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Cancer > 1. Cellular pathology of cancer > Flashcards

1. Cellular pathology of cancer Flashcards

1
Q

What is metaplasia?

A

A reversible change, in which one adult cell type (usually epithelial) is replaced by another adult cell type

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2
Q

What changes occur in gastric metaplasia?

A

Stratified squamous to simple columnar

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3
Q

What cells appear in intestinal metaplasia?

A

Goblet cells

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4
Q

What is pathological metaplasia and give an example

A

• Reversible, benign change due to chronic physical or chemical irritation

• Barrett’s oesophagus
- gastro-oesophageal reflux causes the oesophageal epithelium to change from squamous to columnar

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5
Q

What is physiological metaplasia and give an example?

A

• Reversible, benign change due to the surrounding environment

  • Endocervical canal exposed to acidic uterine fluids during pregnancy, as the cervix opens up
  • Columnar => squamous epithelium
  • Changes back to normal when cervix closes up
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6
Q

What is dysplasia?

A
  • Pre-invasive stage of cancer development, with intact basement membrane
  • Abnormal pattern of growth in which some cellular and architectural features of malignancy are present
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7
Q

How does the nucleo-cytoplasmic ratio change in dysplasia?

A
  • Increased

* Cell size is normal, but too much nucleus

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8
Q

Describe the nuclei and mitotic figures in dysplasia

A
  • Hyperchromatic and enlarged nuclei

* Abundant and abnormal mitotic figures, in places they shouldn’t be

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9
Q

Where is dysplasia common and what causes it in these places?

A
  • Cervix - HPV
  • Bronchus - smoking
  • Colon - ulcerative colitis
  • Larynx - smoking
  • Stomach - pernicious anaemia
  • Oesophagus - acid reflux
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10
Q

How does smoking change the bronchus epithelium?

A

Pseudostratified columnar => squamous - dysplasia => cancer

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11
Q

In a cervical biopsy how can you tell if the cells are normal or potentially cancerous?

A
  • Normally compact at the bottom and more spaced out towards the lumen - normal cellular maturation
  • Abnormal cells don’t undergo normal maturation, so you get compact cells with dark, dense nuclei on the surface
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12
Q

What is low and high grade dysplasia?

A
  • Low - unlikely to go onto cancer, more likely to be reversible
  • High - more severe: darker, higher nucleo-cytoplasmic ratio, less likely to be reversible
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13
Q

What is malignancy?

A

An abnormal, autonomous proliferation of cells unresponsive to normal growth control mechanisms

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14
Q

What is a neoplasia?

A

Any new growth, benign or malignant

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15
Q

What is a tumour?

A

A swelling, generally without inflammation, caused by abnormal growth of a tissue e.g. nasal polyps

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16
Q

How are benign tumours different from malignant tumours?

A
  • Do not metastasise
  • Encapsulated (still can invade the basement membrane)
  • Usually well differentiated
  • Slow growing
  • Normal mitoses
17
Q

When can benign tumours be fatal?

A

Growing in a dangerous place
• Meninges => epilepsy
• Pituitary => secrete hormones
• Lateral ventricles => increased intracranial pressure
• Insulinoma => hypoglycaemic episodes
• Gets infected e.g. in bladder
• Bleeds e.g. stomach tumours
• Ruptures e.g. liver adenoma => haemoperitoneum
• Torts (twists) e.g. ovarian cyst => infarction

18
Q

How are malignant tumours different to benign tumours?

A
  • Invade surrounding tissues
  • Spread to distant sites
  • Have no capsule
  • Well to poorly differentiated - hard to determine where it originated
  • Rapidly growing
  • Abnormal mitoses
19
Q

What is a metastasis?

A

Discontinuous growing colony of tumour cells, at some distance from the primary cancer (can break off and embolise around the body)

20
Q

Where else is a pancreatic carcinoma likely to cause metastasis?

A
  • Liver

* Pancreas drained by the splenic vein => hepatic portal vein -> lover

21
Q

Outline how colon cancer survival changes when lymph nodes are involved?

A

Dukes staging system
• Dukes A - confined to bowel wall (90% survival)
• Dukes C - lymph node involvement (30% survival)

22
Q

What type of tumour is a carcinoma?

A

Malignant epithelial tumour

23
Q

What type of tumour is a sarcoma?

A

Malignant tumour arising from cells of mesenchymal (connective tissue) origin - soft tissue tumour

24
Q

What is a papilloma and adenoma?

A

Types of benign epithelial tumours
• Papilloma - surface epithelium e.g. skin, bladder
• Adenoma - glandular epithelium e.g. stomach, thyroid

25
Q

Give 4 examples of different carcinomas?

A

1) Squamous cell carcinoma - from skin/oesophagus
2) Adenocarcinoma - from glandular epithelium
3) Transitional cell carcinoma - from transitional epithelium (stratified epithelium where the surface cells change shape when stretched) e.g. bladder)
4) Basal cell carcinoma

26
Q

Give 5 examples of benign soft tissue tumours?

A

1) Osteoma - bone
2) Chondroma - cartilage
3) Lipoma - fat
4) Leiomyoma - smooth muscle
5) Rhabdomyoma - striated muscle

27
Q

Give 6 examples of sarcomas?

A

1) Liposarcoma - fat
2) Osteosarcoma - bone
3) Chondrosarcoma - cartilage
4) Leiomyosarcoma - smooth muscle
5) Rhabdomyosarcoma - striated muscle
6) Malignant peripheral nerve sheath tumour

28
Q

What is the difference between leukaemia and lymphoma?

A
  • Leukaemia - malignant tumour of bone marrow derived cells which circulate in blood
  • Lymphoma - malignant tumour of lymphocytes, in lymph nodes or spleen

Lymphocytes produce in bone marrow and found in lymph nodes, so can get a mix of both types

29
Q

What is a teratoma and how are they different in males and females?

A

• Tumour derived from germ cells
• Have the potential to develop into tumours of all 3 germ cell layers:
- Ectoderm
- Mesoderm
- Endoderm
• Gonadal teratomas are almost always malignant in males
• Gonadal teratomas are almost always benign in females (contain hair and teeth)

30
Q

What is a hamartoma?

A
  • Localised overgrowth of cells and tissues native to the organ
  • Cells are mature but architecturally abnormal - no cytological issue
  • Common in children, and should stop growing when they stop growing
  • Most are benign, but there is a risk of malignancy

e.g. bile duct hamartomas (lots of bile ducts instead of one) , bronchial hamartomas

31
Q 
How can you look for evidence of normal function for the following cells:
• squamous cells
• glandular epithelium
• hepatocytes
• pancreas
A
  • Squamous cells - keratin production
  • Glandular epithelium - mucin production
  • Hepatocytes - bile production
  • Pancreas - insulin production
32
Q

What is an anaplastic tumour?

A

Tumours with little or no differentiation - lost morphological characteristics of mature cells and their orientation

33
Q

How does TNM staging work?

A
  • Stands for ‘Tumour, Node, Metastasis’
  • Grade - describes degree of differentiation (high grade = poor differentiation)
  • Stage - describes how far it has spread (high stage = greater spread)
  • Stage is more important
34
Q

Which of the following do well-differentiated tumours not have:
• small number of mitoses
• lack of nuclear pleomorphism
• high nuclear-cytoplasmic ratio
• relatively uniform nuclei
• close resemblance to corresponding normal tissue

A

Well differentiated tumours do not have a:

• high nuclear-cytoplasmic ratio

Cancer (15 decks)

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