8. Lumps & Bumps I Flashcards

1
Q

What might result in a lump or a bump in the orbit?

Increased cellular mass:
..., ..., ..., ..., and ....

Other causes:
..., ... blockage, ..., ..., ..., ..., ....

A

What might result in a lump or a bump in the orbit?

Increased cellular mass:
Hyperplasia, hypertrophy, dysplasia, metaplasia, and neoplasia.

Other causes:
Inflammatory, vesicle, cyst, or duct blockage, foreign body, non-inflammatory oedema, haemorrhage, product deposition, encapsulated micro-organism proliferation.

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2
Q

Define each of the following:
Hyperplasia: ...
Hypertrophy: ...
Dysplasia: ...
Metaplasia: ...

A

Define each of the following:
Hyperplasia: increase in number of cells
Hypertrophy: abnormal increase in cell size
Dysplasia: replacement with a less mature cell type
Metaplasia: replacement with another mature cell type

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3
Q

What are tumours?

A

Group of abnormal cells that cause swelling or mass of extra tissue.

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4
Q

Benign tumours are ....
Result from ..., ..., ..., or ....
Result of normal ... to a stimulus and ... or is .... on ... of the stimulus.

A

Benign tumours are non-cancerous.
Result from hyperplasia, metaplasia, dysplasia, or hypertrophy.
Result of normal cellular adaptation to a stimulus and ceases or is reversible on removal of the stimulus.

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5
Q

Cancer is also known as ....
Cells show ... and ... which results in ....

A

Cancer is also known as neoplasia.
Cells show uncontrolled growth and spread which results in malignant tumour.

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6
Q

Hyperplastic tumours
Pterygia are common ... which which originate from ... that are exposed to .... Causes ... of normal tissue.

A

Hyperplastic tumours
Pterygia are common ocular surface lesions which originate from limbal stem cells that are exposed to chronic UV irritation. Causes overgrowth of normal tissue.

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7
Q

Benign neoplasia.
They show ... but can .... They have a ... growth rate and are often .... Some lesions with benign characteristics have the potential to ....

A

Benign neoplasia.
They show no tendency to spread but can expand. They have a slow growth rate and are often encapsulated. Some lesions with benign characteristics have the potential to become malignant.

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8
Q

Malignant neoplasia.
Abnormal tissue with ....
Cells that have ... in normal cellular functions due to .... These cells ..., ..., and spread by way of .... Growth is usually ... and there is ... of cells. Has the following risk factors: ..., ..., ..., .../..., and ....

A

Malignant neoplasia.
Abnormal tissue with uncoordinated excess growth.
Cells that have defects in normal cellular functions due to gene mutations. These cells divide uncontrollably, invade surrounding tissue, and spread by way of vascular/lymphatic systems. Growth is usually rapid and there is incomplete differentiation of cells. Has the following risk factors: genetics, smoking, diet, occupation/environment, and infectious agents.

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9
Q

What are the six major histological categories of neoplasia?

... (eye/lids): ..., account for ...-...% of cancers
... (eye/lids): ...
... (eye/lids): ...
...: ...
...: ...
...

A

What are the six major histological categories of neoplasia?

Carcinoma (eye/lids): epithelial tissues, account for 80-90% of cancers
Sarcoma (eye/lids): supportive/connective tissues
Lymphoma (eye/lids): lymph glands/nodes
Myeloma: bone marrow plasma cells
Leukemia: bone marrow WBC/RBC
Mixed

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10
Q

Biopsy - Neoplastic behaviours
Based on ....

Benign growths contain cells that .... They are ... and are ....

Malignant growths contain cells that vary in ...; they vary in ... and .... Have irregular cells called ... and/or ....

A

Biopsy - Neoplastic behaviours
Based on cellular differentiation.

Benign growths contain cells that resemble normal cells. They are encapsulated and are uniformly well differentiated.

Malignant growths contain cells that vary in growth structure; they vary in size and shape. Have irregular cells called pleoplasia and/or anaplasia.

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11
Q

Pleomorphism vs anaplasia

Pleomorphism is ... and the cells exhibit ....

Anaplasia has cells that ... with ..., ..., and ....

A

Pleomorphism vs anaplasia

Pleomorphism is an early sign of cancer and the cells exhibit marked variation in size and shape.

Anaplasia has cells that adopt immature forms with large nuclei, unusual shapes, and little cytoplasm.

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12
Q

What are the clinical signs of neoplasia?

...: neoplastic tissue requires ... in order to .... Therefore, lots of ... which are needed to ....

Malignant tumours ... and show .... Around ...% are ... and often show ... which represents the ....

A

What are the clinical signs of neoplasia?

Unusual blood supply: neoplastic tissue requires rich blood supply in order to grow. Therefore, lots of feeder vessels which are needed to grow quickly.

Malignant tumours invade surrounding tissues and show irregular borders. Around 20% are metastatic and often show haloing which represents the invasion zone.

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13
Q

Metastasis - secondary neoplasia
Spread via .../.../... routes.

A

Metastasis - secondary neoplasia
Spread via lymphatic/blood/intra-peritoneal routes.

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14
Q

Cysts vs vesicles

Cysts arise from ... that becomes .... They are ... on palpation due to ... and they ... with time.

Vesicles are ... within a ...; they are more widespread if they are more .... They are often ... on palpation as they are ....

A

Cysts vs vesicles

Cysts arise from secreting epithelium that becomes trapped at a deeper location. They are hard on palpation due to internal pressure and they enlarge with time.

Vesicles are containers of fluid within a natural cleavage of skin layers; they are more widespread if they are more superficial. They are often soft on palpation as they are non-secreting sacs.

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15
Q

Dermoid cysts

Form at ... from ... in ..., ..., or .... They contain ... which is why they are hard. They grow ... can contain .../....

A

Dermoid cysts

Form at birth from entrapped dermis in orbit, lid, or limbus. They contain keratin which is why they are hard. They grow slowly can contain lashes/hair.

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16
Q

When can you refer any cyst?

A

When they become painful/inflamed, grow rapidly or change colour, or when removal is desired for cosmetic reasons.

17
Q

Lymphangiectasia
They are blockages of ... which result in ....
This is usually secondary to ... or .... They are ..., require ..., and ....

A

Lymphangiectasia
They are blockages of conjunctival lymphatic vessels which result in bubbly appearance.
This is usually secondary to trauma or inflammation. They are harmless, require no treatment, and resolve on their own.

18
Q

Papilloma
It’s a ... of the ... and is an .... It’s ... and has modest ... in growth.

A

Papilloma
It’s a benign mass of the conjunctiva and is an overgrowth of epithelial cells. It’s non-invasive and has modest blood vessel in growth.

19
Q

Conjunctival neoplasias
Also known as ... - ...

There are two types of ... conjunctival neoplasias.
They only involve the ... and DO NOT ....
The second type is called ... which are considered ....

The third type is ..., also known as ... which are distinct as they ....

A

Conjunctival neoplasias
Also known as Ocular Surface (Squamous) Neoplasia - OSSN

There are two types of benign conjunctival neoplasias.
They only involve the conjunctival squamous epithelium and DO NOT invade the cornea.
The second type is called conjunctival intra-epithelial neoplasia (CIN) which are considered pre-malignant.

The third type is malignant conjunctival neoplasia, also known as squamous cell neoplasia (SCN), which are distinct as they invade the cornea and substantia propria.

20
Q

OSSN: conjunctival papilloma

Overgrowth of ... which is provoked by ... or ... at limbus.
Circumference of ... with ... as well as modest ....
When biopsying, ..., it’s contained by ..., with no ..., ..., or ....

Differ from malignancy because:
* ...
* ...
* ...
* ...
* ...
* ...

A

OSSN: conjunctival papilloma

Overgrowth of epithelium which is provoked by HPV infection or excess UV at limbus.
Circumference of blood vessels with strawberry spots as well as modest feeder vessels.
When biopsying, normal cells, it’s contained by basement membrane, with no metaplasia, anaplasia, or pleomorphism.

Differ from malignancy because:
* lesser red colour
* no corneal invasion
* motile over sclera
* fewer feeders
* low chance of malignancy
* cosmetic surgery

21
Q

OSSN: CIN
Conjunctival epithelium ... and ... without ... and are caused by ... and ....
More ... and ... than conjunctival papilloma.

When biospysing will find ... and ... and it’s contained by .... However, it can ....

They have a high chance of ... but differ from malignancy by ..., ..., and ....

A

OSSN: CIN
Conjunctival epithelium metaplasia and pleomorphism without stromal invasion and are caused by HPV virus and excess UV.
More strawberry spots and feeder vessels than conjunctival papilloma.

When biospysing will find metaplasia and pleomorphism and it’s contained by basement membrane. However, it can invade the corneal limbus.

They have a high chance of malignancy but differ from malignancy by motility, OCT, and biopsy.

22
Q

OSSN: Conjunctival malignant lesion (SCN)

When CIN’s break though ... and ..., they become this.
More ... than CIN and biopsy shows ..., ..., and .... They are also ... compared to CIN.

If they resemble a CIN too much, requires ... and/or ... for differential.

A

OSSN: Conjunctival malignant lesion (SCN)

When CIN’s break though basement membrane and invade the underlying substatia propria, they become this.
More feeder vessels than CIN and biopsy shows metaplasia, pleomorphism, and keratin. They are also non-motile compared to CIN.

If they resemble a CIN too much, requires biopsy and/or OCT for differential.