{"id":1112,"date":"2024-02-22T15:05:14","date_gmt":"2024-02-22T20:05:14","guid":{"rendered":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/?post_type=chapter&p=1112"},"modified":"2026-01-03T16:16:38","modified_gmt":"2026-01-03T21:16:38","slug":"neoplasms-benign-and-malignant","status":"web-only","type":"chapter","link":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/chapter\/neoplasms-benign-and-malignant\/","title":{"raw":"Neoplasms - Benign and Malignant","rendered":"Neoplasms – Benign and Malignant"},"content":{"raw":"

What is a Neoplasm?<\/strong><\/h3>\r\nThe term neoplasm<\/strong> originates from the words 'neo'<\/em> meaning new and 'plasma'<\/em> which is Greek for formation. Within humans neoplasm refers to a new growth, or an abnormal mass of cells\u00a0 that are not responding to normal genetic controls, reproducing excessively and possibly depriving nearby cells of nutrition.\u00a0 This exuberant growth is characterized by cells that continue to divide (i.e. proliferate or go through mitosis) without the need for them to do so.\u00a0 This mass of cells or neoplasm can be called a tumor<\/strong> and it may be malignant<\/strong> (cancerous) and it may be benign<\/strong> (non-cancerous).\u00a0 Typically the cells are investigated using different laboratory tests including viewing their appearance under a microscope.\u00a0 In this way it is often possible to identify the origin cell type<\/strong> (e.g. thyroid, lung, bone, etc.).\u00a0 The appeance of the cells under the microscope, their morphology<\/strong> (shape, size of nuclei, etc.) can also be indicative of whether cells are pre-cancerour or cancerous.\r\n

Tumors are categorized as Benign or Malignant<\/strong><\/h3>\r\nIn order to determine the best treatment, it is necessary to assess the tumor (neoplasm) to determine whether the mass of cells is potentially harmful or not.\u00a0 There are some characterisitics that are typical of benign tumors and some characteristics that are observed when the tumor is cancerous (or malignant).\r\n\r\n \r\n

Benign Tumors<\/h3>\r\nBenign tumors<\/strong> are typically slow-growing, encapsulated, and freely movable on palpation.\u00a0 Benign tumors don't metastasize and are therefore not considered cancerous.\u00a0 The morphology of cells is similar to normal cells and is still considered differentiated (mature).\u00a0 \u00a0Cells in benign tumors usually have a normal number of chromosomes. The rates of mitosis are fairly normal and the mass grows slowly.\u00a0 Benign tumors rarely cause systemic effects.\u00a0 Additionally, once benign tumors are removed, they don't usually recur.\u00a0 Any damage to the body, typically is limited to surrounding tissue that may be compressed (e.g. blood vessels, esophagus).\u00a0 However, benign tumors can be fatal in the brain due to the increase in intracranial pressure that can arise which leads less cranial blood flow, hypoxia and neuronal death.\r\n\r\nThere is a naming pattern for benign tumors, in that the suffix -oma<\/strong><\/em> is frequently used (e.g. adenoma<\/strong> = benign tumor comprised of epithelial glandular cells).\u00a0 There are some exceptions to this rule, in the glioma is a malignant tumor consisting of cancerous neuroglial cells, and lymphoma is cancer of the lymphocytes.\r\n\r\n \r\n

Malignant Tumors<\/h3>\r\nMalignant tumors<\/strong> on the other hand, lack a capsule, invade surrounding tissues, and are characterized by atypical, immature cells that are undergoing continual cell cycling.\u00a0 Cells are accumulating not due to the speeding up of the cell cycle itself, but by the fact that in comparison to healthy tissue, more cells are going through cell cycling and at times fewer cells are quiescent (inactive\/dormant) or going through apoptosis.\u00a0 The morphology of these cells typically reveals that they are immature<\/strong> and undifferentiated.<\/strong>\u00a0 \u00a0This may make sense as it is known that cells that go through cycle cycling are typically immature and haven't exited the cell cycle to differentiate and mature.\u00a0 \u00a0Under the microscope these cells are likely graded as dysplastic<\/strong> (pre-cancerous, slightly immature) or anaplastic<\/strong> (fully immature and cancerous) based on their appearance (e.g. altered cell membranes and organelles) and growth patterns (over-lapping, clustered, homogeneity of cell type etc.).\u00a0 Most cancerous cells exhibit aneuploidy (too few or too many copies of some chromosomes) which is suspected to play a role in their rogue style of survival.\r\n\r\nCancerous cells typically have altered surface antigens and lost their cell contact inhibition<\/strong> abilities.\u00a0 Cell contact inhibition, is the ability of most human cells to sense the presence and pressure of neighbouring cells and take that as a clue to stop growing.\u00a0 Cancerous cells have lost this ability and continue to go throught mitosis and accumulate.\u00a0 Additionally, cancerous cells no longer adhere to each other, meaning that they more easily can break loose from the mass and invade other tissues and spread to distant site via the blood or lymphatic vessels.\u00a0 Interestingly, most cells die during transit, though without treatment, some do establish secondary tumors.\u00a0 This invasion of tissues and spreading is termed metastasis<\/strong> and often causes systemic effects.\u00a0 Cancerous cells, if not treated, spread into local tissues and metastasize distantly forming secondary sites of cancerous growth.\u00a0 Common secondary sites include: lungs, liver, bone and brain.\u00a0 Unlike benign tumors, malignant tumors can recur if removed and are also more likely to be life-threatening if not removed, as they cause tissue destruction which leads to organs failing.\r\n\r\nThere is a naming pattern for malignant tumors, in that the suffix -carcinoma<\/strong><\/em> is frequently used (e.g. adencarcinoma<\/strong> = malignant tumor comprised of epithelial glandular cells).\r\n\r\nThe Greek physician Hippocrates (460-370 B.C.) is credited with being the first to use the terms carcinos<\/em> and carcinoma<\/em> which translate to crab.\u00a0 This was based on the appearance of cancerous malignant tumors spreading with finger-like projections making them look like crabs.\u00a0 If you are a familiar with astrology, you may know the sign for Cancer is in the shape of a crab, though the associated constellation of stars looks more like a lobster or crayfish.\r\n\r\n \r\n

Types of Malignant Tumors and Naming Patterns<\/h3>\r\nCancers can technically arise in any cells that can divide and are often named based on the cell type of origin.\u00a0 It is worth remembering that there are 4 tissue types of the human body:\u00a0 epithelial tissue, connective tissue, nervous tissue and muscle tissue.\u00a0 This is reflected in the naming patterns of cancers.\r\n
    \r\n \t
  1. Carcinomas:<\/strong>\u00a0 The most common type of cancers are comprised of epithelial cells, and account for 90% of all cancers.\u00a0 It is thought that lymphatiThe suffix -carcinoma<\/strong><\/em> is frequently used to name these types of cancers.\u00a0 For example:\r\n
      \r\n \t
    • \r\n
      Adenocarcinomas:<\/strong> epithelial cancers in a gland<\/div><\/li>\r\n \t
    • \r\n
      Squamous cell carcinoma:<\/strong> epithelial cancers originating in the skin<\/div>\r\n
        \r\n \t
      • However there are exceptions to this naming pattern, for example:<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
      • \r\n
        Melanomas:<\/strong> epithelial cancers originating in the melanocytes of the skin<\/div><\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
      • Sarcomas:<\/strong> Cancers can also arise in connective tissue and muscle tissue (i.e. mesenchymal tissue, e.g. bone, muscle, cartilage), are usually very malignant and are given the suffix -sarcoma<\/em><\/strong>.\u00a0\u00a0For example:\r\n
          \r\n \t
        • \r\n
          Osteosarcoma:<\/strong> bone cancer<\/div><\/li>\r\n \t
        • \r\n
          Rhabdomyosarcoma:<\/strong> cancer of the striated muscle<\/div><\/li>\r\n \t
        • Chondrosarcoma:<\/strong>\u00a0 cancer of the cartilage<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
        • Glioma:<\/strong>\u00a0 This category consists of cancers of any one (or combination) of the four types of neuroglial cells, though more commonly these three neuroglial cell types are involved:\r\n
            \r\n \t
          • \r\n
              \r\n \t
            • astrocytoma<\/strong> = cancer of the astrocytes (scaffolding and support neuroglial cells)<\/li>\r\n \t
            • ependyoma<\/strong> = cancer of the ependymal cells (cells that line the brain ventricles and central canal that produce cerebrospinal fluid, CSF)<\/li>\r\n \t
            • oligodendroglioma<\/strong> = cancer of the oligodendrocytes (myelin sheath cells)<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n<\/li>\r\n \t
            • Unique Nomenclature:<\/strong>\u00a0 Several malignant tumors have unique names: Hodgkin\u2019s disease, Wilms\u2019 tumor, Leukemia, Lymphoma, Ewing Sarcoma<\/li>\r\n<\/ol>\r\n

              Immune Response to Cancer and Metastasis - Almost Perfect?<\/strong><\/h3>\r\nIt is apparent that for cancerous cells to establish themselves, they have to evade<\/strong> the immune system.\u00a0 In previous sections, it was noted that several leukocytes<\/strong> (i.e. White Blood Cells, WBCs) are capable of destroying cancerous cells.\u00a0 Natural killer cells<\/strong> insert perforin portals causing cancerous cells to lyse.\u00a0 Cytotoxic T lymphocytes<\/strong> (i.e. CD8 cells) are capable of causing lysis of cancerous cells using perforin, lymphotoxin or even by inducing the cell to undergo apoptosis.\u00a0 It is thought that most cancerous cells that do occur are successfully destroyed by the immune system.\u00a0 It has been found that when the immune system is compromised, for example when a person is immunocompromised due to an underlying disease (e.g. AIDS), they are more likely to develop cancers.\r\n\r\n \r\n\r\nThink About Questions:<\/strong>\r\n\r\nWhat is fibroma?\u00a0 benign fibrous tissue tumor\r\n\r\nDoes brain cancer more commonly refer to cancer of the neuroglial cells or neurons?\r\n\r\nWhat is oncology?\u00a0 Study of malignant tumors (cancer)\r\n\r\nWhat is carcinogenesis?\r\n\r\nWhat is oncogenesis?\r\n\r\nName that cancer?\r\n
                \r\n \t
              • Lung carcinoma:<\/strong> most often lung cancer begins in epithelial cells (e.g. glandular or squamous epithelial cells)<\/li>\r\n \t
              • Breast carcinoma:<\/strong> most often start in glandular epithelial cells (so can be called adenocarcinomas)<\/li>\r\n \t
              • Cervical carcinoma: <\/strong>most often cervical cancer begins in epithelial cells (e.g. glandular or squamous epithelial cells)<\/li>\r\n \t
              • Prostate Cancer:<\/strong> remembering that the prostate is a gland, this type of cancer is an adenocarcinoma<\/li>\r\n \t
              • Liposarcoma:<\/strong> cancer of adipose tissue<\/li>\r\n<\/ul>","rendered":"

                What is a Neoplasm?<\/strong><\/h3>\n

                The term neoplasm<\/strong> originates from the words ‘neo’<\/em> meaning new and ‘plasma’<\/em> which is Greek for formation. Within humans neoplasm refers to a new growth, or an abnormal mass of cells\u00a0 that are not responding to normal genetic controls, reproducing excessively and possibly depriving nearby cells of nutrition.\u00a0 This exuberant growth is characterized by cells that continue to divide (i.e. proliferate or go through mitosis) without the need for them to do so.\u00a0 This mass of cells or neoplasm can be called a tumor<\/strong> and it may be malignant<\/strong> (cancerous) and it may be benign<\/strong> (non-cancerous).\u00a0 Typically the cells are investigated using different laboratory tests including viewing their appearance under a microscope.\u00a0 In this way it is often possible to identify the origin cell type<\/strong> (e.g. thyroid, lung, bone, etc.).\u00a0 The appeance of the cells under the microscope, their morphology<\/strong> (shape, size of nuclei, etc.) can also be indicative of whether cells are pre-cancerour or cancerous.<\/p>\n

                Tumors are categorized as Benign or Malignant<\/strong><\/h3>\n

                In order to determine the best treatment, it is necessary to assess the tumor (neoplasm) to determine whether the mass of cells is potentially harmful or not.\u00a0 There are some characterisitics that are typical of benign tumors and some characteristics that are observed when the tumor is cancerous (or malignant).<\/p>\n

                 <\/p>\n

                Benign Tumors<\/h3>\n

                Benign tumors<\/strong> are typically slow-growing, encapsulated, and freely movable on palpation.\u00a0 Benign tumors don’t metastasize and are therefore not considered cancerous.\u00a0 The morphology of cells is similar to normal cells and is still considered differentiated (mature).\u00a0 \u00a0Cells in benign tumors usually have a normal number of chromosomes. The rates of mitosis are fairly normal and the mass grows slowly.\u00a0 Benign tumors rarely cause systemic effects.\u00a0 Additionally, once benign tumors are removed, they don’t usually recur.\u00a0 Any damage to the body, typically is limited to surrounding tissue that may be compressed (e.g. blood vessels, esophagus).\u00a0 However, benign tumors can be fatal in the brain due to the increase in intracranial pressure that can arise which leads less cranial blood flow, hypoxia and neuronal death.<\/p>\n

                There is a naming pattern for benign tumors, in that the suffix -oma<\/strong><\/em> is frequently used (e.g. adenoma<\/strong> = benign tumor comprised of epithelial glandular cells).\u00a0 There are some exceptions to this rule, in the glioma is a malignant tumor consisting of cancerous neuroglial cells, and lymphoma is cancer of the lymphocytes.<\/p>\n

                 <\/p>\n

                Malignant Tumors<\/h3>\n

                Malignant tumors<\/strong> on the other hand, lack a capsule, invade surrounding tissues, and are characterized by atypical, immature cells that are undergoing continual cell cycling.\u00a0 Cells are accumulating not due to the speeding up of the cell cycle itself, but by the fact that in comparison to healthy tissue, more cells are going through cell cycling and at times fewer cells are quiescent (inactive\/dormant) or going through apoptosis.\u00a0 The morphology of these cells typically reveals that they are immature<\/strong> and undifferentiated.<\/strong>\u00a0 \u00a0This may make sense as it is known that cells that go through cycle cycling are typically immature and haven’t exited the cell cycle to differentiate and mature.\u00a0 \u00a0Under the microscope these cells are likely graded as dysplastic<\/strong> (pre-cancerous, slightly immature) or anaplastic<\/strong> (fully immature and cancerous) based on their appearance (e.g. altered cell membranes and organelles) and growth patterns (over-lapping, clustered, homogeneity of cell type etc.).\u00a0 Most cancerous cells exhibit aneuploidy (too few or too many copies of some chromosomes) which is suspected to play a role in their rogue style of survival.<\/p>\n

                Cancerous cells typically have altered surface antigens and lost their cell contact inhibition<\/strong> abilities.\u00a0 Cell contact inhibition, is the ability of most human cells to sense the presence and pressure of neighbouring cells and take that as a clue to stop growing.\u00a0 Cancerous cells have lost this ability and continue to go throught mitosis and accumulate.\u00a0 Additionally, cancerous cells no longer adhere to each other, meaning that they more easily can break loose from the mass and invade other tissues and spread to distant site via the blood or lymphatic vessels.\u00a0 Interestingly, most cells die during transit, though without treatment, some do establish secondary tumors.\u00a0 This invasion of tissues and spreading is termed metastasis<\/strong> and often causes systemic effects.\u00a0 Cancerous cells, if not treated, spread into local tissues and metastasize distantly forming secondary sites of cancerous growth.\u00a0 Common secondary sites include: lungs, liver, bone and brain.\u00a0 Unlike benign tumors, malignant tumors can recur if removed and are also more likely to be life-threatening if not removed, as they cause tissue destruction which leads to organs failing.<\/p>\n

                There is a naming pattern for malignant tumors, in that the suffix -carcinoma<\/strong><\/em> is frequently used (e.g. adencarcinoma<\/strong> = malignant tumor comprised of epithelial glandular cells).<\/p>\n

                The Greek physician Hippocrates (460-370 B.C.) is credited with being the first to use the terms carcinos<\/em> and carcinoma<\/em> which translate to crab.\u00a0 This was based on the appearance of cancerous malignant tumors spreading with finger-like projections making them look like crabs.\u00a0 If you are a familiar with astrology, you may know the sign for Cancer is in the shape of a crab, though the associated constellation of stars looks more like a lobster or crayfish.<\/p>\n

                 <\/p>\n

                Types of Malignant Tumors and Naming Patterns<\/h3>\n

                Cancers can technically arise in any cells that can divide and are often named based on the cell type of origin.\u00a0 It is worth remembering that there are 4 tissue types of the human body:\u00a0 epithelial tissue, connective tissue, nervous tissue and muscle tissue.\u00a0 This is reflected in the naming patterns of cancers.<\/p>\n

                  \n
                1. Carcinomas:<\/strong>\u00a0 The most common type of cancers are comprised of epithelial cells, and account for 90% of all cancers.\u00a0 It is thought that lymphatiThe suffix -carcinoma<\/strong><\/em> is frequently used to name these types of cancers.\u00a0 For example:\n
                    \n
                  • \n
                    Adenocarcinomas:<\/strong> epithelial cancers in a gland<\/div>\n<\/li>\n
                  • \n
                    Squamous cell carcinoma:<\/strong> epithelial cancers originating in the skin<\/div>\n
                      \n
                    • However there are exceptions to this naming pattern, for example:<\/li>\n<\/ul>\n<\/li>\n
                    • \n
                      Melanomas:<\/strong> epithelial cancers originating in the melanocytes of the skin<\/div>\n<\/li>\n<\/ul>\n<\/li>\n
                    • Sarcomas:<\/strong> Cancers can also arise in connective tissue and muscle tissue (i.e. mesenchymal tissue, e.g. bone, muscle, cartilage), are usually very malignant and are given the suffix -sarcoma<\/em><\/strong>.\u00a0\u00a0For example:\n
                        \n
                      • \n
                        Osteosarcoma:<\/strong> bone cancer<\/div>\n<\/li>\n
                      • \n
                        Rhabdomyosarcoma:<\/strong> cancer of the striated muscle<\/div>\n<\/li>\n
                      • Chondrosarcoma:<\/strong>\u00a0 cancer of the cartilage<\/li>\n<\/ul>\n<\/li>\n
                      • Glioma:<\/strong>\u00a0 This category consists of cancers of any one (or combination) of the four types of neuroglial cells, though more commonly these three neuroglial cell types are involved:\n
                          \n
                        • \n
                            \n
                          • astrocytoma<\/strong> = cancer of the astrocytes (scaffolding and support neuroglial cells)<\/li>\n
                          • ependyoma<\/strong> = cancer of the ependymal cells (cells that line the brain ventricles and central canal that produce cerebrospinal fluid, CSF)<\/li>\n
                          • oligodendroglioma<\/strong> = cancer of the oligodendrocytes (myelin sheath cells)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<\/li>\n
                          • Unique Nomenclature:<\/strong>\u00a0 Several malignant tumors have unique names: Hodgkin\u2019s disease, Wilms\u2019 tumor, Leukemia, Lymphoma, Ewing Sarcoma<\/li>\n<\/ol>\n

                            Immune Response to Cancer and Metastasis – Almost Perfect?<\/strong><\/h3>\n

                            It is apparent that for cancerous cells to establish themselves, they have to evade<\/strong> the immune system.\u00a0 In previous sections, it was noted that several leukocytes<\/strong> (i.e. White Blood Cells, WBCs) are capable of destroying cancerous cells.\u00a0 Natural killer cells<\/strong> insert perforin portals causing cancerous cells to lyse.\u00a0 Cytotoxic T lymphocytes<\/strong> (i.e. CD8 cells) are capable of causing lysis of cancerous cells using perforin, lymphotoxin or even by inducing the cell to undergo apoptosis.\u00a0 It is thought that most cancerous cells that do occur are successfully destroyed by the immune system.\u00a0 It has been found that when the immune system is compromised, for example when a person is immunocompromised due to an underlying disease (e.g. AIDS), they are more likely to develop cancers.<\/p>\n

                             <\/p>\n

                            Think About Questions:<\/strong><\/p>\n

                            What is fibroma?\u00a0 benign fibrous tissue tumor<\/p>\n

                            Does brain cancer more commonly refer to cancer of the neuroglial cells or neurons?<\/p>\n

                            What is oncology?\u00a0 Study of malignant tumors (cancer)<\/p>\n

                            What is carcinogenesis?<\/p>\n

                            What is oncogenesis?<\/p>\n

                            Name that cancer?<\/p>\n

                              \n
                            • Lung carcinoma:<\/strong> most often lung cancer begins in epithelial cells (e.g. glandular or squamous epithelial cells)<\/li>\n
                            • Breast carcinoma:<\/strong> most often start in glandular epithelial cells (so can be called adenocarcinomas)<\/li>\n
                            • Cervical carcinoma: <\/strong>most often cervical cancer begins in epithelial cells (e.g. glandular or squamous epithelial cells)<\/li>\n
                            • Prostate Cancer:<\/strong> remembering that the prostate is a gland, this type of cancer is an adenocarcinoma<\/li>\n
                            • Liposarcoma:<\/strong> cancer of adipose tissue<\/li>\n<\/ul>\n","protected":false},"author":1370,"menu_order":7,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"Pictures coming soon!","pb_authors":["zoe-soon"],"pb_section_license":"cc-by-nc-sa"},"chapter-type":[],"contributor":[60],"license":[57],"class_list":["post-1112","chapter","type-chapter","status-web-only","hentry","contributor-zoe-soon","license-cc-by-nc-sa"],"part":35,"_links":{"self":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/1112","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/users\/1370"}],"version-history":[{"count":23,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/1112\/revisions"}],"predecessor-version":[{"id":1156,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/1112\/revisions\/1156"}],"part":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/parts\/35"}],"metadata":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapters\/1112\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/media?parent=1112"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/pressbooks\/v2\/chapter-type?post=1112"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/contributor?post=1112"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.bccampus.ca\/pathophysiology\/wp-json\/wp\/v2\/license?post=1112"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}