Tumerigos

Tumerigos= Tumor + Amigos;

That is making friends with Head & Neck tumors.

Sound Insane???

But I believe, mastering any science or subject requires a deep understanding of all its minuities. Just like we know all our family members.

Hence it is important to show that kind of bond with tumors too.

Hence, let us try and divide tumors into their families,

We will try to form tumors families.

1. Oral Squamous Cell Carcinoma

This is the most commonly encountered malignant tumor of oral cavity. It is impossible to not know any aspect of it.

Let us have a look to know key members of it.

1. Squamous Epithelial Cell (Keratinocyte)
2.  Keratin

Families effect on surroundings: –

The Surroundings or social circle of Squamous Cell Carcinoma comprises of→

1. Inflammatory Cells (chiefly lymphocytes) →Police Inspectors.

2. Blood Vessels/ lymph Vessels→ Vehicles for transport…

1. Blood Vessels                                                                      Lymph Vessels

Provides distant transport                                          Local Transport to only two

To other organs.                                                           Lymph nodes.

• Muscles→ The great wall which is difficult to penetrate or Cross) due to its super quality cement.

• Salivary Gland and Perineurium→ Executive class or the VIP class which is tough to reach.

Basic Pathology genesis of Oral Cancer→

For any pathogenesis to occur in any close-knit units, may it be our families, friend circle or even our body, Continuous injury or trauma needs to occur.

Similarly, for cancerous transformation of normal i.e. physiologic squamous Cell it has to undergo continuous trauma for a long duration over the years.

 The trauma or injury causing agents could be external or internal. Main Factor

External→ Tobacco Additives

               → Areca nut

              → Alcohol

             → Consumption of hot & spicy food.

Here the main agent creating problem is tobacco and additives are the agents adding fuel to fire which include areca nut, capsacin

Which are not capable of causing forms but they certainly are harmful as they add ‘fuel to fire’

Internal factors are those that are bodily factors responsible for the state of cancer.

Just like the internal defense system of the too the country needs to be strong to fight external injuries similarly, body defense system also needs to be strong.

Hence any deficiency state of the body such as Iron deficiency anemia, especially in conditions such as “Plummer-vinson” syndrome and other vitamin deficiencies leads to an increased state of cancer in the body.

Moreover, just like in our day to day lives, during bad times opportunistic people play a vital role to increases the diseases.

Similarly, in our body also, opportunistic infections such as Candidiasis, Syphilis etc leads to cancer proliferation.

Basic Histopathology

A Normal Cell (Squamous) Structure

A normal Squamous Cell all is polypoidal with nucleus and cytoplasm in the ratio 1:4 i.e. nucleus is 1 part and cytoplasm is 4 parts.

The cell also has “Cell junctions” by which cell connects and communicates with other cells and also with the basement membranes.

These just like human beings also have hands and legs as connections to communicates with others through “Hand Shake” and legs for communication i.e. connecting the human being with outside world.

Hence, for a cell Desmosones are like hands which connect it with other cells and hemidesmosomes are like legs which hold them to their “Base” (Basement Membrane) and the hemidesmosomes, once cell receives the signal of malignant transformation undergo signaling and allow the malignant epithelial cells to move throughout the space (connective tissue).

Function

The basic function of the Squamous Cell is the production of keratin hence the cell is also known as keratinocytes. Throughout the epithelium from the basement membrane (stratum basal) to the top most layer (stratum corneum) the cell undergoes many changes in structure such as it gets cell junctions, the shape of the cell alters etc and many changes in the functions also, such as the cell gains “keratohyalin granules, which prepare the cells for forming keratin etc. (Diagram)

Hence structural differentiation is when the cell transforms from a primitive cell which is an infant all to an adult form of cell.

Just like an infant gets grows into an adult and functional differentiation is when the cell matured from baby cell to know its function or purpose of life, which in this case is formation of keratin.

Hence, the basic properties of Normal Keratinocytes include→

1. Polypoidal Shape
2. Nucleus to Cytoplasm ratio 1:4
3. Close connection with adjunct Squamous Cell through cell junctions.
4. Division or Mitosis→ The Squamous Cells continuously replenish or divide to form more and more Squamous Cells. The reservoir for which is the basal layer of the epithelium which is also known as “stratum basale” or “stratum germinativum” = Germination (Forming new one)
5. And the most important property of Squamous Cell is the production of proteins.

Normal Epithelium → ( Diagram)

What happens in maligancy→

Due to continuous trauma the head of the call i.e. “Nucleus” losses its cool and starts behaving abnormally just like any of us any of us will behave. On exposure to continuous trauma and stress our brain also lose control and behave abnormally.

Inside the nucleus lie the genetic material which control the division, growth, differentiation of cells and death of the cell. Basically, there are two types of genes responsible.

→ Decreased apoptosis

→ Tumor oncogenes → Increase the abnormal division of cell→ Aid in formation of Neoplasia (Tumor)

→Tumor Suppressor genes→ Suppress the occurrence of tumor

Few examples

1. RAS                 1) P53
2. VEGF

Tobacco and its derivatives by causing continuous injury to the cellular mechanism cause imbalance.

(Diagram)

As also there is imbalance in birth and death rate of cells i.e. formation and clearance of the cells as the apoptotic pathways gets blocked.

Increase in proliferation of ells.

Decrease death of cells(No apoptosis)

This imbalance caused by loss of genetic control leads to abnormal proliferation of cell.

To make it clear, Imagine the story of “who will bell the cat”, if there were no cats in the house with rodents or mice. What would the house look like!!!

Hence, Neoplasia in formal language is termed as →

“A neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the surrounding normal tissues and persists in the same excessive manner after cessation of the stimuli that evoked the change.”

By Willis