1: Cellular pathology of cancer

Question 1

Define metaplasia

Answer 1

Reversible change where one adult cell type is replaced by another cell type
Adaptive, usually epithelial cells

Question 2

Define dysplasia

Answer 2

Abnormal pattern of growth in which some of the cellular + architectural features of malignancy are present

Pre-invasive stage, INTACT basement membrane

Question 3

What are the features of dysplasia?

Answer 3

1. Loss of architectural orientation
2. Loss in uniformity of cells
3. Hyperchromatic, enlarged nuclei
4. Abundant + abnormal mitosis, in places where not usually found

Question 4

Define neoplasia/tumour/malignancy

Answer 4

Abnormal, autonomous proliferation of cells unresponsive to growth control mechanisms

Question 5

List 5 features of benign tumours

Answer 5

1. No metastasis
2. Encapsulated
3. Well differentiated
4. Slow growing
5. NORMAL mitosis

Question 6

5 ways in which a benign tumour can be fatal?

Answer 6

1. Secretes something
2. In a dangerous place causing compression (e.g. pituitary, meninges)
3. If it gets infected
4. Bleeds -> pernicious anaemia (stomach)
5. Ruptures

Question 7

List 6 features of malignant tumours

Answer 7

1. Invades surrounding tissue - METASTASIS
2. Spreads to distant sites
3. NO capsule
4. Can be poorly differentiated
5. RAPID growth
6. Abnormal mitosis

Question 8

Define metastasis

Answer 8

Discontinuous growing colony of tumour cells at some DISTANCE from primary cancer

Question 9

What affects the degree of metastasis?

Answer 9

Lymphatic and vascular drainage of the primary cancer

Lymph node involvement has WORSE prognosis

Question 10

How does the nuclear-cytoplasmic ratio change as you go from dysplasia to benign and malignant tumours?

Answer 10

Dysplasia - NORMAL nuclear-cytoplasmic ratio

As tumour develops you get HIGH nuclear-cytoplasmic ratio

Question 11

Describe the nomenclature of tumours

Answer 11

Epithelial:
Papilloma = Surface epithelia (benign)
Adenoma = Glandular (benign)
Carcinoma = Malignant

Mesenchymal:
Sarcoma - Lipo, osteo, chondro, rhabdomyo, leiomyo
Malignant peripheral nerve sheath tumour

Question 12

What is a teratoma?

Answer 12

Tumour derived from germ cells
Gonadal teratomas in males = all malignant
Gonadal teratomas in females = mostly benign

Question 13

What is a hamartoma?

Answer 13

Localised overgrowth of cells/tissues native to the organ
Mature but architecturally abnormal cells
Common in children

Question 14

What are the criteria for assessing differentiation of a malignant tumour?

Answer 14

1. Evidence of normal function still present?

2.

Question 15

If tumour has NO differentiation at all, what is it called?

Answer 15

ANAPLASTIC cancer

Question 16

Define grading and staging

Answer 16

Grading = Degree of differentiation
Staging = how far it has spread

High grade tumour = POORLY differentiated
High grade tumours tend to be higher stage

STAGE is more important than GRADE in prognosis