chart

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=22 BGCOLOR="#FFFFFF" TEXT="#080000" bgproperties="fixed" background="041000d2egerdp.gif"> <div> </div> </td> </tr><tr> <td valign="top" width=145 BGCOLOR="#333399" TEXT="#080000" background="040a2c00erkjzj.gif"> <div> <A HREF="index.htm" TARGET="_top" TITLE="TUMORS"><U><IMG SRC="0431e140.gif" border=0 width="30" height="20" ALT="up" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="generality and definition"><U><IMG SRC="044280e0.gif" border=0 width="40" height="14" ALT="previous" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A><A HREF="id22.htm" TARGET="_top" TITLE="diag and treatment"><U><IMG SRC="045280e0.gif" border=0 width="40" height="14" ALT="next" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></A></div> <div> <IMG BORDER="0" SRC="1x1.gif" HEIGHT="20" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="30"></div> <div>  <img src="HTMLobj-498/aniGif.gif" border="0" align="bottom" width="26" height="27">   <img src="HTMLobj-499/aniGif.gif" border="0" align="bottom" width="463" height="258">   <img src="HTMLobj-500/aniGif.gif" border="0" align="bottom" width="78" height="120">  </div> </td> <td valign="top" height=458 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#336600" FACE="Times New Roman" ><I>TUMORS</I></FONT><FONT SIZE="1" COLOR="#663399" FACE="Times New Roman" >    </FONT> |    <B> </B><FONT SIZE="2" COLOR="#0000BF" FACE="Times New Roman" ><A HREF="index.htm" TARGET="_top" TITLE="TUMORS"><U><B>home</B></U></A></FONT></div> <div> <IMG SRC="04207040.gif" border=0 width="263" height="4" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <div> <B>chart</B></div> <div> <B><U> <img src="HTMLobj-501/aniGif.gif" border="0" align="bottom" width="180" height="248">   <img src="HTMLobj-502/aniGif.gif" border="0" align="bottom" width="82" height="75">   <img src="HTMLobj-503/aniGif.gif" border="0" align="bottom" width="53" height="72">   <img src="HTMLobj-504/aniGif.gif" border="0" align="bottom" width="55" height="126">  </U></B></div> <div> <B><U>from my pathology chart book part1 will be publish by Cambridge UK</U></B></div> <div> <B><U>CYTOLOGIC FEATURES OF MALIGNANCIES</U></B></div> <bR> <div> <B><U>1/ CELL</U></B></div> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="837" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 WIDTH="145"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="145" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="354"><div> <I><B>BENIGN</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="328"><div> <I><B>MALIGNANT</B></I></div> </tD> </tR> </TABLE></div> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="837" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="HSIDES" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 96 WIDTH="145"><bR> <div> <I><B>CELL ARRANGEMENT IN GROUPS</B></I></div> <bR> </tD> <tD VALIGN=BOTTOM BGCOLOR=#FFFFCC WIDTH="354"><bR> <div> <B>UNIFORM</B></div> <div> <B>REGULAR SPACING</B></div> <div> <B>COHESIVEVEL ROUNDED GROUPS</B></div> <bR> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> Nuclei oriented in different directions</div> <div> Irregularly spaced</div> <div> Molding of nuclei </div> <div> Loss of cohesiveness</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 113 WIDTH="145"><bR> <div> <I><B>CELL UNIFORMITY IN GROUP</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="354"><bR> <div> <B>BENIGN TISSUE</B></div> <div> <B>UNIFORM</B></div> <div> <B>REACTIVE STATES</B></div> <div> <B>NUCLEAR SIZE MAY VARY BUT NOT AS IN MALIGNANCY</B></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> Pleomorphism </div> <div> [variation of size - size - numbers of nuclei]</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 59 WIDTH="145"><bR> <div> <I><B>NUCLEAR [CYTOPLASMIC RATIO [N:C]</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> <B>May be increased in reactive conditions</B></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="328"><div> Usually increased</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 48 WIDTH="145"><bR> <div> <I><B>NUCLEAR SIZE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> <B>Size increased and variable in reactive conditions.</B></div> <bR> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="328"><bR> <div> Increased +++</div> <div> Variable than in reactive conditions</div> </tD> </tR> </TABLE></B></div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="854" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 WIDTH="274"><div> <U>2/ CHROMATIN</U></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="145"><div> <I><B><U>BENIGN</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="425"><div> <I><B><U>MALIGNANT</U></B></I></div> </tD> </tR> </TABLE></div> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="854" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="HSIDES" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 59 WIDTH="274"><bR> <div> <I>HYPERCHROMASIA</I></div> <bR> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> BLAND</div> <div> NOT HYPERCHROMATIC</div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="425"><bR> <div> HYPERCHROMATIC</div> <div> [INCREASED CHROMOSOME NUMBER]</div> </tD> </tR> </TABLE></div> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="854" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 62 WIDTH="274"><bR> <div> <I>DISTRIBUTION</I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="145"><bR> <div> EVEN</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="425"><bR> <div> IRREGULAR CLUMPING</div> <div> IRREGULAR AREAS OF CLEARING</div> <bR> </tD> </tR> </TABLE></div> <bR> <bR> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="855" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 36 WIDTH="157"><bR> <div> <B><U>3/ NUCLEOLI:</U></B></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="203"><div> <I><B>BENIGN</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="485"><div> <I><B>MALIGNANT</B></I></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 65 WIDTH="157"><bR> <div> <I><B>SIZE</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> SMALL OR NOT VISIBLE NORMALLY</div> <div> PROMINENT IN REACTIVE ATYPIA</div> <bR> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="485"><bR> <div> OFTEN PROMINANT</div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 46 WIDTH="157"><bR> <div> <I><B>SHAPE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="203"><bR> <div> ROUND</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="485"><bR> <div> ROUND OR IRREGULAR</div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 30 WIDTH="157"><bR> <div> <I><B>NUMBERS</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="203"><bR> <div> REACTIVE CELLS SEVERAL</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="485"><bR> <div> NUMEROUS</div> </tD> </tR> </TABLE></B></div> <bR> <bR> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="859" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 39 WIDTH="166"><div> <B><U>4/ NUCLEAR MEMBRANES</U></B></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="199"><div> <I><B><U>BENIGN</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="484"><div> <I><B><U>MALIGNANT</U></B></I></div> </tD> </tR> </TABLE></B></div> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="859" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="HSIDES" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 62 WIDTH="166"><bR> <bR> <div> <I><B>CONTOUR</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="199"><bR> <bR> <div> SMOOTH</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="484"><bR> <div> IRREGULAR</div> <div> ANGULAR BITES</div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 47 WIDTH="166"><bR> <bR> <div> <I><B>THICKNESS</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="199"><bR> <bR> <div> REGULAR</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> MANIFESTATION OF IRREGULAR CHROMATINE CLUMPING ON OR NEAR THE NUCLEAR MEMBRANE.</div> <bR> </NOBR></tD> </tR> </TABLE></B></div> <bR> <bR> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="854" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 ><NOBR><div> <I><B><U>5/ MITOSES</U></B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="226"><div> <I><B><U>BENIGN</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="524"><div> <I><B><U>MALIGNANT</U></B></I></div> </tD> </tR> </TABLE></B></div> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="854" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="HSIDES" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 43 WIDTH="94"><bR> <div> <I><B>NUMBER</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <div> SEEN IN NORMAL CELLS</div> <div> GREATER NUMBER IN REACTIVE CELLS</div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="524"><bR> <div> MITOTIC RATE MAY BE LOW OR HIGH</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 46 ><NOBR><bR> <div> <I><B>MORPHOLOGY</B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="226"><bR> <div> NORMAL</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="524"><bR> <div> ABNORMAL MITOSES [QUADRIPOLAR OR DISPERSED]</div> <bR> </tD> </tR> </TABLE></B></div> <bR> <div> *** Nuclear features are more important in cytology than architecture. Providing the diagnostic of malignancy.</div> <bR> <div> *** Cytoplasm and architecture features provide information on differentiation.</div> <bR> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="886" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FF0000 HEIGHT= 312 ><NOBR><bR> <bR> <div> <B><U>MALIGNANCY FEATURES:</U></B></div> <bR> <bR> <div> <I><B>INVASION OF THE UNDERLYING OR SURROUNDING TISSUE [ GOING BEYONG THE BASEMENT MEMBRANE]</B></I></div> <bR> <div> <I><B>STROMA CHANGES = DESMOPLASIA = IS A RESPONSE TO INVASION OF TISSUE BY MALIGNANT TUMOR CELLS.</B></I></div> <bR> <div> <I><B>LOSS OF NORMAL STRUCTURE.</B></I></div> <bR> <div> <I><B>NEW STRUCTURES: </B></I></div> <div> <I><B>EX: CRIBRIFORM GLAND STRUCTURE [ COLON, ENDOMETRIUM CANCERS] </B></I></div> <div> <I><B>PAPILLARY STRUCTURES [THYROID, BLADDER CANCERS].</B></I></div> <div> <I><B>SARCOMAS </B></I><FONT SIZE="1" COLOR="#FFFF00" FACE="Wingdings" ><I><B>è</B></I></FONT><I><B> HERRINGBONE ARRANGEMENT.</B></I></div> <bR> <div> <I><B>NECROSIS</B></I></div> <div> <I><B>ANGIOGENESIS</B></I></div> <div> <I><B>INFLAMMATION</B></I></div> <div> <I><B>IRREGULAR BORDERS</B></I></div> <div> <I><B>METASTASIS</B></I></div> </NOBR></tD> </tR> </TABLE></div> <bR> <DIV ALIGN="LEFT"></DIV> <div> THE NEOPLASMS VOCABULARY</div> <bR> <bR> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="883" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="NONE" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 WIDTH="227"><div> <I><B>ORIGIN</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="204"><div> <I><B>TISSUE TYPE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="166"><div> <I><B>BENIGN</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="273"><div> <I><B>MALIGNANT</B></I></div> </tD> </tR> </TABLE></div> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="883" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="HSIDES" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 385 WIDTH="227"><div> <I><B>I/ EPITHELIUM</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="204"><bR> <div> STRATIFIED SQUAMOUS</div> <bR> <bR> <div> BASAL CELL OF THE SKIN</div> <bR> <bR> <div> EPITHELIAL LINING FROM GLANDS OR DUCTS</div> <bR> <div> HEPATOCYTES</div> <bR> <bR> <bR> <bR> <div> MELANOCYTES</div> <bR> <bR> <bR> <div> RENAL</div> <bR> <bR> <div> URINARY EPITHELIUM [TRANSITIONAL]</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="166"><bR> <div> SQUAMOUS CELL PAPILLOMA</div> <bR> <bR> <bR> <bR> <div> ADENOMA [COLON]</div> <bR> <bR> <div> HEPATOCELLULAR ADENOMA</div> <bR> <bR> <bR> <div> NEVUS</div> <bR> <bR> <div> RENAL CELL ADENOMA</div> <bR> <bR> <bR> <div> TRANSITIONAL CELL PAPILLOMA</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="273"><bR> <div> SQUAMOUS CELL CARCINOMA</div> <bR> <bR> <div> BASAL CELL CARCINOMA</div> <bR> <bR> <div> ADENOCARCINOMA </div> <bR> <bR> <div> HEPATOCELLULAR CARCINOMA [HEPATOMA]</div> <bR> <bR> <bR> <div> MELANOMA</div> <bR> <bR> <bR> <div> RENAL CELL CARCINOMA</div> <bR> <bR> <bR> <div> TRANSITIONAL CELL CARCINOMA</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 499 WIDTH="227"><bR> <bR> <div> <I>II/MESENCHYMAL ORIGIN</I></div> <bR> <bR> <div> <I><B><U>CONNECTIVE TISSUE</U></B></I></div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <div> <I><B><U>HEMATOPOEITIC</U></B></I></div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <div> <I><B><U>MUSCLE</U></B></I></div> <bR> <bR> <bR> <bR> <div> <I><B><U>VASCULAR</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <bR> <bR> <bR> <bR> <div> BONE</div> <bR> <bR> <div> CARTILAGE</div> <bR> <bR> <bR> <div> FIBROBLAST</div> <bR> <bR> <bR> <bR> <div> ERYTHROID</div> <bR> <div> MYELOID</div> <bR> <div> LYMPHOID</div> <bR> <bR> <div> SMOOTH MUSCLE</div> <bR> <bR> <div> STRIATED [SKELETTAL MUSCLE]</div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="166"><bR> <bR> <bR> <bR> <bR> <div> OSTEOMA</div> <bR> <bR> <div> CHONDROMA</div> <bR> <bR> <bR> <div> FIBROMA</div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <div> LEIOMYOMA</div> <bR> <bR> <bR> <div> RHABDOMYOMA</div> <bR> <div> HEMANGIOMA</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="273"><bR> <bR> <bR> <bR> <bR> <div> OSTEOSARCOMA</div> <bR> <bR> <div> CHONDROSARCOMA</div> <bR> <bR> <bR> <div> FIBROSARCOMA</div> <bR> <bR> <bR> <bR> <div> ERYTHROID LEUKEMIA</div> <bR> <div> MYELOGENOUS LEUKEMIA</div> <bR> <div> LYMPHOCYTIC LEUKEMIA</div> <div> MALIGNANT LYMPHOMA</div> <bR> <div> LEIOMYOSARCOMA</div> <bR> <bR> <bR> <div> RHABDOMYOSARCOMA</div> <bR> <div> HEMANGIOSARCOMA</div> <bR> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 164 WIDTH="227"><div> <I><B><U>III/ORIGIN FROM A SINGLE GERM LAYER WITH MORE THAN ONE TYPE OF DIFFERENTIATION</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <bR> <bR> <div> RENAL </div> <div> [PROMITIVE MESODERMAL TISSUE]</div> <bR> <bR> <bR> <div> SALIVARY GLANDS</div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="166"><bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <div> PLEOMORPHISM ADENOMA [MIXED TUMOR OF SALIVARY GLAND]</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <bR> <bR> <bR> <div> WILMS'S TUMOR</div> <bR> <bR> <bR> <bR> <div> MALIGNANT   MIXED TUMOR OF SALIVARY GLAND</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 83 WIDTH="227"><div> <I><B><U>IV/ ORIGIN FROM MORE THAN ONE GERM LAYER</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="204"><bR> <bR> <bR> <bR> <div> GERM CELLS OF GONADS</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><bR> <bR> <bR> <bR> <div> TERATOMA</div> <div> [DERMOID CYST OR TERATOMA]</div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="273"><bR> <bR> <bR> <bR> <div> TERATOCARCINOMA</div> </tD> </tR> </TABLE></B></div> <bR> <bR> <bR> <bR> <bR> <DIV ALIGN="LEFT"></DIV> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="886" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFF00 HEIGHT= 70 WIDTH="876"><div> <U>THE IMPORTANCE OF TUMOR DIFFERENTIATION</U></div> <div> <B>SITE OF ORIGIN IN METASTATIC DISEASE:   BIOPSY LYMPH NODES  IF SQUAMOUS CELL CARCINOMA=</B><FONT SIZE="1" COLOR="#000000" FACE="Wingdings" ><B>è</B></FONT><B> TISSUES WITH SQUAMOUS DIFFERENTIATION ARE IMPLICATED</B><FONT SIZE="1" COLOR="#000000" FACE="Wingdings" ><B>è</B></FONT><B> EXAMINATION OF : LUNGS, UPPER RESPIRATORY TRACT, THE GYNECOLOGICAL TRACT, SKIN</B><FONT SIZE="1" COLOR="#FF0000" FACE="Arial" ><B>.</B></FONT></div> <bR> <bR> </tD> </tR> </TABLE></div> <bR> <bR> <div> <B><U>BENIGN VERSUS MALIGNANT TUMORS:</U></B></div> <bR> <bR> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="975" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 WIDTH="220"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="19" ALIGN="bottom" WIDTH="220" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="278"><div> <I><B>BENIGN</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="467"><div> <I><B>MALIGNANT</B></I></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 72 WIDTH="220"><bR> <div> <I><B>DIFFERENTIATION</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><bR> <div> Differentiated</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><bR> <div> Loss of differentiation </div> <div> Architectural</div> <div> Cytoplasmically</div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 83 WIDTH="220"><bR> <bR> <div> <I><B>GROWTH RATE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><bR> <div> Slow</div> <div> May cease to grow</div> <div> Mitotic figure rare and normal</div> <div> EXPENDING, DISPLACING</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><bR> <div> Slow to rapid</div> <div> Mitotic figures numerous and abnormal</div> <div> [disorganized or quadripolar]</div> <div> INFILTRATING </div> <div> INVASIVE</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 59 WIDTH="220"><bR> <div> <I><B>INVASIVENESS</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><bR> <div> Well circumscribed mass without invasion of surrounding tissues.</div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> Locally invasive</div> <div> [sometimes well circumscribed]</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 30 WIDTH="220"><bR> <div> <I><B>METASTASIS</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><bR> <div> no</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> Often</div> <div> Risk higher the larger and less well-differentiated the primary</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>SEX</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> NO SIGNIFICANT</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> NOT SIGNIFICANT</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>AGE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> CHIEFLY IN YOUNG POEPLE</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> CHIEFLY IN OLDER PERSONS</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 43 WIDTH="220"><div> <I><B>LOCATION OF TUMOR</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><bR> <div> ALL ORGANS</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><bR> <bR> <div> ALL ORGANS</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 41 WIDTH="220"><div> <I><B>CLINICAL SYMPTOMS</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> RATHER SLIGHT </div> <div> NON SPECIFIC</div> <div> EXCEPTION: ENDOCRINE TUMORS</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> MARKED</div> <div> OFTEN DETECTED FIRST IN ADVANCED STAGES</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>DURATION OF ILLNESS</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> LONG [YEARS OR DECADES]</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> RATHER SHORT [MONTHS]</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>SPECIFIC CELL FUNCTION</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> CHEFLY NORMAL</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> MOSTLY LACKING </div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>RECURRENCE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> CAN OCCUR</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> COMMON</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>ORGAN CHANGES</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> PRESSURE ATROPHY</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> DESTRUCTION</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>TUMOR CAPSULE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> PRESENT</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> ABSCENTE</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>CONSISTENCY</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> VARIABLE</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> MOSTLY SOFT</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 27 WIDTH="220"><div> <I><B>CUT SURFACE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> UNIFORM</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> RED HEMMORHAGE</div> <div> YELLOW NECROSIS</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 27 ><NOBR><div> <I><B>TISSUE TYPE [resembles parent tissue]</B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> HOMOLOGUS</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> HETEROLOGUS</div> <div> IMMATURE</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>CELLULARITY</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> OFTEN POORLY CELLULAR</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> RICHLY CELLULAR</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 27 WIDTH="220"><div> <I><B>CELL SIZE AND SHAPE</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> REGULAR </div> <div> ISOMORPHUS</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> IRREGULAR </div> <div> POLYMORPHOUS</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 WIDTH="220"><div> <I><B>CELL ATYPIA</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> LACKING</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> COMMON</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 57 ><NOBR><div> <I><B>MITOSES [NUMBER AND TYPE]</B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> RARE</div> <div> TYPICAL</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><bR> <bR> <div> COMMON </div> <div> ATYPICAL</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 41 WIDTH="220"><div> <I><B>CHROMATIN</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> REGULAR DIVISION</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> IRREGULAR</div> <div> PARLY DENSE</div> <div> PARTLY VESICULAR</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 14 ><NOBR><div> <I><B>CHROMOSOMES [DNA CONTENT]</B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> EUPLOID</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> CHIEFLY ANEUPLOID WITH CHROMOSOMAL ABERRATIONS</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 43 WIDTH="220"><div> <I><B>NUCLEOLUS</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> SIMMILAR TO PARENTS CELLS</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><div> DISTINTLY LARGE</div> <div> OFTEN PROMINENT</div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 43 ><NOBR><div> <I><B>NUCLEUS/CYTOPLASM RATIO</B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> NORMAL</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><bR> <bR> <div> DISPLACEMENT IN FAVOR OF NUCLEUS</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 43 WIDTH="220"><div> <I><B>CYTOPLASMIC STAINING</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> NORMAL</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><bR> <div> OFTEN ONCREASED BY DNA</div> <div> SLIGHTLY BASOPHILIC</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 30 ><NOBR><div> <I><B>ENZYME CONTENT OF CELLS</B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="278"><div> NORMAL</div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="467"><bR> <div> OFTEN DEFICIENT</div> </tD> </tR> </TABLE></div> <bR> <div> <B><U>Neoplasm composition:</U></B></div> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="741" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 WIDTH="207"><div> <I><B><U>Neoplastic cells</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="527"><div> <I><B>TUMOR TYPE WITH THEIR VARIANCES</B></I></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 73 WIDTH="207"><div> <I><B>stroma</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> Tumors induce :  expension of stroma  = DESMOPLASIA</div> <div>                               HYPERPLASIA OF FIBROBLASTS </div> <div>                               ABUNDANT COLLAGENOUS STROMA</div> <bR> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 19 WIDTH="207"><div> <I><B><U>vessels</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> Tumor induce:     greater numbers of vessels <U>= ANGIOGENESIS</U></div> </NOBR></tD> </tR> </TABLE></div> <div> <B><U>DISEASES ASSOCIATED WITH INCREASED RISK OF NEOPLASIA:</U></B></div> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="740" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 ><NOBR><div> <I><B><U>NONNEOPLASTIC OR PRENEOPLASTIC CONDITION</U></B></I></div> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="310"><div> <I><B><U>NEOPLASM</U></B></I></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 35 WIDTH="423"><bR> <div> <I><B>Down syndrome    [trisomy 21]</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> Acute leukemia [lymphoblastic and myelogenous]</div> </NOBR></tD> </tR> </TABLE></div> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="740" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 57 ><NOBR><bR> <div> <I><B>Xeroderma pigmentosum [plus sun exposure]</B></I></div> <bR> </NOBR></tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="310"><div> skin cancers </div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 48 WIDTH="423"><bR> <div> <I><B>Gastric atrophy [pernicious anemia]</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="310"><div> adenocarcinoma</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 48 WIDTH="423"><bR> <div> <I><B>Tuberous sclerosis</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="310"><div> hamartomas</div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 48 WIDTH="423"><bR> <div> <I><B>Café au lait skin patches</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> neurofibromatosis (nerve tumors, pheochromocytoma]</div> <bR> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 48 WIDTH="423"><bR> <div> <I><B>Actinic dermatitis [sunlight]</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="310"><div> Basal squamous cell carcinoma</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 64 WIDTH="423"><bR> <div> <I><B>Glandular metaplasia of esophagus</B></I></div> <div> <I><B>[Barret's esophagus]</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="310"><div> adenocarcinoma</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 64 WIDTH="423"><bR> <div> <I><B>Dysphagia associated with anemia</B></I></div> <div> <I><B>[Plummer- Vinson Syndrome]</B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="310"><div> Postcricoid carcinoma</div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 32 WIDTH="423"><div> <I><B>Li-Fraumeni syndrome </B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> cancer-family syndrome, breast cancer and sarcomas</div> <bR> </NOBR></tD> </tR> </TABLE></B></div> <div> <B> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="740" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 96 WIDTH="423"><div> <I><B>Von Hippel-Lindau syndrome </B></I></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> pheochromocytoma, </div> <div> renal cell carcinoma,</div> <div>  cerebellar hemangioblastoma,</div> <div>  retinal angiomas, </div> <div> pancreatic cysts and islet cell adenomas</div> <bR> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 96 WIDTH="423"><bR> <div> <I><B>Cirrhosis </B></I></div> <div> <I><B>[alcoholic, Hepatitis B]</B></I></div> <bR> <bR> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC WIDTH="310"><div> hepatocarcinoma</div> </tD> </tR> </TABLE></B></div> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <bR> <div> <B><U>Neoplasm composition:</U></B></div> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="741" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BELOW" RULES="ROWS" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#800000 HEIGHT= 19 WIDTH="207"><div> <I><B><U>Neoplastic cells</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#800000 WIDTH="527"><div> <I><B>TUMOR TYPE WITH THEIR VARIANCES</B></I></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 73 WIDTH="207"><div> <I><B>stroma</B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> Tumors induce :  expension of stroma  = DESMOPLASIA</div> <div>                               HYPERPLASIA OF FIBROBLASTS </div> <div>                               ABUNDANT COLLAGENOUS STROMA</div> <bR> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FFFFCC HEIGHT= 19 WIDTH="207"><div> <I><B><U>vessels</U></B></I></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFFCC><NOBR><div> Tumor induce:     greater numbers of vessels <U>= ANGIOGENESIS</U></div> </NOBR></tD> </tR> </TABLE></div> <bR> <bR> <bR> <div> <IMG SRC="1ebc91b0.gif" border=0 width="713" height="539" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"><B><U><IMG SRC="1edf3190.gif" border=0 width="755" height="537" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></U></B><FONT SIZE="3" COLOR="#FF0000" FACE="Arial" ><B><U>NEOPLASIA DEFINITION </U></B></FONT></div> <bR> <bR> <div> <TABLE BORDER="2" CELLPADDING="1" CELLSPACING="1" WIDTH="815" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 73 WIDTH="220"><div> <B>BENIGN  NEOPLASM</B></div> <bR> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00 WIDTH="580"><div> NEOPLASM GROWING WITHOUT INVASION OF THE ADJACENT TISSUE OR SPREAD LOCALY OR TO DISTANT SITES FROM THE ORIGIN.</div> <div> <B>WELL CIRCUMSCRIBED.</B></div> <div> <B>WELL ENCAPSULATED</B><FONT SIZE="2" COLOR="#000000" FACE="Arial" ><B>.</B></FONT></div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 30 WIDTH="220"><bR> <div> <B>MALIGNANT NEOPLASM</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00><NOBR><bR> <div> <B>NEOPLASMS THAT GROWTH ,INVADING, DESTROY, SPREAD LOCALY REGIONALLY AND AT DISTANCE</B></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 97 WIDTH="220"><bR> <div> <B>DIFFERENTIATION</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00 WIDTH="580"><bR> <div> <B>THE TISSUE TYPE REPRESENTED BY THE TUMOR.</B></div> <div> <B>WELL DIFFERENTIATED: TUMOR RESEMBLE THE TISSUE OF ORIGIN</B></div> <div> <B>POORLY DIFFERENTIATED: DOES NO LONGER RESEMBLE OF HIS ORIGINATE TISSUE. IDENTIFIABLE BY :</B></div> <div> <B>                  ***EXPRESSION OF CELL MARKERS</B></div> <div> <B>                  ***BY EXTREMELY FOCAL  AND SUBTITLE HISTOLOGIC AND /                                                                             OR CYTOLOGIC FINDING.</B></div> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 49 WIDTH="220"><bR> <div> <B>ANAPLASIA</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00 WIDTH="580"><bR> <div> <B>LOSS OF DIFFERENTIATION</B></div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 129 WIDTH="220"><bR> <div> <B>DYSPLASIA</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00 WIDTH="580"><bR> <div> <B>ATYPICAL PROLIFERATION OF CELLS.</B></div> <div> <B>NUCLEAR ENLARGEMENT</B><FONT SIZE="2" COLOR="#000000" FACE="Arial" ><B> </B></FONT></div> <div> <B>FAILURE OF MATURATION AND DIFFERENTIATION.</B></div> <div> <B>AS THE DYSPLASIA PROGRESSES, THE NUCLEI OF CELLS BECOME MORE HYPERCHROMATIC AND THE NUCLEAR MEMBRANES BECOME MORE IRREGULAR.</B></div> <div> <B>MAY REGRESS, PERSIST, PROGRESS.</B></div> <div> <B>THE MORE ADVANCED THE DYSPLASIA, THE LESS LIKELY REGRESSION WILL OCCUR.</B></div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 110 WIDTH="220"><bR> <div> <B>REACTIVE ATYPIA</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00><NOBR><bR> <div> <B>ABNORMAL CELLULAR APPEARANCE</B></div> <div> <B>INCREASE MITOTIC RATE</B></div> <div> <B>ASSOCIATED WITH REPARATIVE STATE DUE TO ENVORONMENTAL INFLUENCES [INFLAMMATION]</B></div> <div> <B>ONCE THE ENVIRONMENTAL INFLUENCE STOP, ATYPIA DISAPEARS.</B></div> <div> <B>REACTIVE ATYPIA ARE NON NEOPLASTIC.</B></div> <div> <B>INVOLVEMENT :  -ENLARGEMENT CYTOPLASM AND NUCLEUS</B></div> <div> <B>                                    - INCREASED PROMINENCE OF NUCLEOLI</B></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 46 WIDTH="220"><bR> <div> <B>CARCINOMA IN SITU</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00><NOBR><bR> <div> <B>BEGINNING MALIGNANT TUMOR  [DYSPLASIA] THAT DOES NOT GROW ABOVE THE BASEMENT MEMBRANE</B></div> <bR> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 46 WIDTH="220"><bR> <div> <B>INVASION</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00 WIDTH="580"><bR> <div> <B>GROWTH INTO THE SURROUNDING TISSUE BY DIRECT EXPENSION.</B></div> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 416 WIDTH="220"><bR> <div> <B>METASTASIS</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00 WIDTH="580"><bR> <div> SPREAD OF TUMOR TO DISTANT SITES BY:</div> <div> DIRECT SPREADING CONTACT TO CONTACT,</div> <div> IN BODY CAVITIES [SEEDING] PLEURA, PERITONEUM, PERICARDIUM]</div> <div>  HEMATOGENOUS </div> <div>  LYMPHATIC ROUTES</div> <div> <IMG SRC="1ee621b0.gif" border=0 width="98" height="27" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"><IMG SRC="1ef481b0.gif" border=0 width="328" height="27" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"><IMG SRC="1f16f0f0.jpg" border=0 width="367" height="271" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></div> <bR> <bR> </tD> </tR> <tR> <tD VALIGN=TOP BGCOLOR=#FF00FF HEIGHT= 49 WIDTH="220"><bR> <div> <B>PRIMARY TUMOR</B></div> </tD> <tD VALIGN=TOP BGCOLOR=#FFFF00 WIDTH="580"><bR> <div> <B>TUMOR AT THE ORIGIN SITE  </B></div> <bR> </tD> </tR> </TABLE></div> <bR> <bR> </td> </tr></table></body>