113P How to tell a benign and malignant tumor apart? Differentiation and Anaplasia

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What is Differentiation and Anaplasia? How to tell a benign and malignant tumor apart?
Differentiation and anaplasia refer only to the parenchymal cells that constitute the transformed elements of neoplasms. The differentiation of parenchymal cells refers to the extent to which they resemble their normal forebears morphologically and functionally. The stroma carrying the blood supply is crucial to the growth of tumors but does not aid in the separation of benign from malignant ones. The amount of stromal connective tissue does determine, however, the consistency of a neoplasm. Certain cancers induce a dense, abundant fibrous stroma (desmoplasia), making them hard, so-called scirrhous tumors. Malignant neoplasms are characterized by a wide range of parenchymal cell differentiation, from surprisingly well differentiated to completely undifferentiated. For example, well-differentiated adenocarcinomas of the thyroid may contain normal-appearing follicles. Such tumors sometimes may be difficult to distinguish from benign proliferations. Between the two extremes lie tumors loosely referred to as moderately well differentiated.
The better the differentiation of the cell, the more completely it retains the functional capabilities found in its normal counterparts. Benign neoplasms and even well-differentiated cancers of endocrine glands frequently elaborate the hormones characteristic of their origin. Well-differentiated squamous cell carcinomas elaborate keratin, just as well-differentiated hepatocellular carcinomas elaborate bile. In other instances unanticipated functions emerge. Some cancers may elaborate fetal proteins not produced by comparable cells in the adult. Cancers of nonendocrine origin may produce so-called ectopic hormones. For example, certain lung carcinomas may produce adrenocorticotropic hormone (ACTH), parathyroid-like hormone, insulin, glucagon, and others. More is said about these phenomena later. Despite exceptions, the more rapidly growing and the more anaplastic a tumor, the less likely it is to have specialized functional activity.