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Module 4 - oral cancer > Benign and Malignant disease > Flashcards

Benign and Malignant disease Flashcards

1
Q

In adult tissues what is the size of the cell population determined by?

A

rates of cell proliferation, differentiation and death by apoptosis

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2
Q

what is apoptosis?

A

pre programmed cell death

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3
Q

what is the balance in tissue homeostasis?

A

cell division and cell loss

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4
Q

what can alter cell numbers?

A

rates of stem cell input
cell death by apoptosis
changes in rate of proliferation or differentiation

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5
Q

what controls cell cycle?

A

stimulators and inhibitors

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6
Q

in terms of cell cycle, what can result in growth?

A

shortening cell cycle time
recruiting cells from resting or quiescent population

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7
Q

what type of cells are terminally differentiated?

A

monocytes

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8
Q

what does terminally differentiated mean?

A

not capable of replicating

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9
Q

what does quiescent mean?

A

state of dormancy/ inactivity

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10
Q

where would you find quiescent cells that can proliferate when needed?

A

liver/ kidney

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11
Q

where would you find terminally differentiated cells that may be replaced by new cells arising from stem cells?

A

epithelia of oral cavity, gut and skin

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12
Q

what act as inhibitors of apoptosis?

A

growth factors
cell matrix components
viral proteins

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13
Q

what acts as inducers of apoptosis?

A

withdrawal of GF
loss of matrix attachment
viruses
free radicals
ionising radiation
DNA damage
Fas ligand/ CD95 interaction

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14
Q

what are molecular mediators and regulators of apoptosis?

A

extrinsic pathway
intrinsic pathway
caspases - cascade
p53

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15
Q

What is the extrinsic pathway in mediation of apoptosis?

A

death receptors e.g., CD95/ Fas Ligand

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16
Q

what is the intrinsic pathway in molecular mediation of apoptosis?

A

increased mitochondrial activity
Bcl-2 family
cytochrome c/ Apaf-1
can induce OR inhibit

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17
Q

what can be a result of increased apoptosis?

A

AIDS
neurodegenerative disorders
reperfusion injury

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18
Q

what can be a result of decreased apoptosis?

A

neoplasia
auto-immune disease

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19
Q

what is neoplasia?

A

tumour

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20
Q

what is an increase in cell size?

A

hypertrophy

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21
Q

where may hypertrophy occur?

A

skeletal and cardiac muscle

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22
Q

what is an increase in cell number?

A

hyperplasia

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23
Q

where may hyperplasia occur?

A

hormonally sensitive organs - endometrium, breast, thyroid

24
Q

how may you see hyperplasia in the mouth?

A

hyperplastic responses within epithelium and underlying connective tissue - enlargement of gingival tissues

25
Q

what is the reduction in cell size by loss of cell substance?

A

atrophy

26
Q

what are causes of atrophy?

A

ageing
lack of use/ stimulation
mechanical
functional

27
Q

what is the reduction in size of an organ that never fully developed to normal size?

A

hypoplasia

28
Q

what is the reversible change in which one adult cell type is replaced by another adult cell type?

A

metaplasia

29
Q

when may you find metaplasia?

A

part of adaptive response to stress
reprogramming of stem cells
e.g., Barett’s oesophagus, Bronchus, Salivary ducts (siametaplasia)

30
Q

in what way may metaplasia manifest as dysplasia and progress to malignancy?

A

environmental changes persisting

31
Q

what disorders of growth and neoplasia are irreversible?

A

hypoplasia

32
Q

what is dysplasia in general terms?

A

abnormal growth

33
Q

what are examples of types of dysplasia?

A

congenital hip dysplasia
fibrous dysplasia
epithelial dysplasia

34
Q

what tissues is dysplasia commonly found in?

A

squamous e.g., mouth
glandular

35
Q

what do cells show during pre-invasive dysplasia?

A

abnormal features that are also seen in cancer cells
these abnormal cells remain within the epithelium

36
Q

what is neoplasia in general terms?

A

new growth

37
Q

what results in neoplasia?

A

aberration of the normal mechanisms that control cell number
- cell production by cell division
- cell loss by apoptosis

38
Q

what does monoclonal mean?

A

the cells in a tumour appear to arise from one parent cell which has undergone a genetic change

39
Q

why do tumour clones expand?

A

tumour cells lack the normal control mechanisms
expansion due to uncontrolled profileration

40
Q

what are the classifications of tomours?

A

behaviour - benign and malignant
histogenesis

41
Q

what are features of benign tumours?

A

histology - resembles tissue of origin
nuclei - small, regular, uniform
mitoses - few, normal

42
Q

what is pleomorphic adenoma?

A

common benign salivary gland neoplasm

43
Q

compare the growth pattern of benign and malignant tumours?

A

benign - expand and remain localised, well-circumscribed, often encapsulated

malignant - infiltrate locally, metastasize

44
Q

compare the growth rate of benign and malignant tumours?

A

benign - slower
malignant - faster

45
Q

compare the clinical effects of benign and malignant tumours?

A

benign - local pressure effects; hormone secretions

malignant - local pressure and destruction, inappropriate hormone secretion, distant metastases

46
Q

compare the treatment of benign and malignant tumours?

A

benign - local excision
malignant - excision +/- additional therapy

47
Q

what are the features of malignant tumours?

A

histology - variable, may differ from tissue of origin
nuclei - larger, pleomorphic
mitoses - increased, often numerous, abnormal forms

48
Q

what does a pleomorphic adenoma become if it progresses to be malignant?

A

carcinoma ex pleomorphic adenoma

49
Q

why must be have a prognosis?

A

prediction of the probable course and outcome of disease
appropriate treatment and estimate survival

50
Q

what does a cancer prognosis consist of?

A

tumour type
tumour grade
tumour stage - histology, clinical, radiological
other parameters - patient, tumour

51
Q

how does an adenoid cystic carcinoma of salivary gland spread?

A

perineurally

52
Q

what disorder can adenoid cystic carcinoma of salivary gland result in?

A

CNV11 palsy

53
Q

how is tumour graded?

A

how well differentiated the tumour cells are

54
Q

how are tumours staged?

A

anatomical extent of disease
- clinical
- radiological
- pathological findings

55
Q

what is used to stage tumours?

A

TNM classification of malignant tumours

56
Q

what are the components of the TNM classification of malignant tumours?

A

T - extent of primary tumour
N - absence or presence and extent of regional lymph node metastasis
M - described the absence or presence of distant metastasis

57
Q

what is the relation between tumour stage and prognosis?

A

higher stage = poorer prognosis

Module 4 - oral cancer (5 decks)

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