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• Increase in the number of cells present in a tissue
• Reversible and under physiologic control


• An adaptive substitution of one type of adult tissue for another type of adult tissue
• Under stress a more vulnerable type of tissue can be replaced by another that is more capable of withstanding the stress


• An abnormality in cell size and appearance with or without a disorganized growth pattern
• Is not cancer
• Is reversible

Carcinoma In-Situ (CIS):

• Equivalent to severe or full thickness dysplasia
• Severe cervical dysplasia=CIS [CINIII]
• Not cancer
• Respects BM


• A disease of cells characterized by alteration of normal growth regulatory mechanisms


• Tissue replicates without regard to the regulatory influences that control normal cell growth


• Tissue competes with "normal" cells and tissues for metabolic needs


• Neoplasias can flourish while the rest of the body wastes away


• The formation and proliferation of non-neoplastic connective tissue in response to a neoplasm
• Often associated with a malignancy and is the most normal response to the invasion


• A "growth" or "enlargement" which may not necessarily be neoplastic


• Slow growth
• Resemblance to tissue of origin (well differentiated)
• Circumscription with pushing border (+/- encapsulated)
• Lack of invasion or metastases
• Usually not life threatening, but can cause problems through mass effect
• Respects BM

Nomenclature of benign mesenchymal tumors on the parenchymal cell:

• Oma

B9 tumor of uterus:

• Leiomyoma

B9 tumor of fibrous tissue:

• Fibroma

B9 tumor of cartilage:

• Chondroma

Nomenclature of benign epithelial tumors producing glands or derived from glandular tissue:

• Adenoma


• Benign epithelial tumors that grow upward form an epithelial surface and have a frond-like, papillary architecture


• Exophytic masses on a mucosal surface
• Often found in bowel


• A peculiar benign neoplasm which is a localized, but has haphazard growth of tissues normally found at a given site


• B9 neoplasm
• Normal tissue where it should not be
• Heterotopic rest


• The ability of neoplasm to grow into and through adjacent normal tissues by breaching the BM


• The spread of a neoplasm from the area of origin to distant sites through various routes

Lymphatic dissemination:

• Primary mode of dissemination for carcinomas

Hematogenous dissemination:

• Primary mode of dissemination for sarcomas


• Involves tumor dissemination in body cavities
• Seeds the outside of structure

Malignant characteristics:

• **Metastases
• *Invasion
• Others include more rapid increase in size & lack of differentiation (anaplasia)

Histologic features of malignant neoplasms:

• Lack of differentiation (anaplasia)
• Increased nuclear DNA content with subsequent dark staining on H and E slides (hyperchromatism)
• Anaplasia
• Prominent nucleoli within the nuclei
• Increased nuclear size with increase nuclear/cytoplasmic ratio (N/C ratio)
• Necrosis


• Atypical Mitosis and Nuclear Pleomorphism


• The spread of epithelial malignancies just beyond the basement membrane

Mesenchymal malignant neoplasms are named after the parenchymal cell type of origin with the suffix:

• Sarcoma

A malignant tumor of smooth muscle origin:

• Leiomyosarcoma

A malignancy of striated muscle origin:

• Rhabdomyosarcoma

A malignancy of bone (osseous) origin:

• Osteosarcoma

Epithelial malignant neoplasms are:

• Carcinomas

Malignant epithelial neoplasms forming glands or arising from glandular tissues:

• Adenocarcinomas

Malignant squamous and urothelial cells:

• Squamous and urothelial (transitional cell) carcinomas


• Most important criteria
• Tumor size & location
• Node involvement
• *Metastases


• Grade 1- well differentiated
• Grade 2- moderately differentiated
• Grade 3- poorly differentiated


• Any malignant growth of cells (tumor), whether a carcinoma, sarcoma or hematologic malignancy
• Second most common cause of death in US


• Derives from ectoderm, endoderm, or mesoderm

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