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PATH3309 > 2. Pathology and Clinical Features of Neoplasia > Flashcards

2. Pathology and Clinical Features of Neoplasia Flashcards

1
Q

What are some features of a neoplasm?

A
  1. Not coordinated with normal tissue
  2. Persists after removal of stimulus
  3. Result of genetic alterations
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2
Q

Does tumour = neoplasm?

A

Yus

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3
Q

Major risk factor for cancer?

A

Age

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4
Q

Where has there been significant advancement in treatment?

A

Niche cancers

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5
Q

What cancers have seen only moderate advances in treatment?

A

Breast, prostate, melanoma

Common cancers

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6
Q

What can malignant neoplasms be classified as?

A

Primary or secondary

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7
Q

What does Aetiology mean?

A

Cause of a condition/disease

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8
Q

What is the aetiology of cancer?

A

Genetic predisposition
Environmental factors
Non-genetic predisposition

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9
Q

What are some environmental factors influencing cancer aetiology?

A

Chemical carcinogens
Viruses
Radiation
Hormones

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10
Q

List pathways commonly involved in cancer pathogenesis.

A
  1. Growth promoting genes (proto-oncogenes)
  2. Growth inhibiting genes (tumour supressor genes)
  3. Genes regulating apoptosis
  4. Genes involved in DNA repair
  5. Telomere maintenance
  6. Angiogenesis
  7. Invasion
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11
Q

What mutations are common in lung adenocarcinoma?

A 
EGFR
KRAS
BRAF
MEK1
HER2

These are mutually exlusive

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12
Q

What is a non-invasive precursor?

A

Epithelial malignancies often have non-invasive precurser

Meaning they have some steps on the multi step model

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13
Q

When is detection of cancer most important?

A

At the non-invasive precursor stage

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14
Q

How many doublings in 1g of tumour?

A

30 doublings

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15
Q

How many doublings in 1kg of tumour?

A

40 doublings

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16
Q

What are tumour kinetics?

A

Rate of division
Proportion of cells in replicative pool
Rate of cell death

17
Q

What defines a malignant neoplasm from a benign one?

A

Local destructive invasion
Capable of metastasis

BONUS:
show anaplasia (loss of differentiation)
Pleomorphism
High mitosis
Necrosis
18
Q

What are the clinical effects of malignancy?

A
  1. Local
  2. Metastatic
  3. Systemic/Hormonal (Paraneoplastic syndromes, Cachexia)
  4. Secondary effects (pneumonia etc)
  5. Effects of therapy
19
Q

What are the routes of malignancy spread?

A
  1. Local invasion
  2. Lymphatic Spread
  3. Haematogenous spread
Others:
Body cavity
Aerogenous
Implantation
Intraepithelial
20
Q

What are some of the local effects of malignancy?

A
  1. Invasion of vital structures
  2. Obstruction of viscera (e.g. ureter, bowel, airway)
  3. Ulceration/Perforation (skin, bowel)
  4. Mass effects/organ destruction
21
Q

What are the effects of metastasis?

A
  1. Destructive growth in vital organs, liver, brain etc (significant cause of death and morbidity)
22
Q

What are some paraneoplastic syndromes?

A
  1. Hypercalcaemia (PTHrP)
  2. Endocrinopathies (Cushing, SIADH)
  3. Coagulopathy
  4. Neurological
  5. Haematological
23
Q

What is Cachexia?

A

Wasting away to nutin

24
Q

What are the treatments for malignancy?

A

Surgery
Chemotherapy
Radiotherapy

25
Q

What are problems associated with surgery?

A

Operative risks
Healing
Functional impairment

26
Q

What are some problems associated with Chemo?

A

Bone marrow supression
Mucous membrane damage
Severe GI disturbance
Future malignancy

27
Q

What are some problems associated with radiotherapy?

A

Marrow supression
Skin toxicity
Brain damage
Post RT malignancy

28
Q

How is malignancy diagnosed?

A
  1. Usually medical algorithm, history, examination etc
  2. Cytology (fine needle aspiration, pleural fluid)
  3. Histology (small biopsy, surgical procedure)
29
Q

What is the major factor affecting prognosis?

A

Its stage defined by AJCC/UICC TNM system

30
Q

What does TNM mean?

A

Tumour
Node
Metastases

31
Q

The major factor being TNM, what other factors effect tumour prognosis?

A

Novel IHC/molecular prognostic markers
- Useful mainly in haematolymphoid + paediatric
Most not truly useful

Predictive markers - have value

32
Q

What are predictive markers?

A
  1. Hormone receptors
  2. HER2
  3. CD117 in GIST
  4. EGFR mutations
  5. BRAF in melanoma
  6. CD20 in lymphoid malignancy
33
Q

How can cancer be prevented?

A 
Smoking
Diet
Sun protection
Vaccination
Education

Screen specific groups (BRCA1 and FAP)
- Can be motivated

PATH3309 (14 decks)

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