Neoplasia: Spread Of Cancer

1. Seeding

-Neoplasms invade a natural body cavity

-Characteristic of cancers of the ovary, which often cover the peritoneal surfaces

-Can glaze all peritoneal surfaces yet not invade the underlying parenchyma

2. Lymphatic spread

-more typical of carcinomas

-may traverse all of the lymph nodes ultimately to reach the vascular compartment via the thoracic duct

-the necrotic products of the neoplasm and tumor antigens often evoke reactive changes in the nodes, such as enlargement and hyperplasia of the follicles (lymphadenitis) and proliferation of macrophages in the subcapsular sinuses (sinus histiocytosis)

3. Hematogenous spread

-more typical of sarcomas

-most feared consequence of a cancer

-arteries are penetrated less readily than veins

-liver and lungs are the most frequent secondary sites of hematogenous dissemination.

-Renal cell carcinoma often invades the renal vein up to the inferior vena cava reaching the right side of the heart

-prostatic carcinoma preferentially spreads to bone

-bronchogenic carcinomas involve the adrenals and brain

-neuroblastomas spread to the liver and bones

-skeletal muscles are rarely the site of secondary deposits

Category: Pathology Notes