肿瘤商学院PPT.ppt

2018-1-28 1 肿瘤(Tumor, Neoplasma) 2018-1-28 2 第一节    肿瘤的概念和一般形态 肿瘤：在各种致瘤因素作用下，局部组织的细胞在基因水平上失去对其生长的正常调控，导致异常增生而形成的新生物。常以局部肿块表现。 基本特征： 组织块呈过度而不协调的生长； 即便诱发刺激因素停止后，这种组织块仍不断生长。 2018-1-28 3 一般形态（一）肉眼1 数目和大小：体积差别大。 2 形状：形态多种多样，与发生部位、组织起源、生长方式和肿瘤的良恶性有关。 3 颜色：灰白色，灰红色，少数有特定颜色。 2018-1-28 4 Fig The normal appearance (upper left) of the cervix is shown grossly. Note the central cervical os and the smooth, glistening epithelial surface.Fungating, exophytic tumor (upper right) is seen on the cervix, typical for invasive squamous cell carcinoma.(lower right) Here is the uterus with tubes and ovaries resected at surgery. The uterus is opened to reveal a fungating tan mass. This is an endometrial carcinoma. 2018-1-28 5 Small cell anaplastic (oat cell) carcinoma of the lung appears here in a smoker. Smokers who stop will diminish their risk for lung cancer, even after just a couple of years. Middle A large squamous cell carcinoma of the lung in a smoker is shown here. The incidence of both squamous cell carcinomas and small cell anaplastic carcinomas of lung is far greater in smokers than non-smokers. Right Emphysema, of the centrilobular type, with numerous enlarged air spaces as a result of the loss of lung tissue from smoking is demonstrated here grossly. Right normal lung. 2018-1-28 8 第二节    肿瘤的同型性和异型性 同型性：不论良性或恶性肿瘤，与发生该肿瘤的正常组织相比较，总有一定程度上的相似之处。常作为诊断其组织起源的依据。 异型性：肿瘤组织无论在细胞形态和组织结构上，都与其发源的正常组织有不同程度的差异。异型性大小是确定肿瘤良恶性的主要组织学依据。 2018-1-28 9 肿瘤细胞的异型性1 瘤细胞的多型性：形态不一。2 瘤细胞核的多型性：细胞核体积大，多形核。3 瘤细胞胞浆的改变：胞浆内核蛋白体增多，呈嗜碱性。分泌物不同而不完全一样。 2018-1-28 10 Fig Upper , the appearance of a normal breast acinus is shown here. A layer of myoepithelial cells, some of which are slightly vacuolated, is seen just around the outside of the acinus. Middle, is atypical ductal epithelial hyperplasia of the breast. A increased risk (5 times normal) for breast carcinoma occurs with cytologically atypical epithelial hyperplasia. Lower , Lobular carcinoma in situ (LCIS) is seen here. LCIS consists of a neop