Serdar Balcı

Nomenclature and Classification of Neoplasia

Serdar BALCI, MD

What is Cancer?

Cancer is a genetic disease

Genetic changes allow excessive and unregulated proliferation that becomes autonomous (independent of physiologic growth stimuli), although tumors generally remain dependent on the host for their nutrition and blood supply.

Karkinos: Crab like

Rosai and Ackerman’s Surgical Pathology

The field of Cancer Research is broad

When will there be a cure for cancer?

Which cancer?

Hodgkin lymphoma is highly curable

Pancreas Cancer is nearly always fatal

Cancer is a genetic disorder

Genetic alterations are heritable

Passed to daughter cells via cell division

Cells with growth and survival advantages dominate the population

One single cell ultimately gives rise to the tumor → all tumors are clonal

Hallmarks of Cancer - Properties of Cancer


Some Terminology








Oncology (oncos: tumor)

Neoplasia “new growth”

Benign Tumors

Microscopic and gross characteristics are considered to be relatively innocent

remain localized, local surgical removal

patient generally survives

sometimes they are responsible for serious disease

Malignant Tumors


From the Latin word for “crab”

Adhere to any part that they seize in an obstinate manner, similar to a crab’s behavior




Malignant Epithelial Tumor

Malignant Mesenchymal Tumor

Small Blue Round Cell Tumor




Invade and destroy adjacent structures

**Spread to distant sites (metastasize) **

Cause death

Not all cancers go into a deadly course

Most aggressive are also some of the most curable

Tumors have two components

Nomenclature of Neoplasms

WHO Classification of Neoplasms

Tumors are named according to embryologic origin

Endoderm derived → Epithelial

Ectoderm derived → Epithelial, Neuronal

Mesoderm derived → Epithelial, Mesenchymal and Hematolymphoid

Tumors are named according to normal cell type they resemble or derived from

Squamous cell, Urothelial cell

Fibroblast, Chondrocyte



Nomenclature of Benign Tumors

Tumor cell type + oma

Fibroblast + oma → Fibroma

Chondrocyte + oma → Chondroma

Robbins Basic Pathology

Nomenclature of Benign Tumors

Thyroid Follicular Adenoma

Tumor is Forming Glands that resemble normal tissue

Robbins and Cotran’s Pathological Basis of Diseases

Tubular Adenoma of Colon




Gland forming tumor/mass

Projecting into the lumen

Connected to mucosa with a stalk

Robbins Basic Pathology

Robbins Basic Pathology

Robbins Basic Pathology


Finger like projections

Robbins Basic Pathology

Urologic Surgical Pathology, Chapter 6, 228-316.e23

Ovary, Serous Cystadenoma

Benign Neoplasm forming Cyst

Rosai and Ackerman’s Surgical Pathology

Nomenclature of Malignant Tumors

Chondrocyte + Sarcoma → Chondrosarcoma

Fibroblast + Sarcoma → Fibrosarcoma

Epithelial tumors forming glands → Adenocarcinoma

Epithelial tumors forming squamous cells → Squamous cell carcinoma

Papillary carcinoma

Papillary cystadenocarcinoma

Ovarian Cystadenocarcinoma

Rosai and Ackerman’s Surgical Pathology

Nomenclature of Malignant Tumors Differentiation

How much the tumor cell resemble the normal counterpart

Well differentiated

Moderately differentiated

Poorly differentiated


Elsevier’s Integrated Pathology

Robbins Basic Pathology

Robbins Basic Pathology

Malignant tumors ending with -oma





Insulinoma, gastrinoma, somatostatinoma, glucagonoma


Tumors with more than one cell type

Mixed tumor of salivary gland, Pleomorphic Adenoma

Robbins Basic Pathology

Fibroadenoma of Breast

Robbins Basic Pathology

Wilms tumor (nephroblastoma)

Rosai and Ackerman’s Surgical Pathology


Mixed tumor

Mature, immature cells

More than one germ layer

Originate from totipotent germ cells

Ovary, testis

give rise to neoplasms that mimic, in helter-skelter fashion, bits of bone, epithelium, muscle, fat, nerve, and other tissues

Mature Csytis Teratoma of Ovary

Robbins Basic Pathology

Robbins and Cotran’s Pathological Basis of Diseases

Mixed Tumors

Robbins Basic Pathology


Tumors composed of immature cells resembling those that form the fetal anlage or primordia of adult organs.

Retinoblastoma is a tumor of the eye

Neuroblastoma is a tumor composed of nerve precursors cells (neuroblasts)

Hepatoblastoma is a tumor composed of fetal hepatocytes

Nephroblastoma: Wilms tumor


Hodgkin disease: a special form of malignant lymphoma

Ewing sarcoma: a malignant bone tumor

Wilms tumor: a malignant kidney tumor of childhood, also known as nephroblastoma

Kaposi sarcoma: a blood vessel tumor of the skin and internal organs

Burkitt lymphoma: a form of malignant lymphoma


Bile Duct Hamartoma in Liver

Pulmonary Hamartoma in Lung

Robbins and Cotran’s Pathological Basis of Diseases


A congenital anomaly

Heterotopic rest of cells

A small nodule of well-developed and normally organized pancreatic tissue in the submucosa of the stomach, duodenum, or small intestine

May contain islets of Langerhans and exocrine glands

Heterotopic exocrine pancreas tissue in stomach

Rosai and Ackerman’s Surgical Pathology