NEOPLASIA
Dr.CSBR.Prasad, M.D.,

 Metaplasia
 Dysplasia
 Anaplasia
 Complication of chronic inflammation /
irritation

Clinical examples of Neoplasia

Nomenclature
 Neoplasia
 Neoplasm
 Tumor
 Oncology
 Clonal / Clonality
 Benign
 Malignant (Latin)
 Cancer

Neoplasia - Definition
Neoplasia = New growth
 Neo = New
 Plasia = Growth
 Tumor = Swelling
 Cancer = Crab (L)
 Oncology = Study of tumor / Neoplasm
(Oncos = Tumor)

Nomenclature
 Normal
 Abnormal
 Non neoplastic
 Hyperplasia
 Metaplasia
 Precancerous (dysplasia / in situ carcinomas)
 Neoplastic
 Benign
 Epithelial
 Mesenchymal
 Malignant
 Epithelial
 Mesenchymal

Cancer (L. Crab)
 Any malignant growth of cells (clonal)
 Nearly 7 lakh people die of cancer in
India (2015)
Gross features Microscopic features

Cancer (L. Crab)

Cancer (L. Crab)

The following figure shows how cancer cases have
been progressively increasing from 2004 to 2010

Definition
 “Willis” definition of Neoplasia - (new growth)
abnormal mass of tissue, the growth of which
exceeds and is uncoordinated with the normal
tissues and continues to grow even after the
cessation of the stimulus that evoked the
initial response
 New Definition: (Robbins Path) a neoplasm
can be defined as a disorder of cell growth
that is triggered by a series of acquired
mutations affecting a single cell and its clonal
progeny

Normal – Hyperplasia – Dysplasia – Carcinoma

Neoplasm
The causative mutations give the
neoplastic cells a survival and growth
advantage, resulting in excessive
proliferation that is independent of
physiologic growth signals
(autonomous)

Makes an interesting reading…

Neoplasia
 It is autonomous, purposeless
 Proliferation is uncontrolled
 Competes with normal cells for its needs
 It is a clonal disorder
 It is a genetic disorder
 In 95% of cases acquired genetic disorder
 In 5% of cases inherited

Nomenclature
 All tumors have two components
 Parenchyma
 Represents tumor proper; the growth of the tumor
is due to proliferation of these cells
 Stroma
 Provides the framework, blood supply and nutrition
for the parenchymal cells

Parenchyma
Stroma

Desmoplasia
 Formation of abundant collagenous stroma
 Stimulated by parenchymal cells
• Ex: Schirrous. ca of breast Linitus plastica
(ca stomach) Carcinoma prostate

Scirrhous carcinoma of breast

Scirrhous carcinoma of breast

Linitus plastica

Nomenclature
 Tumors are designated by attaching suffix “–oma”
to the cell or tissue of origin
 Fibroma, chondroma, lipoma, osteoma etc
 Benign tumor arising from glandular structure is called
adenoma
 Benign tumor arising from epithelial surface having finger
like projections is called papilloma
 Malignant tumor arising from epithelial tissue is called
Carcinoma
 Malignant tumor arising from mesenchymal tissue is
called Sarcoma

Papilloma / Polyp / Adenoma

Papilloma / Polyp / Adenoma
Pedunculated polyp
Sessile polyp

Papilloma / Polyp / Adenoma

Malignant
Tissue of Origin Benign
Composed of One Parenchymal Cell Type
Tumors of mesenchymal origin
Connective tissue and Fibroma Fibrosarcoma
derivatives
Liposarcoma
Chondrosarcoma
Osteogenic sarcoma
Lipoma
Chondroma
Osteoma
Endothelial and related tissues
Hemangioma
Lymphangioma
Blood vessels
Lymph vessels
Synovium
Mesothelium
Brain Coverings Meningioma
Angiosarcoma
Lymphangiosarcoma
Synovial sarcoma
Mesothelioma
Invasive
meningioma

Tissue of Origin Benign Malignant
Blood cells and related cells
Hematopoietic cells Leukemias
Lymphoid tissue Lymphomas
Muscle
Smooth Leiomyoma Leiomyosarcoma
Striated Rhabdomyoma Rhabdomyosarcoma

Tumors of epithelial origin
Stratified
squamous
Basal cells of skin
or adnexa
Epithelial lining of
glands or ducts
Squamous cell Squamous cell carcinoma
papilloma
Basal cell carcinoma
Adenoma Adenocarcinoma
Papilloma
Cystadenoma
Papillary carcinomas
Cystadenocarcinoma
Bronchogenic carcinoma
Respiratory
passages
Renal epithelium
Bronchial
adenoma
Renal tubular
adenoma
Renal cell carcinoma
Liver Cell
Urothelial cell
Adenoma
Papilloma
Hepatocellular carcinoma
Urothelial carcinoma

Placental epithelium Hydatidiform mole Choriocarcinoma
Testicular epithelium
(germ cells)
Seminoma
Melanocytic Tumors Nevus
Embryonal carcinoma
Malignant melanoma
More Than One Neoplastic Cell Type-Mixed Tumors, Usually Derived from
One Germ Cell Layer
Salivary glands Pleomorphic adenoma
(mixed tumor of salivary
origin)
Malignant mixed tumor
of salivary gland origin
Renal anlage Wilms’ tumor
More Than One Neoplastic Cell Type Derived from More Than One Germ
Cell Layer-Teratogenous
Totipotential cells in
gonads or in embryonic
rests
Mature teratoma, dermoid
cyst
Immature teratoma,
teratocarcinoma

Tissues with NO benign tumors
 Synovium
 Mesothelium
 Lymphoid tissue
 Hematopoietic cells
 Basal cells of skin or adnexa

Nomenclature
 Malignant tumor arising from epithelial
structures is called “Carcinoma”
 Malignant tumor of the mesenchymal
tissues is called “Sarcoma”
 Embryonal tumors usually have the suffix
“Blastoma”
 Malignant lesions of the blood are called
“Leukemia”
 Malignant lesions of the lymphoid tissue is
called “Lymphoma”

Neoplasms of
Totipotent Cells

Neoplasms of Embryonic
Pluripotent Cells
 Pluripotent cells can mature into several
different cell types
 These neoplasms are generally called
Embryomas or Blastomas

Blastoma
 All blastomas are childhood tumors
 All blastomas are malignant tumors
Except:
 Chondroblastoma
 Osteoblastoma
 Pulmonary blastoma

Neoplasms of pluripotent embryonic-type cells
(BLASTOMAs)

Nomenclature of Neoplasms of
Differentiated Cells

Exceptions to These Rules
 Neoplasms That Sound Benign But Are
Really Malignant
 Neoplasms That Sound Malignant But Are
Really Benign
 Leukemias
 Mixed Tumors
Whose Cell
o
f Origin Is
 Neoplasms
Unknown
Lymphoma
Plasmacytoma
Melanoma
Glioma
Astrocytoma
Osteoblastoma
Chondroblastoma

Nomenclature
 Some malignant tumors named like
benign tumors
 Melanoma, Hepatoma, Lymphoma
 Some benign tumors named like
malignant tumors
 Cystosarcoma phylloides, chondroblastoma
 Some unusual tumors
 Mixed tumor of salivary gland (pleomorphic
adenoma)
 Teratoma

Mixed tumor
 Tumors with single type of
parenchymal cells that differentiates
into many cell lines
–Eg: Pleomorphic adenoma of
salivary gland.

Pleomorphic adenoma - Parotid

Teratoma
 Tumor arising from totipotent cells (germ
cells) showing differentiation towards
tissues derived from all the three germ cell
layers
 Seen usually along the midline
 Common sites
 Ovary, testis, sacro-coccygeal region, retro-
peritoneum, mediastinum, base of the brain etc

What are the common sites for teratomas ?
 Gonads
 Mid line
 Lines of fusion

Along the lines of fusion

Neoplasms of
Totipotent Cells

Sacrococcygeal teratoma

Teratoma

Teratoma

Named tumors

Hamartomas & Choristomas
 A hamartoma is composed of tissues that are
normally present in the organ in which the tumor
arises
 Eg: a hamartoma of the lung consists of a
disorganized mass of bronchial epithelium and
cartilage that may become so large that it presents as
a lung mass. Its growth is coordinated with that of the
lung itself
 A choristoma resembles a hamartoma but
contains tissues that are not normally present in
its site of origin
 Eg: A orderly mass of pancreatic acini and ducts in
the wall of the stomach is properly called a
choristoma.

Sarcomas are very vascular
-local rise of temperature

Hamartoma
• Definition - Jumbled mixture of tissue native to
the site / organ
• Eg: Hamartoma of lung

Choristoma
•
•
Definition – Normal organized tissue at an abnormal
site (ectopic rest of normal tissue)
Eg: adrenal cells under kidney capsule, pancreas in
stomach

A wrong decision
Johannes Fibiger
Nobel prize winner in 1926
Katsusaburo Yamagiwa

In 1915 Drs. Koichi Ichikawa
and Katsusaburo Yamagiwa of
the Hokkaido University, Japan
painted coal tar on the ears of
101 rabbits every 2 or 3 days.

In 1775, Dr. Percivall Pott, a British surgeon,
reported one of the earliest observations on
environmental / occupational cancer

Two common
cancers in
our country
in India, cancers of
lung and mouth in
men and cervix and
breast in women are
the biggest killers

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