2. Specific learning objectives
• Understand the invasion-metastasis cascade
• Concept of tumor grade
• Concept of tumor stage
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11. Organ predilection ?
• location of the primary tumor and its vascular or
lymphatic drainage
• organ that presents the first capillary bed they
encounter after entering the circulation
• Natural pathways of drainage do not readily
explain the distribution of metastases !
• Adhesion molecules – ligands
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13. Grading / Staging
• quantify the probable clinical aggressiveness
of a given neoplasm (grading) and
• its apparent extent and spread (stage) in the
individual patient
• Why is it needed ?
• Make an accurate prognosis and for
comparing end results of various treatment
protocols
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14. Grading
• estimate aggressiveness based on
– cytologic differentiation of tumor
cells
– Number of mitoses within the
tumor.
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15. Staging
• based on
– the size of primary tumor
– spread to regional lymph nodes
– presence or absence of metastases
• TNM stage
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16. Take home points
• Invasion – hallmark of malignancy
• 4 steps of invasion
• Metastatic site depends on location /
chemokines
• Grading – cytologic appearance
• Staging – TNM – more value than grading
clincially
1617/10/2015 Dept of Pathology