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ICS - Pathology > Benign And Malignant Tumours > Flashcards

Benign And Malignant Tumours Flashcards

1
Q

Definition of a tumour

A

Any abnormal swelling e.g. neoplasm, inflammation, hypertrophy, hyperplasia
All neoplasm are tumours but not all tumours are neoplasms

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2
Q

Definition of a neoplasm

A

A lesion resulting from the AUTONOMOUS or relatively autonomous ABNORMAL growth of cells which PERSISTS after the initiating stimulus has been removed
A new and abnormal growth of tissue in a part of the body, especially as a characteristic of cancer

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3
Q

Summary of neoplasms

A

Autonomous, abnormal persist at new growths
Common
High mortality
Benign -> malignant
Tumour cells and stroma
Angiogenesis essential to growth

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4
Q

Behavioural classification of neoplasms

A

Benign
Borderline
Malignant

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5
Q

Behavioural characteristics of benign neoplasms

A

E.g. Tubulovillous adenoma
Localised (no BM invasion)
Slow growing
Well circumscribed
EXOPHYTIC (outward growth)
Rare ulceration + necrosis
Close resemblance to normal tissue
They can cause morbidity and mortality
- pressure on adjacent structures
- obstruct flow
- production of hormones
- transformation to malignant neoplasm
- anxiety

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6
Q

Behavioural characteristics of malignant neoplasms

A

E.g prostate cancers, squamous cell carcinoma
BM invading
V.fast mitotic growth - HYPERDENSE NUCLEI
Poor circumscription
ENDOPHYTIC - inward growing
Common necrosis + ulceration
Poorly differentiated
Can cause morbidity or mortality
- destruction of adjacent tissue
- pressure on structures
- metastasis
- blood loss from ulcers
- obstruction of flow
- hormone production
- paraneoplastic effects (SIADH, Cushings)
- anxiety and pain

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7
Q

Where may neoplasia arise from + general naming rule?

A

Epithelial cells
- non glandular benign = PAPILLOMA
- non glandular malignant = CARCINOMA
- glandular benign = ADENOMA
- glandular malignant = ADENOCARCINOMA
Connective tissue
- SARCOMA
Lymphoid/haematopoietic organs
- leukemia, lymphoma (always malignant)
= All neoplasm have the suffix ‘oma’
= prefix depending on behavioural classification and cell type

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8
Q

Benign epithelial neoplasm nomenclature

A

Prefix with cell type of origin
- papilloma + cell type of origin = squamous cell papilloma
- adenoma + cell type or origin = thyroid adenoma

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9
Q

Papilloma definition

A

Benign tumour of non-glandular, non-secretory epithelium

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10
Q

Adenoma defintion

A

Benign tumour of glandular or secretory epithelium

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11
Q

Malignant epithelium neoplasm nomenclature

A

Carcinoma + epithelial cell type = transitional cell carcinoma
Carcinomas of glandular epithelium = adenocarcinoma

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12
Q

Carcinoma defintion

A

Malignant tumour of epithelial cells

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13
Q

Benign connective tissue neoplasms nomenclature

  • adipocytes
  • cartilage
  • bone
  • vascular
  • muscle, smooth
  • muscle, striated
A

Named according to cell of origin -suffix by ‘oma’
Lipoma - adipocytes
Chondroma - cartilage
Osteomalacia - bone
Angioma - vascular
Leiomyoma - muscle, smooth
Rhabdomyoma - muscle, striated

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14
Q

Malignant connective tissue neoplasms

  • adipose tissue
  • striated muscles
  • smooth muscles
  • bone cartilage
  • bone
  • blood vessels
A

Sarcoma prefixed by cell type of origin
Liposarcoma - adipose tissue
Rhabdomyoscarcoma - striated muscles
Leiomyosarcoma - smooth muscles
Chondrosarcoma - bone cartilage
Osteosarcoma - bone
Angiosarcoma - blood vessels

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15
Q

How are carcinomas and sarcomas classified?

A

According to degree of differentiation - the less differentiated they are the higher the grade

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16
Q

Exceptions to the rule: not all ‘-omas’ are neoplasms

A

Granuloma,
Tuberculoma

17
Q

Exceptions of the rule: Not all malignant tumours are carcinoma or sarcoma

A

Melanoma - malignant neoplasms of melanocytes
Mesothelioma - malignant tumour of mesothelial cells
Lymphoma - malignant neoplasm of lymphoid cells

18
Q

Exceptions of the rule: eponymously named tumours

A

Burkitt’s lymphoma - B cell malignancy caused by EBV
Ewing’s sarcoma - bone malignancy
Grawitz tumour
Kaposi’s sarcoma - vascular endothelial malignancy HIV associated

19
Q

Exclusion of neoplasm: teratoma

A

Neoplasm containing tissues from all 3 embryological layers

20
Q

Tumours graded based on similarity to parent cell

A

Well differentiated (>75% cells resemble parent)
10-75%
Poorly differentiated (<10% cells resemble parent)

21
Q

Characteristics of the neoplastic cell

A

Autocrine growth stimulation = over expression of GF and mutation of tumour suppressor genes e.g p53 and under expression of growth inhibitors
Evasion of apoptosis
Telomerase = prevents telomeres shortening with each replication (this normally rate limits the extent of mitosis a single cell can undergo)
Sustained angiogenesis + ability to invade BM

22
Q

Classes of carcinogenesis (cancer-causing agents)

A

Chemical - e.g. paints, dyes, rubber, soot
Viruses - EBV (Burkitts), HPV (cervical cancer)
Ionising + Non ionising radiation - UVB in skin cancer, ionising is lots
Hormones, parasites, mycotoxins - e.g. increased oestrogen implicated in breast cancer
Misc e.g Asbestos

23
Q

Germ line vs somatic mutations

A

Germ line = mutated ORIGINAL GERM CELL = will pass onto next gen
Somatic = mutated MITOTIC COPY OF GERM CELL = wont pass to next gen

24
Q

Pathway of metastasis

A
  1. Detachment (from 1’)
  2. Invasion of other tissues
  3. Invasion of BV
  4. Evasion of host defence, ADHERENCE of BV wall
  5. Extravasation to distant site
25
Q

Methods of spread

A

HAEMATOGENOUS = via blood = bone, breast, lung, liver
- 5 main mets to bone = BLT KP = breast, lung, thyroid, kidney, prostate
LYMPHATIC = 2’ formation in lymph nodes e.g. lymphoma (rubbery lymphadenopathy)
TRANSCOLEMIC = via Exudative fluid accumulation, spreads through PLEURAL, PERICARDIAL + PERITONEAL EFFUSIONS

26
Q

Sarcomas spread mostly

A

Haematogenous

27
Q

Carcinomas spread mostly

A

Lymphatic
* exceptions =
- follicular thyroid
- chondrocarcinoma
- RCC
- HCC

28
Q

Staging Tumours

A

Mostly TNM (Tumour - Node - Metastasis)
Different for leukemias + lymphomas and CNS cancers
E.g lymphoma = Ann Arbour

29
Q

Mutation involved in colorectal cancer

A

FAP (familial adenomatous polyposis) = Autosomal dominant mutation APC gene, millions of colorectal adenomas
- inevitable adenocarcinoma by 35 years old
- over expression of c-MYC and point mutation in KRAS
HNPCC (lynch syndrome) = mutated MSH gene, autosomal dominant, this genes involved in DNA mismatch repair

30
Q

Screening

A

Method of early detection (essentially 2’ prevention, making management easy)
Cancers screened for in UK = CERVICAL (cervical swab), BREAST (mammograms), COLORECTAL (faecal occult)
Heel prick test birth = sickle cell, CF, hypothyroid

ICS - Pathology (13 decks)

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