NEOPLASM

Synonyms – cancer, tumor, growing of cells

 Neoplasm means new growth.

 Second lethal disease in epidemeologitis.
 Cancer is like claw of a crab. If a claw of crab garbs something it doesn’t let it go same
with cancer. Cancer may spread but it doesn’t let go. They move in same direction.
 Not monoclonal
 Very notorious
 Very untidy and ugly in nature

Registry – provides no. of cases.

Mortality rate rising doesn’t mean that hospital isn’t giving correct treatment to patients.

Palliative Care- as death is a defined period, the particular treatment given to terminal patients
to decrease symptoms.

Terminal patients are those who cant be saved from surgery or medicine as in if cancer is
removed from one spot it will grow in another. These types of patients are given palliative care.

In Situ- a stage in breast cancer. Where cancer stays confined in one area and doesn’t spread.

Autonomous- Cancer works on it own even after the removal of stimulis.

Tumor

 Innocent, tidy
 No invading power
 Localized
 No multiplying power
 Stimulus removal can remove tumor
 Sometimes cannot mature cells

Liquid tumors – lines cancer, leukemia

Solid Tumor – colon, penal call carcinoma

Cancer

 Bypass apoptosis
 immature cells
 Notorious, cruel, untidy and ugly
 Invading power
 Not lacolaized
  Autonomous
 Removal of stimulus such as chemicals cannot remove cancer

Translocation – when a component of chromosome breaks off and attaches to another.

Philadelphia Chromosome. The hybrid/ fusion chromosome formed by the translocation of

chromosome 9 and 22

Leukemia – formed by translocation. Or by fusion of two chromosomes into a third

chromosome.

 CML – Chronic Myeloid Leukemia, present in adults. Contains a protein which when
activated makes immature cells. Effects neutrophils (abundant and immature) along with
leukocytes.
 AML – Acute Myeloid Leukemia, present in children.

Tyrosine Kinase – activated by Philadelphia chromosome, proliferates the leukocytes.

Nomenclature

Totipotent – Generates embryo (embryogenesis) and organs (organogenesis). Forms extra

embryonic tissues (umbilical cord, placenta)

Multipotent – embryogenesis and organogenesis will go on organ level. But doesn’t form extra
embryonic tissue.

Pluripotent – restricted in time frame. Forms stem cells such as neuronal stem cells.

Stem cell- present in embryo. Neurons grow but can’t regenerate or multiply. When the
production of fetus is going on, progenitor cells goes in neurons and continue to mature.

If neurons multiplied, neuro degenerative disease wouldn’t be possible. Eg: the damage of
dopamine neurons causes degenerative disease.

Neurons differentiate and mature but after adulthood they no longer get matured.

Pluripotent upto some level will differentiate eg: hematopoietic pluripotent stem cells
(generates RBCs)

Cholesterol based hormones require a precursor which is found in fenugreek (methi dana). This
is the only precursor for endogen and steroid hormones.

Malignant – ugly, very untidy cells

Benign – innocent

Carcinoma – formed in epithelia (origin of the cell). Eg: Glandular Epithelium (Adenocarcinoma),
origin would be glandular (sweet, savory, parotid, squamous, basal cells) and carcinoma
(malignant cells).

 Adenoma – glandular
 Papilloma – finger like projections
 Polyps – originate from surface of cell/organ

Sarcoma – originate from mesenchymal cells which originates from mesothelium. Any areas
that touch mesothelium are part of it. Eg ; Plueral cavity, osteocytes, chondrocytes.

 Liposarcoma – lipid sarcoma, including body cavity, adipose tissues also touch
mesothelium.
 Chondrosarcoma – touches mesothelium.
 Osteosarcoma – touches mesothelium. (originates in central shaft)

Mix tumor – pleomorphism is the hallmark of cancer. It is the mixture of cancer and tumor.
Phenomenon where cells of different shapes and sizes are present. Adenoma along with
pleomorphic characters are present. Eg: Pleomorphic Adenoma of salivary gland (paratoid cells
which produce saliva)

Adenoma can also occur in tumors as origin doesn’t change but pleomorphic characters wont
be present.

Hamartoma – the mass of a solid which is of ugliest nature and multiply continuously. Can be of
different organs such as liver, bladder, brain, pancreas but needs to be solid organ. Renal cell
carcinoma has pleomorphism unevenly present.

Teratoma – ugliest cancer as all three germ layers fuse together. Due to which gonads won’t be
properly visible because pleomorphism are undifferentiated, immature and uneven. It is not
related to any organs but gonads. Germ cells help identify the sex. Cause can be UV rays or
mutagenicity (mutatnt rays, chemicals, pigments)

Cancer Epigenetics – Cancer interacts with environment. The role of environmental genes

 Genes – carry information from generation to generation

 Chromosome – carry genes in nucleus.
 Alleles – different forms of genes that occupy some position on chromosome/
alternative form of genes. (2 or more)
o Cancer in multifactorial
o Benzene is carcinogenic
 o H2S – neuronal cancer (In neuronal cancers (like gliomas or neuroblastomas), H₂S levels
may be elevated due to overexpression of H₂S-producing enzymes, promotes cell
proliferation, enhances angiogenesis (formation of new blood vessels), aids in invasion
and metastasis) - NIN

Haploinsufficiency - Occurs when a single functional copy of a gene is not enough to maintain
normal function. NIN

Diploinsufficiency - Not a standard genetic term and may be confused with haploinsufficiency.
It’s sometimes used informally to describe a condition where even two normal copies of a gene
don't produce enough product. NIN

DNA Methylation - Epigenetic modification where a methyl group (-CH₃) is added to cytosine
bases, often in CpG islands. It typically silences gene expression. Important for regulating genes,
X-inactivation, genomic imprinting, and preventing transposon activity. Abnormal methylation
patterns are linked to cancers and developmental disorders. NIN

To differentiate between cancer and tumors few things are considered such as liquid biopsies,
CT scan, MRI and histopathology.

Differentiation – Tumors are well differentiated while caners are poorly differentiated. In
pancreas, during the time of embryogenesis, to produce cells with same morphology, they will
first differentiate and get matures.

Growth rate – of tumor (leiomyoma and chondroma) is slow and indolent, which cancer
(parotoid, breast, colon) is rapid.

Localization - Tumor are localized and will stay confined to the area from where they were
initiated. Cancer and not localized.

Metastasis – cancer has pleomorphism and metastasis – spreading power.

Cancer operates through blood vessels made by growth factors (angiogenesis- process of
forming of new blood vessels from existing ones)

Growth factors – VEGF (vascular endothelial growth factor), HIF-1Aplha (hypoxia inducible
factor)

When hif-1alpha senses hypoxia, it releases its factors which help in blood vessel making.

Basic Components
 1. Parenchyma – pathological behavior which defines if it’s a cancer or tumor. Will define
its fate
2. Stoma – will decide how fast the tumor cells will grow, depends on the supportive
framework which binds the cell and defines its evolution.

Desmoplasia – Abundant excessive histoma

Nonspecific – dengue

Immunoglobin – typhoid (high fever)

Anaplasia

Ana- no, plasia- cells

Poorly differentiated cells, resemblance of parenchymal to its corresponding normal

parenchymal cells. Highly differentiated cells, loss of differentiation, association and
morphology.

Changes observed during anaplasia

1. Polymorphism
2. Mitosis – cell differentiation goes in growth phase. G1, S, G2, split (M phase), G0 (resting
station). Mitosis in cancer cells never stop due to which G0 phase never occurs.
3. Nuclear material’s presence: nuclear cytoplasmic ratio gets disturbed.
4. Loss of polarity: due to disorientation
5. Dysplasia: loss of uniformity or structural orientation

Environmental Factors

1. Hereditary/ Inheritance – Gene silencing (Reduction in expression of gene NIN) and over
expression (increase of expression of gene NIN) activates different kinds of cancer.
 BAX – apoptosis
 Decreased CAS – executioner caspse
 Glioblastoma, neuroblastoma, colon cancer
 Breast cancer – the changes in expression of brca1 and 2 will indicate breast
carcinoma in females.
2. Environment – home / Workplace
 P-53 – water pollution, ozone depletion, smoking
3. Alcohol Usage – Liver carcinoma. An enzyme is required to break down the alcohol
which effects hepatocytes which then causes liver cirrhosis which inturn causes liver
cancer
Role of chemicals – benzene, CO2, CO, SO2 (latter 2 causes lung cancer), arsenic lead, tobacco,
chaliya. Cell lines change, loss of uniformity, dysplasia, pleomorphism. Inhalation of silica causes
alveoli in sedimentation which causes cancer.

Role of Age –

 Young individual – CML juvenile

 Infants – retinoblastoma, neuroblastoma, AML
 Female Oriented – ovarian, breast and cervical cancer.40-79 – more prominent
cases.
 Male oriented – prostate cancer 60- 70 age
 Germ cell Related – teratoma (totipotent and germ layers), teratological cancer,
malignancies, hematological malignancies (children)