1 Tumour Definition and Nomenclature

Question 1

Define hyperplasia

Answer 1

increase in number of normal cells

Question 2

give causes for hormonal hyperplasia + state what effect it has on risk of cancer

Answer 2

• increased hormonal stimulation - increase risk in cancer (e.g. endometrial gland hyperplasia due to increase in oestrogen)
• increase in sensitivity to hormone - no effect on cancer risk (e.g. Benign prostatic hyperplasia (BPH), which is caused by an increase in sensitivity to dihydrotestosterone (DHT))

Question 3

give causes for chronic irritation hyperplasia

Answer 3

• constant scratching of itchy skin, producing thickening (hyperplasia of epidermis)
• bronchial mucus gland hyperplasia, commonly occurs in smokers and asthmatics

Question 4

state other causes of hyperplasia

Answer 4

• chemical imbalance (e.g. iodine deficiency = thyroid enlargement as gland has to work harder to increase thyroid hormone synthesis)
• stimulating antibody (hyperthyroidism in Grave’s disease; due to thyroid-stimulating antibodies (IgG) directing against thyroid hormone receptors)
• viral infection (e.g. skin infections by HPV produces epidermal hyperplasia - common wart)

Question 5

Define neoplasia

Answer 5

new overgrowth of abnormal tissue not under normal physiological control (both benign or malignant tumours)

Question 6

Define benign tumours

Answer 6

benign tumours are usually well differentiated, even though they are a neoplasm they resemble their parent tissue and have no metastatic potential

Question 7

Define malignant tumour

Answer 7

Tumour involving a neoplasm, which can lead to cancer (can include blood cancer)

Question 8

How to grade a malignant cancer + list the grades

Answer 8

Whether tissue resembles parent tissue

• Is it well differentiated (low-grade) - parent tissue
• poorly differentiated, high grade or anaplastic does not resemble parent tissue
• intermediate grade; features are between a low and high grade cancer (occasional gland-like structures are seen)

Question 9

define anaplasia

Answer 9

the loss of mature or specialised features of a cell/tissue - malignant tumours

Question 10

State the main types of benign tumour + where they originate form
(they end in -oma)

Answer 10

Epithelial, connective tissue (Mesenchymal)

- they can arise originate from ectoderm (squamous) or endoderm (glandular epithelia)

Question 11

give examples of epithelial benign tumours

Answer 11

• papilloma - tumour of squamous or transitional epithelium

- adenoma - arise from glandular origin

Question 12

State the name of benign mesenchymal tumour of bone

Answer 12

Osteoma

Question 13

State the name of benign mesenchymal tumour of adipose tissue

Answer 13

Lipoma

Question 14

State the name of benign mesenchymal tumour of cartilage

Answer 14

Chondroma

Question 15

State the name of benign mesenchymal tumour of smooth muscle

Answer 15

Leiomyotoma

Question 16

State the name of benign mesenchymal tumour of striated muscle

Answer 16

Rhabdomyotoma

Question 17

What unusual benign tumours are there?

Answer 17

• Mixed tumours- neoplastic cells with 2 morphological patterns but from same germ layer
• Teratoma - derived from all germ layers (meso, ecto and endo) - metastatic potential

Question 18

List the main types of malignant neoplasia

Answer 18

• carcinoma - derive from epithelial tissue (squamous, glandular and transitional)
• sarcoma - derive from connective tissue (mesodermal origin)

Question 19

Give different types of carcinomas

Answer 19

squamous cell carcinoma sites
adenocarcinoma (glandular epithelium)
Transitional cell carcinoma (TCC)

Question 20

State the name of the sarcoma of bone

Answer 20

osteosarcoma

Question 21

State the name of the sarcoma of adipose tissue

Answer 21

liposarcoma

Question 22

State the name of the sarcoma of cartilage

Answer 22

chondrosarcoma

Question 23

State the name of the sarcoma of smooth-muscle

Answer 23

leiomyosarcoma

Question 24

State the name of the sarcoma of striated muscle

Answer 24

rhabdomyosarcoma

Question 25

What is the name of tumours of lymphoid tissue?

Answer 25

lymphoma

Question 26

What is the name of tumours of haemopoietic cells in bone marrow

Answer 26

Leukaemia

Question 27

What is the name of tumour derived from neuroendocrine cells, scattered in many sites?

Answer 27

neuroendocrine tumour

Question 28

What is the name of tumours of melanocytes

Answer 28

Melanoma

Question 29

What is the name of tumour derived from the glial cells in the CNS?

Answer 29

Gliomas

Question 30

State the features of growth rate in benign and malignant tumours

Answer 30

Benign: slow
Malignant: variable (can be treated with cell-cycle specific chemotherapy agents)
- growth rates correlate with degree of anaplasia in tumour

Question 31

State the features of monoclonality in benign and malignant tumours

Answer 31

Neoplastic proliferation derived from multiple cells (polyclonal)
- Benign and MOST malignant tumours derive from a single precursor cell = monoclonality

Question 32

State the features of regulation of decay accelerating factors in benign and malignant tumours

Answer 32

(DAF normally degrades C3 and C5 convertase in the classical and alternative complement pathway)

• Malignant cells up regulate DAF
• Upregulation of DAF ensures that degradation of the convertase (C3 and C5) prevents the formation of the membrane attack complex (MAC; C5b-9); therefore, cancer cells cannot be killed by the MAC

Question 33

State the features of regulation of local invasion and metastasis in benign and malignant tumours

Answer 33

Benign tumours do not invade - exception if dermatofibroma
- they are enclosed in fibrous capsule
Malignant tumours invade tissue
- they need O2 and nutrients - get it by stimulating angiogenesis