12. Neoplastic Effects of Malignancy

Question 1

What is dyskaryosis?

Answer 1

Dysplasia in a cytological preparation (floating)

Atypical cells but no background architecture

Question 2

What is dysplasia?

Answer 2

Atypical cells confined within epidermis or mucosa

Early manifestation of malignancy

Question 3

What is mild dysplasia defined as?

Answer 3

Confined to the lower 1/3 of the epidermis or mucosa

Question 4

What is severe dysplasia defined as?

Answer 4

Involves the full thickness of the epidermis or mucosa

Question 5

What is a carcinoma in situ?

Answer 5

All layers of the epithelium show neoplasia, but BM isn’t broken

Question 6

How might Fe deficiency anaemia be linked to malignancy?

Answer 6

Bleeding in GIT cancers

Question 7

How might megaloblastic anaemia be linked to malignancy?

Answer 7

Cytotoxic drugs interfere with DNA synthesis

Question 8

How might hypoplastic anaemia be linked to malignancy?

Answer 8

Tumour infiltrates bone marrow or chemo/radiotherapy destroy haematopoietic cells

Question 9

Why is increased clotting associated with malignancy?

Answer 9

Tumour activates clotting factors, platelets and endothelial cells
Inhibit fibrinolysis

Question 10

What is paraneoplastic syndrome?

Answer 10

Effects that can’t be explained by the local neoplasm itself or the hormone that tissue would naturally produce

Question 11

What hormone is commonly made by a small cell carcinoma of the lung?

Answer 11

PTH

Question 12

Give some symptoms of paraneoplastic syndrome?

Answer 12

Peripheral neuropathy
Myopathy
Dermatomyositis
Cerebellar degeneration
Fever
Night sweats

Question 13

What type of cells are involved in a melanoma?

Answer 13

Melanocytes

Question 14

What mole changes are indicative of a melanoma?

Answer 14

Asymmetry
Border irregular or bleeding
Colour variable
Diameter
Elevation

Question 15

Apart from the skin, where else can melanomas be found?

Answer 15

Anal margin

Eyes

Question 16

What name is given to how deep the melanoma goes beyond the granular layer of epidermis?

Answer 16

Breslow thickness

Question 17

What does Clarkes level of invasion describe?

Answer 17

Assess level into different parts of the dermis

Question 18

What is a sarcoma?

Answer 18

Malignant tumour arising from connective tissue

Question 19

What type of sarcoma can be linked to the herpes virus type 8?

Answer 19

Kaposi’s sarcoma

Question 20

What can cause an increased risk of sarcomas?

Answer 20

Radiotherapy

Question 21

Give an example of a sarcoma caused by a genetic defect

Answer 21

Li Fraumeni syndrome

Question 22

How are sarcomas treated?

Answer 22

Wide local incision

radio and chemo therapy

Question 23

Which drugs is given to treat a GI stromal tumour?

Answer 23

Imatinib

Question 24

How would a neuroendocrine cell appear under the microscope?

Answer 24

Small nests of cells
Granular cytoplasm
Neuroendocrine markers (chromogranin)

Question 25

Name 2 benign neuroendocrine tumours

Answer 25

Insulinoma | Parathyroid adenoma

Question 26

Name 2 malignant neuroendocrine tumours

Answer 26

``` Carcinoid tumour Small cell Pancreatic islet cell Parathyroid Phaeochromocytoma Medullary carcinoma thyroid ```

Question 27

What is a carcinoid tumour?

Answer 27

Biologically malignant but don't metastasise so low grade

Question 28

Name 3 places where carcinoid tumours occur

Answer 28

Appendix Ileum Bronchus

Question 29

What is carcinoid syndrome?

Answer 29

Carcinoid tumours can produce serotonin which regulates intestinal movement and bronchospasm The syndrome develops when the liver can no longer detoxify serotonin

Question 30

What are the symptoms of carcinoid syndrome?

Answer 30

Facial flushing Diarrhoea Bronchospasm Pulmonary stenosis

Question 31

How is carcinoid tumour diagnosed?

Answer 31

Presence of 5HIAA in urine | breakdown product of serotonin

Question 32

What group of people do multiple endocrine neoplasms occur in?

Answer 32

Men | Genetically inherited

Question 33

What is a germ cell tumour?

Answer 33

Derived from cells that can split into endo, meso and ecto derm

Question 34

Where can germ cell tumours arise?

Answer 34

``` Testis (seminoma) Ovaries (dysgerminoma) Thymus Pineal gland Retroperitoneum ```

Question 35

Name 4 types of germ cell tumours

Answer 35

Teratoma Choriocarcinoma Yolk sac tumour Embryonal

Question 36

Why do seminomas have a good prognosis, despite being malignant?

Answer 36

Good host and lymphocyte response

Question 37

What blood marker is present in choriocarcinomas?

Answer 37

hCG

Question 38

Is a teratoma benign or malignant in testis?

Answer 38

Malignant | Benign in ovary

Question 39

Name 2 types of glial neoplasms

Answer 39

Astrocytoma | Oligodendroglioma

Question 40

What is a common complication of glial neoplasms?

Answer 40

Brain herniation

Question 41

How do embryonic tumours appear under the microscope?

Answer 41

Small round blue

Question 42

Name 4 embryonic tumours

Answer 42

Neuroblastoma Nephroblastoma Retinoblastoma Medullablastoma