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Semester 2 - PathPro > 13. Neoplasia 1 > Flashcards

13. Neoplasia 1 Flashcards

1
Q

Define neoplasm.

A

An abnormal growth of cells that persists after the initial stimulus is removed

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2
Q

Define malignant neoplasm.

A

An abnormal growth of cells that persists after the initial stimulus is removed AND invades surrounding tissue with potential to spread to distant sites

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3
Q

Define benign neoplasm

A

Gross and microscopic appearances that are considered to be innocent, implying that it will remain localised and will not spread to other sites

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4
Q

Define tumour.

A

Any clinically detectable lump or swelling

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5
Q

Define oncology

A

study of tumours and neoplasms

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6
Q

What is a cancer?

A

any malignant neoplasm

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7
Q

What is a metastasis?

A

Malignant neoplasm that has spread from its original site to a new non-contiguous site

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8
Q

What is the primary and secondary location of a cancer?

A

Primary: Original location of the malignant neoplasm
Secondary: place to which it has spread

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9
Q

What is dysplasia?

A

Pre-neoplastic alteration in which cells show disordered tissue organisation

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10
Q

Why is dysplasia not neoplastic?

A

The change is reversible in dysplasia whereas neoplasia is irreversible

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11
Q

What can displastic tumours exhibit?

A

Can exhibit considerable pleomorphism, with large hyperchromatic nuclei and high nuclear to cytoplasmic ratios

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12
Q

What are the 2 classifications of the causes of a tumour (swelling)?

A
  • non-neoplastic

- neoplastic

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13
Q

Give examples of non-neoplastic tumours.

A

Abscess, haematoma

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14
Q

What are the two types of neoplastic tissues?

A

Benign

Malignant

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15
Q

What can a malignant tumour be divided into?

A

Primary and Secondary

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16
Q

What are the 3 ways in which benign and malignant are different?

A
  • Behaviour
  • Appear different to the naked eye
  • Differentiation
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17
Q

What is the difference in benign and malignant neoplasm behaviours?

A

Benign neoplasms remain confined to their site of origin and do not produce metastases. Malignant neoplasms have the potential to metastasise.

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18
Q

How do benign neoplasms appear to the naked eye?

A
  • Grow in a confined local area
  • They have a pushing outer margin
  • Rarely dangerous (location)
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19
Q

How do malignant neoplasms appear to the naked eye?

A
  • Irregular outer margin and shape
  • May have ulcerations and necrosis
  • Infiltrative
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20
Q

What is a well differentiated neoplasm?

A

Mostly resembles normal tissue and usually has a good prognosis

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21
Q

What is a poorly differentiated neoplasm?

A

Doesn’t resemble normal tissue as well. Tumours spread easier than other tumours, and their prognosis is a worse than for others

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22
Q

What type of differentiation do benign neoplasms show?

A

Benign neoplasms closely resemble the parent tissue – well differentiated

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23
Q

What type of differentiation do malignant neoplasms show?

A

Malignant neoplasms range from well to poorly differentiated, dependent on how closely they resemble the cell of origin.

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24
Q

What are cells that show no resemblance to any tissue called?

A

Anaplastic

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25
Q

How do appearance of cells change as differentiation becomes worse?

A
  • Increasing nuclear size
  • Increased nuclear to cytoplasmic size
  • Increased nuclear staining (hyperchromasia)
  • Increased mitotic figures
  • Abnormal mitotic figures (Mercedes Benz)
  • Variation in size and shape of cells and nuclei (pleomorphism)
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26
Q

What grade represent which type of differentiation?

A

Grade 1: well differentiated
Grade 2: moderately differentiated
Grade 3: poorly differentiated

27
Q

Summarise the differences between benign and malignant neoplasms

A

Benign:
• Expansive Growth
• Grow Locally
• Retained functions of their cells of origin
• Resembles cells/tissues of origin
• Few mitoses
• Normal or mild increase in nuclear to cytoplasmic ratio
• Cells are uniform throughout the tumour

Malignant:
• Expansive and invasive
• Potential to metastasise
• Less likely to retain functions of cells of origin and may sometimes acquire unexpected functions due to derangements in differentiation
• Failure to differentiate fully
• Many mitoses
• High nuclear to cytoplasmic ratio
• Cells/nuclei vary in size and shape (pleomorphism)
28
Q

What are the 2 reasons we get neoplasia?

A

Non-lethal genetic damage

Accumulated mutations in somatic cells

29
Q

What 2 factors cause mutations?

A

initiators and promoters

30
Q

What are initiators?

A

mutagenic agents

31
Q

What are promoters?

A

cause cell proliferation

32
Q

Give examples of initiators.

A
  • Chemicals
  • Smoking
  • Alcohol consumption
  • Diet and obesity
  • Infectious agents
  • HPV
  • Radiation
  • Inherited mutations
33
Q

What do initiators and promoters in combination result in?

A

expanded, monoclonal population of mutant cells

34
Q

Describe the process of carcinogenesis. Hint : initiation, promotion, progression.

A

1) Initiation - mutagenic agents/initiators causes mutations in somatic cells. These accumulate.
2) Promotion - promoters cause cell proliferation
3) Progression - A tumour/neoplasm is formed by the clonal expansion of a single precursor cell that has incurred genetic damage. Characterised by the accumulation of yet more mutations.

35
Q

What is a tumour formed by?

A

A tumour is formed by the clonal expansion of a single precursor cell that has incurred genetic damage

36
Q

What is meant by monoclonal and how can this process to neoplasia

A

A collection of cells is monoclonal if they originated from a single founding cell

Neoplasm then emerges form this group of cells by a process called progression

This is characterised by the accumulation of yet more mutations

37
Q

Which genes are the targets of cancer to cause mutations

A

4 classes of normal regulatory genes:
• Growth promoting proto-oncogenes
• Growth inhibiting tumour supressor genes
• Genes that regulate programmed cell death
• Genes involved in dna repair

38
Q

What are proto-oncogenes and how can they become oncogenes

A
  • Multiple functions but all participate at some level in signalling pathways that drive proliferation
  • Mutations that activate these generally cause an excessive increase in one or more normal functions
  • Sometimes they impart a completely new function on the affected gene
  • “Gain-of-function” mutations
  • Oncogenes are created by mutations in proto oncogenes and encode proteins called oncoproteins that have the ability to promote cell growth in the absence of normal growth promoting signals
  • They can transform cells despite a normal copy of the same gene
  • Oncogenes are dominant over their normal counterparts
39
Q

What are tumour suppressor genes and how do mutations effect them

A
  • Normal function is to stop cell proliferation
  • Generally cause a ‘loss-of-function’
  • In most instances both alleles must be damaged for transformation to occur
  • Abnormalities in these genes leads to failure of growth inhibition
40
Q

What are apoptosis regulating genes and how do mutations effect them

A

May acquire abnormalities that result in less cell death and enhanced survival of cells

41
Q

How do mutations effect DNA repair genes

A
  • Loss of function mutations
  • Contribute indirectly to carcinogenesis
  • Impair the ability of the cell to recognise and repair non-lethal genetic damage in other genes
  • As a result affected cells acquire mutations at an accelerated rate, a state referred to as a mutator phenotype and is marked by genomic instability
42
Q

What do the names of benign tumours end in?

A

-oma

43
Q

What do the names of malignant tumours end in?

A
  • carcinoma (epithelial neoplasm)

- sarcoma (stromal neoplasm)

44
Q

What are the 2 different classifications of carcinomas?

A
  • carcinoma in-situ (no invasion through epithelial basement membrane)
  • carcinoma invasive (penetrated through basement membrane)
45
Q

Give examples of benign stratified squamous, transitional and glandular neoplasm

A

SS=squamous papilloma(any tumour with fingerlike projections) e.g. skin, buccal mucosa
T= transition cell papilloma e.g, bladder mucosa
G= adenoma
cystadenoma e.g. ovary

46
Q

Give examples of malignant stratified squamous, transitional and glandular neoplasm

A 
SS= squamous cell carcinoma: skin, larynx, oesohpagus, lung, others
T= transitional cell carcinoma: bladder, ureters
G= adenocarcinoma:stomach, colon, lung, prostrate, breast,pancreas, oesophagus
Other = basal cell carcinoma: skin
47
Q

What do you call benign connective tissue neoplasms?

A
  • smooth muscle: leiomyoma
  • fibrous tissue: fibroma
  • bone: osteoma
  • cartilage: chondroma
  • fat: lipoma
  • nerve: neuroma
  • nerve sheath: neurofibroma
  • glial cells: glioma
48
Q

What do you call malignant connective tissue neoplasms?

A
  • smooth muscle: leiomyosarcoma
  • fibrous tissue: fibrosarcoma
  • bone: osteosarcoma
  • cartilage: chondrosarcoma
  • fat: liposarcoma
  • glial cells: malignant glioma
49
Q

What do you call benign and malignant blood vessel neoplasms?

A

benign: Haemangioma
malignant: Angiosarcoma

50
Q

What do you call benign and malignant lymph vessel neoplasms?

A

benign: Lymphangioma
malignant: Lymphangiosarcoma

51
Q

What do you call benign and malignant smooth muscle neoplasms?

A

benign: Leiomyoma
malignant: Leiomyosarcoma

52
Q

What do you call benign and malignant striated muscle neoplasms?

A

benign: Rhabdomyoma
malignant: Rhabdomyosarcoma

53
Q

What do you call benign and malignant Stratified squamous epithelium neoplasms?

A

benign: Squamous cell papilloma
malignant: Squamous cell carcinoma

54
Q

What do you call benign and malignant Epithelial Lining of Glands or Ducts neoplasms?

A

benign: Adenoma
malignant: Adenocarcinoma

55
Q

What do you call benign and malignant Urinary Tract Epithelium neoplasms?

A

benign: Transitional cell papilloma
malignant: Transitional cell carcinoma

56
Q

What do you call benign and malignant Blood cells, Lymphoid Tissue, Plasma Cells neoplasms?

A

malignant:
Leukaemia
Lymphoma
Myeloma

57
Q

Define leukaemia.

A

malignant neoplasm of blood forming cells arising in the bone marrow

58
Q

Define lymphoma.

A

malignant neoplasms of lymphocytes, mainly affecting lymph nodes

59
Q

What is myeloma?

A

malignant neoplasm of plasma cells

60
Q

Where do germ cell neoplasms arise from?

A

pluripotent cells, mainly in the testis or ovary

61
Q

What are blastomas?

A

occur mainly in children and are formed from immature precursor cells

62
Q

What is the most common type of cancer?

A

Carcinomas (90%)

63
Q

Give examples of germ cell neoplasms

A 
Testis= malignant teratoma and seminoma(a malignant neoplasm)
Ovary= benign teratoma = dermoid cyst

Semester 2 - PathPro (16 decks)

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