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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
What are problems associated with surgery?
Operative risks Healing Functional impairment
26
What are some problems associated with Chemo?
Bone marrow supression Mucous membrane damage Severe GI disturbance Future malignancy
27
What are some problems associated with radiotherapy?
Marrow supression Skin toxicity Brain damage Post RT malignancy
28
How is malignancy diagnosed?
1. Usually medical algorithm, history, examination etc 2. Cytology (fine needle aspiration, pleural fluid) 3. Histology (small biopsy, surgical procedure)
29
What is the major factor affecting prognosis?
Its stage defined by AJCC/UICC TNM system
30
What does TNM mean?
Tumour Node Metastases
31
The major factor being TNM, what other factors effect tumour prognosis?
Novel IHC/molecular prognostic markers - Useful mainly in haematolymphoid + paediatric Most not truly useful Predictive markers - have value
32
What are predictive markers?
1. Hormone receptors 2. HER2 3. CD117 in GIST 4. EGFR mutations 5. BRAF in melanoma 6. CD20 in lymphoid malignancy
33
How can cancer be prevented?
``` Smoking Diet Sun protection Vaccination Education ``` Screen specific groups (BRCA1 and FAP) - Can be motivated

PATH3309 (14 decks)

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