4 NEOPLASIA Flashcards
What is neoplasia?
Tissue formation and involves overgrowth of a tissue to form a neoplastic mass or neoplasm, called a tumor
What is the 2nd highest mortality rate?
Cancer
What are the Adaptive growth responses of Neoplasia?
- hypertrophy
- hyperplasia
- metaplasia
- dysplasia
- neoplasia
- hypoplasia
- aplasia
What is Hypertrophy?
Cell and Organ enlargement that occurs in response to an increased demand of that tissue
What does hypertrophy of cells actually mean?
An increase in SIZE, NOT an increase in numbers of a cell
When would hypertrophy be normal?
In response to exercise
What is a prime example of Hypertrophy?
Heart Enlargement* due to hypertension, increased demand on the heart pump, enlarged myofibrils
What is Hyperplasia?
Mitosis produces new cells, but only in quantities needed to meet particular demand
When would Hyperplasia happen?
Increased rate of mitosis as a reaction to increased irritation
Why does Hyperplasia happen?
To create more layers to prevent damage and decrease friction
Where is Hyperplasia naturally found?
In the sole of the feet (skin thickness)
What is Metaplasia?
A change of the cell type
What is the actual change happening in Metaplasia?
Change from NORMAL to NORMAL, NOT normal to abnormal
What is unique about Metaplasia?
Change from Normal to Normal (but NOT for that tissue type).
It is a more SERIOUS* adaptive response, but it is REVERSIBLE**
What disease would you see Metaplasia?
Chronic Bronchitis in smokers
What happens in NORMAL lungs (Metaplasia)?
Normal lung epithelium is composed of Goblet cells (mucous producing cells) and columnar cells with villi; mucous traps particles from the air and the villi remove it
What happens during Chronic Bronchitis?
Columnar cells are replaced by squamous epithelial cells = full loss of normal function and more vulnerable to infection
Is Chronic Bronchitis reversible?
YES if you stop smoking
What is Dysplasia?
Loss in the uniformity of the individual cells as well as a loss in their architectural orientation
Can Dysplasia be reversed?
YES (even though it is very serious)
What do the cells look like in Dysplasia?
Normal cells are present along with pleomorphic cells in the affected tissue
What is the subcategory of Dysplasia?
Pleomorphism
What is Pleomorphism characterized by?
Variability in cell size and shape in contrast to the regularity of the cell structure seen in normal tissue
What is increased in Pleomorphism?
Mitosis rate
Where would Pleomorphism be found?
In MALIGNANT TUMORS (cervix cancer)
What does Pleomorphism result from?
Metaplasia with continuous, chronic irritation: after change from columnar to squamous cells (metaplasia) a change in shape occurs (dysplasia)
Is Pleomorphism reversible?
YES
What is Neoplasia?
Formation of a tumor mass represents an IRREVERSIBLE alteration in a cell’s growth pattern
How are the cells categorized in Neoplasia?
In neoplasia all cells are abnormal (pleomorphic)
What is an example of Neoplasia?
Malignant tumors
What is the consistent “Type” in Neoplasia cells?
In Neoplasia, All cells are pleomorphic type: Change nuclei, size, and shape
What is Hypoplasia?
Inadequate development, so that the resulting tissue is immature and functionally deficient
What is Aplasia?
Lack of organ/tissue development
What is an example of Aplasia?
Massing a finger usually associated with parasite infection
What are the characterization of tumors?
- Pattern of growth ' Benign ' Malignant - Tissue Origin ' Benign ' Malignant ' Exceptions -Melanom -Hepatom -Lymphom
How are benign tumors categorized?
Relatively slow growing, orderly growth, and remains localized
How are malignant tumors categorized?
More rapid, distorted froth, aggressive invasion into adjacent normal tissue and
What is the greatest characteristic of Malignant tumors?
Ability to metastasize -
Sends malignancy to other distant tissues without physically contacting the tissue (primary tumor generates a secondary tumor elsewhere in the body)
What are 2 examples of Benign bone tumors?
Osteoma and Adenoma
How are Benign bone tumors named?
By a ROOT word (suffix) indicating a type of tissue that has become neoplastic
How are Malignant tissues named?
According to their embryonic origin
What is a Carcinoma?
Tissues derived from ectoderm and endoderm
example: adenocarcinoma
Tissues derived from mesoderm =
Sarcoma
What are 3 examples of Sarcomas?
- Fibrosarcoma
- Chondrosarcoma
- Osteosarcoma
What are the EXCEPTIONS, in regards to malignant tumors?
- Melanoma
- Hepatoma
- Lymphoma
What is Melanoma?
(Malignant melanoma)
First more malignant tumor of the human body
What is hepatoma?
(Hepatocellular carcinoma)
Primary tumor of the liver
What is special about Lymphoma?
Virtuall incurable
What are the 2 components of “Tumor Structure”?
Parenchyme and Stroma
What is Parenchyme?
Functional tissue + stroma CT
In regards to Parenchyme, tumor cells affect _____
Functional cells of the tissue
In parenchyma, the degree of resemblance of the tumor’s tissue ______ ?
Degree of resemblance of the tumor’s tissue to the origin tissue is greater in benign tumors than in malignant tumors
In Parenchyme, how do things differ?
Cell size, shape, and distribution differs for benign and malignant tumors
What is the subcategory under Parenchyme?
Anaplasia
What is Anaplasia?
Reversed or lack of normal differentiation (from the most immature to mature = normal)
- Cells are difficult to differentiate / recognized under a microscope
Tumor cells can differentiate _____
From any type of immature cell
The more immature the cell from which the tumor cell differentiates _____
The more malignant the tumor (the degree of anaplasia and the degree of malignancy are directly linked)
What is Stroma?
Connective tissue
NOT tumor cells (therefore doesn’t have tumor cell characteristics unless it is a fibrous/CT tumor)
What is the function of stroma?
Contains/supports the tumor
What is the subcategory under stroma?
Scirr
What is Scirr?
(Scirrhous Cancer) - when the tumor primarily consists of stroma rather than parenchyma
What is an example of Scirr?
Breast Adenocarcinoma
What is the process of Breast adenocarcinoma?
Tumor growth - CT is made - CT constricts and pulls skin inward (classic late stage sign is inversion of the nipple)
What are “Male breast cancers?’
Sarcoma - “Meat” primarily parenchyma, little stroma
Ulcerating scirrhous carcinoma 2%
What is Osteosarcoma an example of?
Scirr, and it is the most prevalent cancer in young boys
What is Angiogenesis?
As the tumor grows, it obtains its own blood supply and nutrition from near blood supply
When tumor grows to be > 1 mm _______
It cannot steal nutrients from adjacent cells
What is the Tumor angiogenesis factor?
Stimulates vessel formation
What are characteristics of Angiogenesis?
Irregular pattern due to rapid growth (less regular than in wound healing)
Describe endothelial junctions in Angiogenesis:
Looser endothelial junctions (may cause bleeding in the sputum: lung cancer, blood in stool = colon cancer; in urine = kidney cancer)
What may malignant tumors lack?
Basement membranes and therefore lie in direct contact to epithelial cells (all tissues are made upon a base mb, the foundation)
What is the issue with lung cancer within Angiogenesis?
Angiogenesis DOES NOT occur - ischemia - necrosis = horizontal fluid development in lungs
What is the growth rate in benign bone tumors?
Rate of growth is greater than that of normal tissue, but LESS than that of malignant tumors
What is the biggest characteristic that makes a tumor benign?
Presence of fibrous CT capsule = it is CONTAINED
What is an example of a benign bone tumor?
Leiomyoma (stomach cancer)
What are the characteristics of Leiomyoma?
Stomach Cancer - Encapsulated (whiteish layer around tumor) separates tumor cells from digestive tissue preventing spreading. Easy to remove
What is the MAIN characteristic of Malignant tumors?
INVASIVENESS - sends cells into adjacent tissues (makes it hard to remove)
What are the 3 things associated with Malignant tumors?
- pressure atrophy
- reduced adhesiveness
- chemotaxis
What is “Pressure Atrophy” associated with Malignant tumors?
Due to physical compression of adjacent cells or disruption of normal blood supply
What is Reduced Adhesiveness associated with Malignant tumors?
Less cell to cell adhesion by desmosomal cells
What are Chemotaxis associated with Malignant cancer?
Normal tissue attracts malignant cancer cells (nutrients or autocrine motility factors); inhibited by cell matrix or basement membranes
Describe Mesothelioma under the Chemotaxis category:
Mesothelioma (benign or malignant) cannot penetrate the heart or lungs because of the lung pleura and pericardium
Large cell carcinoma aka
Malignant lung cancer, bronchogenic carcinoma, invades the lung
Once malignant cells get into the blood, what happens?
Once in blood supply, it behaves like an embolus, moving through the blood vessels until they get to a tissue
What if Metastatic tumor remnants enters the GI veins?
If entering via GI veins (coming from GI organs), it will metastasize to the liver entering through the hepatic portal system
If metastatic tumor remnants enters veins anywhere but GI, where will it go?
Into the LUNGS
What is Choriocarcinoma?
Uterine cancer mets to the lungs (via veins)
What is Osteocarcinoma?
aka Cannon ball metastases bone cancer mets into lungs (common in boys)
If metastases enter the arteries (rare), where will it go?
Highly VASCULARIZED organs =
brain, kidney, and spleen
What happens if metastases enter the lymphatic system?
Tumor cells may get into the lymphatic node and grow there within it = Lymphadenopathy = enlargement of the node
What are 2 diseases associated with Lymphadenopathy?
Virchow’s node and Horner’s syndrome
What are Virchow’s nodes?
Unilateral (usually left side) lymph node enlargement due to stomach tumor metastasis
What is Horner’s Syndrome?
Subclavicular node enlargement (Mets from the lungs)
What is Lymphostasis?
Tumor cells may cause obstruction of the lymph vessels
Where is lymphostasis common?
In breast cancer (lymph swelling of the arm)
What is a disease associated with Lymphostasis?
Elephantiasis
What can a tumor obstructing lymph vessels lead to?
INFECTION.
Very common in kidneys affecting the urine accumulation = Anemia may be developed (polycythemia) due to erythropoietin being over produced by kidney
When tumor cells metasizes through body cavity -
Krukenberg tumor (ovary tumor)
Sarcoma =
Tumor that metastasizes via blood
Carcinoma =
A tumor that metastasizes via lymph