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Samenvatting Mechanismen van ziekte: neoplasie
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Samenvatting mechanismen van ziekte (deel neoplasie, gegeven door Jo Van Dorpe)
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Neoplasie1: Basisbegrippen en nomenclatuur
Tumor
- Clonale proliferatie tgv mutatie
- Clonale neoplastische cellen
- Reactief tumorstroma
o Desmoplastische stromareactie
- Benigne
o Niet invasief
o Lokaal
o Chirurgie
- Maligne
o Invasief
o Metastasen mglk
- Naamgeving
o Epitheliaal (b: + OMA, m: + CARCINOMA)
Éénlagig klierepitheel Adenoma Adenocarcinoma
Meerlagig plaveiselepitheel Papilloma Plaveiselcelcarcinoma
Overgangsepitheel Papilloma Urotheel/transitioneel celcarcinoma
Cysten Cystadenoma cystadonocarcinoma
Melanocyten / Melanoma
Mesotheel (longvlies) / Mesothelioma
Adenocarcinoma: prostaat/borst/colon/long
Squameus carcinoma: huid/mond/f/larynx/slokdarm/long/anus/cervix
o Mesenchymaal (b: + OMA, m: + SARCOMA)
Fibroblasten Fibroma Fibrosarcoma
Bloedvaten Angioma Angiosarcoma
WBC/voorlopers WBC / Leukemie
Lymfocyten / Lymfoma
Plasmocyten / Plasmocytoma
Lymfevaten Lymfangioma Angiosarcoma
Kraakbeen Chondroma Chondrosarcoma
Vet Lipoma Liposarcoma
GSP Leiomyoma Leimyosarcoma
Gestreept spierweefsel Rhabdomyoma rhabdomyosarcoma
Leukemie
ALL: acute lymfoblastenleukemie
AML: acute myeloïde leukemie
CLL: chronische lymfocytenleukemie
CML: chronische myeloïde leukemie
Lymfomen
Hodgkin: Reed-Sternberg cel
Non-Hodgkin: B/T-cel lymfomen
o Gemengd epitheliaal-mesenchymaal
, Endometrium/speekselklieren
Maligne : carcinosarcoma
o Hamartoma
Ongewone architectuur
Pulmonaal hamartoma, odontoom
o Choristoma
Ectopisch
o Teratoma
Immature/mature cellen uit >1 vd kiembladen
Testes/ovaria
- Kenmerken
o Differentiatie
Anaplasie: gebrek aan diff
Celatypie: celpleomorfisme: tumorcellen variëren in vorm en grootte
Kernatypie:
Hyperchromasie + geklonterd chromatine: donkerder
Onregelmatige vorm
Grote nucleolen
Mitose
Toen mitotische activ + asym/bizarre mitotische figuren
Verlies polariteit
Neovascularisatie < tumorgroei: necrose
Apoptose
Tumorale reuscellen
o Groeisnelheid
Snel: KA
Traag: GA
~ gevoeligheid voor chemo
Celprod tov celverlies
Ki67: proliferatiemerker
o Invasie
GA: gelokaliseerd, enucleatie volstaat
KA: progressieve infiltratie + destructie omgevend weefsel, brede resectie
o Metastasering: steeds maligne
Lymfatisch
Vooral carcinomen
Hematogeen
Directe seeding: visc/par blad
Peritoneaal
Pleuraal
Niet meer operabel
2: Epidemiologie
- Mannen: prostaat – long – colon + rectum
- Vrouwen: borst – colon + rectum – long
- Omg factoren: roken, alcohol, obesitas, dieet, infecties (HPV, EBV, HBV, HCV, H. pylori), UV-
licht, asbest, houtstof
- Leeftijd: >55j
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