma" with "Scarcity" and "Severity."

One memory trick to differentiate between sarcomas and carcinomas is to associate each with its respective cell origin:

Remember that "Carcinoma" starts with "C," which can stand for "Covering" or "Coating," relating to epithelial cells that form linings or coverings in the body. You can associate carcinomas with the ability to "C" for "Crawl" (invade) into surrounding tissues and "C" for "Colonize" (metastasize) to other parts of the body.od vessels, uterus, gastrointestinal tract.

Remember: Sarcomas vs Carcinomas

Benign epithelial tumor that arises from glandular structures.

Adenoma

Benign epithelial tumor with frond-like or papillary structures projecting from the surface

Papiloma

Breast, sclerosing papilloma
Appendix, sessile serrated adenoma
  • Often keep some functional aspects of the gland they originate from like adenocarcinomas do

Remember: Adenoma vs Adrnocarcinoma arcinoma

To differentiate between adenoma and adenocarcinoma, you can use the memory trick "Benign keeps the origin, malignant maligns it."

Adenoma (Benign)

Adenocarcionma (Malignant)

  • "Benign keeps the origin": Adenoma is a benign epithelial tumor that arises from glandular structures and often retains some functional aspects of the gland they originate from.
  • Think of it as "Adeno" (from gland) + "oma" (benign tumor).
  • Example: Adenoma in the colon retains some functional aspects of colon glands.
  • "Malignant maligns it": Adenocarcinoma is a subtype of carcinoma that arises from glandular epithelial tissue.
  • Adenocarcinoma is malignant and often loses the normal function of the gland.
  • Example: Adenocarcinoma in the colon, lung, or breast is aggressive and disrupts the normal function of these organs.

This is an interactive Infographic. Navigate through the poster by clicking on icons, buttons, and images for more information and details. Test your knowledge with embedded quizzes, and gain helpful mnemonics and study tips. Happy Learning!

Localized Well-differentiated Unable to invade Remember LIM

Benign

Metastasize Invasive Life-threatening Remember MIL

Malignant

VS

Environmental Factors

Smoking Increases the risk for lung cancer Certain jobs such as; painting, construction, and petroleum have increased risk of cancer due to exposure to certain carcinogenic agents at work (Parsa, 2012).

Age

Cancer rirsk tends to increase with age People have more time to accumulate cancerous mutations the more they age

Genetics

You can have a genetic predisposition to cancer making it more likely to develop the cancer Example: BRCA genes in breast cancer

Geographic Factors

Skin cancer rates are higher in regions with intense sun exposure

The main goal of surgical treatment of cancer is to remove the tumor at an early stage before it has spread to other parts of the body.

  • During this procedure, the surgeon will remove the cancer tissue, along with some normal tissue around it.
  • This is done to ensure that there are no cancer cells left behind, which lowers the chance of recurrence.Surgery is often done in combination with other treatments

Chemotherapy works by targeting cells that are rapidly growing and dividing, such as cancer cells. However, as a side-effect, chemotherapy also targets normal cells that naturally tend to grow and divide quicker, such as hair cells. This leads to the hair loss that we see with patients on chemotherapy. Chemotherapy can be used alone, or in conjunction with other treatments such as surgery and radiation therapy. It can be used before a surgery in order to shrink the tumor, or after a surgery to destroy any remaining cancer cells.

Radiation treatments are conducted daily, which means that the cancer cells do not have enough time to repair themselves as they are continuously being destroyed. This radiation is produced artificially by machines. However, it is difficult to destroy cancer cells without also destroying some normal cells as well which leads to some unwanted side-effects, though normal cells often recover better than cancer cells.

An MRI produces detailed images of internal structures in the human body (John Hopkins Medicine, 2023). This can indicate a tumors possible shape, size and location.

A CT scan shows detailed image of any part of the body, including bones, muscles, organs, and blood vessels (John Hopkins Medicine,2023). CT can be used to detect cancer in any part of the body (locations, size and shape of tumor).

A PET Scan provides information about how an organ or system in the body is working (Rao, 1998). Can be used in cancer as it detects areas of cell growth. Additionally, more radioactive material will collect in cancer cells, which will cause them to appear brighter on the image (Canadian Cancer Society).

Staging

Grading

"S" for Spread

"G" for Growth

VS