DUSTURBANCES OF GROWTH. MLS Basic histological diagnosis MLS HIST 422 Semester 8- batch 7 L8 Uz: Musa

Transcription

1 DUSTURBANCES OF GROWTH MLS Basic histological diagnosis MLS HIST 422 Semester 8- batch 7 L8 Uz: Musa

2 Agnesia: means complete absence of an organ (Kidney). Aplasia: s defined in general as "defective development or congenital absence of an organ or tissue." In the field of hematology, the term refers to "incomplete, retarded, or defective development, or regenerative process." Hypoplasia: means failure to reach full-sized development (infantile uterus). The infantile uterus shows an abnormal relationship between the length of the cervix and the length of the uterine cavity of 1:1 or 2:1, whereas the hypoplasticuterus shows a normal relationship between the length of the cervix and the length of the uterine cavity of approximately 1:2.

3 ATROPHY Decrease in the size and weight of a tissue or organ after it has reached its full development. Atrophy may be due to reduction in the number or size of component cells or both the atrophic cells usually replaced by fibrous tissue,rarely by fatty tissue as in skeletal muscles and pancreas. Types of atrophy: 1.Physiological atrophy (atrophy of the thymus after puberty) atrophy of the ovary and breast after menopause. 2.Pathological atrophy: A-general B-localizes

4 General atrophy : affect all organs and tissue (increase catabolism in long standing diseases, chronic malnutrition and starvation, senile atrophy in old age. Localized atrophy: Disuse atrophy Pressure atrophy Vascular atrophy Neuropathic atrophy Endocrine atrophy

5 HYPERTROPHY Abnormal Increase in the size and weight of an organ or tissue due to the increase in the size of its cells Types: Physiological: in the pregnant uterus Pathological: Adaptive hypertrophy due to chronic partial obstruction(hypertension,stomach in pyloric stone,bladder obstruction and intestinal obstruction). Compensatory hypertrophy occur in paired organ

6 HYPERPLASIA Increase in the size and weight of an organ or tissue due to the increase in the number of its component cells. Types: Physiological : occur in breast and genital organs at puberty. Pathological: Compensatory hyperplasia (hyperplasia of the bone marrow) Hormonal hyperplasia (breast and endometrium). Irritation( hyperplasia of the lymphoid tissue in infection and toxaemia)

7 METAPLASIA Transformation of differentiated cells (mature) into another type of differentiated cells of the same group to adapt themselves to changes in environment or function. Types: Epithelial metaplasia: columnal or transitional epith changes into more resistant stratified squamous type in chronic inflammation of bronchi and gall bladder. C.T metaplasia: bone,calcified lesion Serosal metaplasia(methothelial metaplasia) may change into cubical,columnal,stratified. Tumor metaplasia: cells of malignant tumor.

8 DYSPLASIA Disordered epithelial cellular proliferation commonly in association with chronic inflammation. Sites :mucous membrane, epidermis and liver. Types: Mild affect the basal third of epithelium Moderate affect the lower two third Sever affect the whole thickness. Prognosis: Revisable when irritant is removed,sever dysplasia consider as pre-invasive neoplasm (pre cancer).

9 TUMOURS

10 A tumor or neoplasm is a self controlling growth formed by unlimited multiplication of abnormal cells in one of the body tissues or organs. General characteristic of tumors: Forms a mass which has no useful function. Do not obey the biologic factors. Any tissue may be the seat of tumor formation. Tumors cells have a supporting stroma of fibrous tissue and supplying blood vessels. Activity of tumors cells spent mainly in multiplication. Tumors classified according to their behaviors into benign and malignant.

11 Differentiate between hyperplasia and neoplsia(tumors)? Hyperplasia Usually has a useful function Excited by stimulus Limited stop on removal of the stimulus Cells normal in shape and pattern The etiology factors in both are different neoplasia Has no useful function Independent of stimulus Not limited and proceed independently Cells abnormal in shape and pattern The etiology factors in both are different

12 BENIGN TUMORS General characters Gross picture: Usually small in size and in a solid organ takes spherical or ovoid shape and margin are sharply defined, growing from surface showing polyploidy mass. Capsulated Cut surface usually solid,cystic necrosis and haemorrhage are very rare or absent. Microscopic picture: Cells resembles the cells of tissue of origin, small and nearly equal size and similar shape.

13 Nuclear usually small compared to the cytoplasm mitotic figures are few or absent. have well formed stroma and few blood vessels. Behavior: Rate of growth slow. Mode of growth by expansion Localized do not spread Effect on host do not kill the host or destroy the surrounding tissue except compresses vital structure. Recurrence absent

14 Malignant transformation: may occur by Increase rate of growth Loss of cellular differentiation Inability to form ground substance (stroma). Infiltration of the capsule and surrounding tissue.

15 MALIGNANT TUMORS General characters Gross picture: Usually reach large size in short time and takes different gross shapes: In solid organ appear as hard fixed irregular mass with will defined edge. In body surface tumors: polyploidy,ulcerative and infiltration. Not capsulated. Cut surface usually solid with area of necrosis and haemorrhage Microscopic picture: Cells not resembles the cells of tissue of origin. Shows loss of differentiation.

16 Malignant tumor showing great similarity well differentiated Malignant tumor showing moderate similarity moderate differentiated. Malignant tumor showing no similarity undifferentiated. Cellular morphology: Variation in shape and size pleomorphism Hyperchromatic nuclear large nuclear variable in shape and size also position, show many mitotic figures, multinucleated tumor giant cell.

17 Tumor giant cell

18 Nuclear pleomorphism & Multiple mitoses

19 Behavior: Rate of growth rapid. Mode of growth by infiltration mode Localization does not remain locally at site of origin. Effect on host usually kill the host Recurrence surgical removal is often followed by recurrence.

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21 Spread of malignant tumors (mechanism of spread): 1.Invasion of matrix: occur along the following steps Attachment-local degradation by hydrolytic enzymesmovement by pseudopodia migration is mainly guided by the chemotactic effect of the degradation products of the matrix. 2.Vascular dissemination : tumors cells invade lymphatic,capillary, veins and rarely arteries. Route of spread: Direct local spread infiltrate the surrounding tissue. Distant spread: By lymphatic spread either lymphatic embolism or lymphatic permeation

22 2.Blood spread: Malignant tumor invade the thin wall of veins and pass through blood stream. From lymphatic vessels drains into the venous circulation organ metastasis most frequently affected Liver then lung and bone and it is rare in intestine,spleen, pancreas and skeletal muscle. Metastasis appear as multiple scattered round nodules slightly variable in size. 3.Transcoelomic spread this spread through serous cavities. it occurs in tumors of organ covered by serous membrane.

23 Sites: peritonium gastric and colonic cancer Pleural and pericardium Malignant tumor in the brain 4.Implantation:either through natural passages pelvis to urinary bladder or direct implantation during surgical removal

24 Tumor spread

25 No Site or origin Benign tumor Malignant tumor 1 Epithelial tissue papilloma carcinoma 2 Adipose tissue adenoma Adeno carcinoma Connective tissue sarcoma 3 Fibrous tissue fibroma fibrosarcoma 4 lipids lipoma liposarcoma 5 Cartilage chondrioma chondriosarcoma 6 bone osteoma osteosarcoma 7 smooth muscle leiomyoma leiomyosarcoma 8 Skeletal muscle rhabdomyoma rhabdomyosarcoma

26 No Site or origin Benign tumor Malignant tumor 9 Vascular tissue haemangioma Haemangiosarcoma 10 Lymphatic vessels lymphangioma lymphangiosarcoma Special types 11 teratoma mature immature

27 TERATOMA A composite tumor containing ectodermal,mesodermal and endodermal tissue. Origin: Totipotent cells of somatic origin Germ cells Sites: Common sites are ovary and testis. Types: Mature teratoma and immature teratoma

28 Mature teratoma Ectodermal tissue :nerve cells stratified epithelial dental structure..etc. Mesodermal tissue :fibrous tissue,cartilage,bone,fat Endodermal tissue:clomnal epithelial,glandular epith Mature teratoma is of two types: Dermoid cyst: common in the ovary cyst usually lined with st.sq.epithelial and contain yellow sebaceous secretion the tumor tissue project show a mass called dermoid which may show hair teeth and other structure. Solid mature teratoma: less common mature teratoma rarely becomes malignant usually squamous cell carcinoma develops

29 Mature teratoma

30 IMMATURE (MALIGNANT )TERATOMA Rare tumor grossly solid tumors with area necrotic and haemorrhage. Microscopically consist of a mixture of mature and malignant immature tissues. The immature teratomas grow rapidly and metasize widely by blood and lymphatics

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