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The four phases of malignant tumors
1) Malignant change in the target cell: TRANSFORMATION

2) Growth of the transformed cells

3) Local invasion

4) Distant metastases
Differentiation
The extent to which neoplastic cells resemble comparable cells (morphologically and functionally)
Anaplasia
A lack of differentiation.

Hallmark of malignant transformation
-OMA
Usually benign


EXCEPTIONS:
MelanOMA (should be melanocarcinoma)
CARCINOMA
Malignancy of endoderm/ectoderm
Epithelial
SARCOMA
Malignancy of mesoderm
CT
Mixed tumor
Tumor comprised of more than one germ layer

Most common: Mixed tumor of salivary gland (Pleomorphic ademona of the parotid)
Teratoma
Tumor comprised of all three germ layers


(Usually in gonads due to presence of totipotent cells: CYSTIC TERATOMA)
Hamartoma
Mass of disorganized but mature cells, benign. May not even count as a neoplasm.
Morphologic changes seen due to ANAPLASIA
1) PLEOMORPHISM: Variation in size and shape

2) ABNORMAL NUCLEUS: Hyperchromaticity, size

3) MITOSES: Atypical spindles

4) LOSS OF POLARITY: Grow in disorganized fashion

5) OTHER:
-----Tumor Giant Cells
Dysplasia
Disordered growth usually in the epithelia. DOES NOT necessarily progress to cancer.
Number of population doublings needed to clinically detect a tumor
30 doublings. About 90 hypothetical daysBy the time a solid tumor is clinically deteccted it has completes a major portion of its life cycle
Capsule
Normally found around benign tumors
Benign neoplasm that can metastasize
Invasive mole
Malignant neoplasms that do not metastasize (just invasive)
Gliomas
Basal cell carcinoma of the skin
Cancer dissemination pathways
Seeding
Lymphatics (Carcinomas mostly)
Hematogenous (Sarcomas mostly)
--------Liver/Lung