NEOPLASMA

Oleh: Tri Sumarni

• Kanker adalah pertumbuhan sel abnormal yang cenderung
menyerang jaringan di sekitarnya dan menyebar ke organ tubuh lain
yang letaknya jauh.
• Karsinoma adalah kanker jaringan epitel, termasuk sel kulit, testis,
ovarium, payudara, pancreas, kolon, esophagus.
• Limfoma adalah kanker jaringan limfe yang mencakup pembuluh
limfe, kapiler limfe.
• Sarkoma adalah kanker jaringan ikat, termasuk sel-sel yang
ditemukan di otot dan tulang.
• Glioma adalah kanker sel –sel glia (penunjang) di system saraf pusat.
Classification of neoplasms
 Epithelial tumors
 Benign forms – adenoma , papilloma
 Malignant forms – carcinoma, eg adenocarcinoma, squamous
cell carcinoma
 Mesenchymal tumors
 Benign forms – fibroma, leiomyoma,
 Malignant forms – sarcoma, eg fibrosarcoma, leiomyosarcoma
Colonic “adenoma”
illustrating a “well-
differentiated” neoplasm
similar to normal colon
mucosa
What are some different kinds of cancer?

Bloodstream

Lung
Lymph nodes
Breast (women)

Colon

Bladder
Prostate (men) Fat
Bone

Muscle R
What are some different kinds of cancer?

Leukemias:
Carcinomas:
Bloodstream
Lung Lymphomas:
Lymph nodes
Breast (women)

Colon

Bladder Sarcomas:
Prostate (men) Fat
Bone

Muscle R
What are some different kinds of cancer?

Cancer Prefixes Point to Location

Prefix Meaning
adeno- gland
chondro- cartilage
erythro- red blood cell
hemangio- blood vessels
hepato- liver
lipo- fat
lympho- lymphocyte
melano- pigment cell
myelo- bone marrow
myo- muscle
osteo- bone R
How are Normal and Cancer Cell Division Different?

Normal
cell division

Cancer
cell division

R
How are Normal and Cancer Cell Division Different?

Normal
cell division

Cell Suicide or Apoptosis

Cell damage—
no repair

Cancer
cell division

First Second Third Fourth or

mutation mutation mutation later mutation R

Uncontrolled growth
How are normal and cancer growth different?

Invasion
Cancer cells grow into
surrounding tissues
and blood vessels

Metastasis
Cancer cells are
transported by the
circulatory system
to distant sites
Cancer cells
reinvade and grow
at new location
R
 What is the difference between a
benign tumor and a malignant tumor?
Benign Malignant

Time
R
 What is the difference between a
benign tumor and a malignant tumor?
Benign (not cancer) Malignant (cancer)
tumor cells grow cells invade
only locally and cannot neighboring tissues,
spread by invasion or enter blood vessels,
metastasis and metastasize to
different sites

Time
R
Why are malignant tumors dangerous?

R
Why are malignant tumors dangerous?

Brain

Melanoma
cells travel
through
bloodstream

Liver

Melanoma
(initial tumor)

R
What does a pathologist look for
examining biopsy tissue?

R
Precursors of
neoplasia
 Hyperplasia
 Metaplasia
 Chronic inflammation
 Dysplasia
 What does a pathologist look for when he
examines biopsy tissue with a microscope?
Carcinoma in
Mild situ (severe Cancer
Hyperplasia dysplasia dysplasia) (invasive)

Normal

R
What does a pathologist look for when he/she
examines biopsy tissue with a microscope?

Normal Hyperplasia Mild Carcinoma in

dysplasia situ (severe
dysplasia) Cancer
(invasive)

R
 Causes of Cancer
 Most cancer arises as
the result of somatic
mutations in the
genome resulting from:
 Environmental factors
– chemical, radiation,
viruses
 Ageing
 Genetic
Environmental carcinogens
 Chemicals capable of DNA damage
 Initiators vs Promoters
 Common denominator is “electrophilic intermediates”
forming adducts with DNA
Radiation
 Ionizing radiation – x-rays, gamma rays, radioactive
materials such as Radon gas – all cause a variety of defects
to DNA
 UV light (non-ionizing) – primarily sun-exposure and T-T
dimerization – skin cancers
Common features of viral carcinogenesis
 Oncogenic viruses typically integrate their genomes into
host cells and enter a period of “latency”
 May be of DNA or RNA type
 DNA viruses include EBV, HPV and Hepatitis B virus
 RNA viruses include retroviruses like HTLV-1 and
indirectly HIV
Viral carcinogenesis
How do mutations in oncogenes
lead to cancer?

Normal cell Normal

genes
regulate
cell growth

Oncogenes
Cancer cell accelerate
cell growth
and division

Mutated/damaged oncogene R
Defect in Cellular Differentiation

 Protooncogenes
 Normal cellular genes that are important regulators
on normal cellular processes
 Mutations that alter their expression can activate
them to act as oncogenes (tumor-inducing)
 Tumor suppressor genes
 Suppress growth of tumors
 Mutations render them inactive
Development of Cancer
 Chemical, environmental, genetic, immunologic, viral,
or spontaneous in origin

 Initiation
 Mutation of genetic structure
 Has potential to develop into clone of neoplastic cells
Process of Cancer Development

Fig. 15-3
Development of Cancer
 Promotion
 Characterized by the reversible proliferation of
altered cells
 Activities of promotion (e.g. obesity, smoking, alcohol)
are reversible
 Latent period
• Initial genetic alteration to clinical evidence of
cancer
Development of Cancer
 Progression
 Characterized by increased growth rate of tumor as
well as its invasiveness and metastasis
 Metastasis = spread of cancer from primary (initial)
site to distant site
TNM: Staging of tumor:
 AJCC Classification System of Tumors

• T—primary tumor
• Tx—primary tumor is unable to be assessed
• T0—no evidence or primary tumor
• Tis—carcinoma in situ
• T1, T2, T3, T4—increasing size and/or local extent of primary tumor
• N—presence or absence or regional lymph node involvement
• Nx—regional lymph nodes are unable to be assessed
• N0—no regional lymph node involvement
• N1, N2, N3—increasing involvement of regional lymph nodes
• M—absence or presence or distant metastasis
• Mx—unable to assess
• M0—absence of distant metastasis
• M1—presence of distant metastasis
 TNM: Staging of tumor:
• T1N1M0 – Means primary tumor is within the organ but
cancer cells have spread to local lymphnodes, there is no
metastasis.

• T3N0Mo - Means tumor has spread beyond primary

organ but has not spread to lymphnodes or other sites.
• Tumor payudara pasien berasal dari ektoderm embrional. Ini memiliki
displasia sedang dan sel terdiferensiasi sedang, keterlibatan kelenjar getah
bening minimal dan tidak ada metastasis. Deskripsi tumor ini yaitu?
A.Sarkoma, derajat II, T3N4M0
B. Leukemia, derajat I, T1N2M1
C. Karsinoma, derajat II, T1N1M0
D.Limfoma, derajat III, T1N0M
E. Karsinoma, derajat II, T0N0M0
• Apa nama tumor dari jaringan mesoderm embrion asal yang terletak di
anatomi meninges yang memiliki kecenderungan menjadi ganas?
A.Meningitis
B.Meningioma
C.Meningocele
D.Sarkoma Meningeal
E.Adenoma meningeal