Neoplasia

Neoplasia

1. Definition

   • Neoplasm
     • Uncontrolled cell proliferation leading to mass or nodule
     • non reactive to stimuli
     • PUPAP
       • Parasitic
       • Uncontrolled
       • Purposeless
       • Autonomous
       • Progressive
   • Tumour
     • lump or mass of any cause
   • Hyperplasia
     • controlled cell proliferation
     • reactive to stimuli
   • Benign
     • cannot metastasize
   • Malignant
     • have ability to metastasize

2. Classification

   • Primary
     • Benign
       • Micro
         • Nuclear features
           • Pleomorphism
           • Hyperchromasia
           • High mitotic index
           • High Nuclear/cytoplasm ratio
         • Architectual
           • disruption of architecture
           • loss of maturation
       • Macro
         • Well circumscribed
         • Often encapsulated
         • Rarely
           • Haemorrhage
           • Necrosis
       • Epithelium
         • Squamous
           • Papilloma
         • Glandular
           • Adenoma
         • Transitional
           • Transitional/Urothelial Papilloma
       • Connective tissue
         • Fat
           • Lipoma
         • Nerve
           • Neuroma
         • Vessel
           • Angioma
         • Cartiledge
           • Chondroma
       • Behaviour
         • grow
         • not metastasize
         • CoDeath
           • blood loss
         • Local spread
     • Malignant
       • Micro
         • Loss of Maturation
         • Hyperchromasia
         • Mitoses
         • High N/C ratio
         • Pleomorphism
       • Surg non curative
         • Add chemo
       • Type
         • Common
           • Carcinoma
           • Lymphoma
           • Leukemia
           • Sarcoma
           • Malignan Melanoma
         • Uncommon
           • Mixed Neoplasm
           • Carcinosarcoma
           • Embryonic Neoplasm
           • Germcell neoplasm
           • Glial Neoplasm
       • Macro
         • Haemorrhage
         • Necrosis
         • Invasion
     • Borderline
       • nuclear features suggest malignancy
         • unsure
   • Secondary (Metastasis)

3. Clinical Presentation

   • Benign
     • Lump
     • Bleeding
       • Heamatemasis
       • Haemoptysis
       • Malaena
       • Per vagina
       • Fe deficiency anemia
     • Mass effect
       • Cerebral stroke
       • GIT obstruction
       • Prostatic Outflow
     • Pain
   • Malignant
     • Effect of primary
       • Mass
       • Bleeding
         • Haematemasis
         • Haemoptysis
         • p.v
         • p.r
         • Malaena
         • Fe def anemia
       • Obstruction
       • Loss of Fx
     • Effect of metastasis
       • Same as primary
     • Hormone Production
       • ACTH from small cell ca
         • Cushing syndrome
       • Estrogen from testicular tumour
         • Gynaecomastia
     • Paraneoplastic
       • Peripheral neuropathy
       • Dermatomyositis
     • General effects
       • Weight loss
       • Fatigue
       • Anorexia
       • Lassitude