benign and malignant tumours

Question 1

what is a tumour

Answer 1

any abnormal swelling

Question 2

4 types of tumour

Answer 2

neoplasm
inflammation
hypertrophy
hyperplasia

Question 3

define neoplasm

Answer 3

a lesion resulting from the autonomous or relatively autonomous abnormal growth of cells which persists after the initiating stimulus has been removed

Question 4

4 features of a neoplasia

Answer 4

1. autonomous
2. abnormal
3. persistent
4. new growth

Question 5

summary of neoplasms

Answer 5

Autonomous, abnormal, persistent new growths
Common
High mortality
Benign -> malignant
Tumours cells and stroma
Angiogenesis essential to growth

Question 6

why study neoplasia

Answer 6

25% of population develop a neoplasm - not all malignant
all ages can suffer
risk increases with age
high mortality rate
account for 20% of all deaths

Question 7

what is the most common cause of cancer death in males

Answer 7

LUNG

then prostate
then bowel

Question 8

what neoplasms are usually borderline malignant

Answer 8

found in ovaries

either look benign but behave in a malignant way
or look malignant but behave in a benign way

Question 10

most common cause of cancer death in females

Answer 10

LUNG

then breast
then bowel

Question 11

what are the 2 components of a neoplasm structure

Answer 11

neoplastic cells
surrounding stroma

Question 12

describe strutcure of neoplastic cells

Answer 12

derive from nucleated cells
usually monoclonal
growth pattern & synthetic activity related to parent cell (eg if from thyroid, will grow like thyroid, may even produce same hormone)

Question 13

describe structure of stroma of neoplasm

Answer 13

made of connective tissue framework
gives mechanical support & nutrition

Question 14

describe tumour angiogenesis

Answer 14

1. trans formed cell
2. a vascular tumour nodule
3. vascularised tumour
4. vascularised tumour with central necrosis

this is growth of tumour

Question 15

describe angiogenesis in benign vs malignant

Answer 15

benign - neoplasm growth tends to keep up with blood supply

malignant - neoplasms grow faster and may grow faster than blood supply so middle of the tumour dies - central necrosis

Question 16

why do we classsify neoplasms

Answer 16

to determine appropriate treatment
to provide prognostic info
to aid communication

Question 17

what are the 2 ways to classify neoplasms

Answer 17

behavioural - benign/malignant

histogenetic - cell of origin

Question 18

what are the 3 behavioural classifications of neoplasms

Answer 18

benign

borderline

malignant

Question 19

describe benign neoplasms

Answer 19

• localised, non invasive
• slow growth rate
• low mitotic activity
• close resemblance to normal tissue
• circumscribed or encapsulated

Question 20

2 examples of benign neoplasms

Answer 20

Fibroid
Tubulovillous adenoma

Question 21

describe histology of benign neoplasm

Answer 21

nuclear morphometry often normal
necrosis rare
ulceration rare
growth on mucosal surfaces usually exophytic - up and outwards

Question 23

why should we worry about benign neoplasms

Answer 23

they can still cause morbidity and mortality
through diff ways:
1. pressure on adjacent structures
2. obstruct flow
3. produce hormones
4. transform to malignant neoplasm
5. anxiety

Question 24

describe malignant neoplasms

Answer 24

• invasive (defining feature)
• metastases (not all metastasise)
• rapid growth rate
• variable resemblance to normal tissue
• poorly defined or irregular border

Question 25

describe histology of malignant neoplasms

Answer 25

Hyperchromatic nuclei - darker than normal Pleomorphic nuclei - larger than normal Increased mitotic activity Necrosis and ulceration common Growth on mucosal surfaces and skin often endophytic

Question 26

examples of malignant neoplasms

Answer 26

Prostate cancer Squamous cell carcinoma

Question 27

why worry about malignant neoplasms

Answer 27

cause morbidity and mortality because of: 1. destruction of adjacent tissue 2. metastases 3. blood loss from ulcers 4. obstruct flow 5. produce hormones 6. paraneoplastic effects 7. anxiety and pain

Question 28

define histogenesis

Answer 28

the specific cell of origin of a neoplasm histopathologist examination required specifies neoplasm type

Question 29

what can neoplasms arise from (3)

Answer 29

epithelial cells connective tissue lymphoid/haematopoetic organs

Question 30

nomenclature of neoplasms

Answer 30

Suffix: ‘-oma’ Prefix: depends on behavioural classification and cell type

Question 31

what is a papilloma

Answer 31

a benign neoplasm of non-glandular non secretory epithelium prefix with cell type of origin eg squamos cell papilloma

Question 32

what is an adenoma

Answer 32

a benign neoplasm of glandular or secretory epithelium prefix with cell type of origin eg thyroid adenoma, colonic adenoma

Question 33

definition of carcinoma

Answer 33

malignant epithelial neoplasm

Question 34

what are adenocarcinomas

Answer 34

all carcinomas of glandular epithelium

Question 35

how are benign connective tissue neoplasms named

Answer 35

according to cell type of origin, suffixed by ‘oma’ lipoma - adipocutes chondroma - cartilage osteoma- bone angloma- vascular rhabdomyoma - striated muscle leiomyoma - smooth muscle (common) neuroma - nerves

Question 36

how are malignant connective tissue neoplasms named

Answer 36

Sarcoma’ prefixed by cell type of origin: Liposarcoma: adipose tissue Rhabdomyosarcoma: striated muscle Leiomyosarcoma: smooth muscle Chrondrosarcoma: cartilage Osteosarcoma: bone Angiosarcoma: blood vessels

Question 37

how are malignant neoplasms carcinomas and sarcomas further classified

Answer 37

by how closely they resemble normal tissue (degree of differentiation)

Question 38

what is an anaplastic neoplasm

Answer 38

where the cell type of origin cannot be determined

Question 39

exceptions to nomenclature rules

Answer 39

Not all ‘-omas’ are neoplasms * e.g. granuloma, mycetoma, tuberculoma Not all malignant neoplasms are carcinomas or sarcomas, e.g.: * Melanoma: malignant neoplasm of melanocytes * Mesothelioma: malignant neoplasm of mesothelial cells * Lymphoma: malignant neoplasm of lymphoid cells Embryonal tumours Mixed tumours APUDomas Carcinosarcomas

Question 40

what are Eponymously named neoplasms (exceptions)

Answer 40

- Burkitt lymphoma • Ewing sarcoma • Grawitz tumour • Kaposi sarcoma

Question 41

what are blastomas

Answer 41

neoplasms that represent embryonic toissue

Question 42

what are teratomas

Answer 42

neoplasms containing tissues from all 3 embryological layers these are also an exception to nomenclature rules

Question 43

what are all sarcomas

Answer 43

malignancies of connective tissue