CA1: Non-neoplastic and neoplastic changes

Question 1

Define atrophy

Answer 1

A wasting or decrease in size

Question 2

Give examples of physiological atrophy

Answer 2

Atrophy of remnant structures during development e.g. thyroglossal cyst which is an embryological growth that should disappear

Muscle atrophy after stopping weight training

Question 3

Give examples of pathological atrophy

Answer 3

1. Cardiac
2. Malnutrition
3. Hair follicles with age
4. Alzheimer’s disease which is secondary to brain atrophy where gaps develop between sulci

Question 4

Define hyperplasia and explain where this can occur

Answer 4

Increase in cell number but not cell size - this occurs in organs which have proliferative capacity and stem cells

Question 5

Give examples of physiological hyperplasia

Answer 5

Endometrium - hyperplasia and then shedding in menstrual cycle

Thyroid hyperplasia due to lack of iodine (this can block the larynx and cause death)

Question 6

Give examples of pathological hyperplasia

Answer 6

Lymph node reaction to viral infection; EBV glandular fever

Hyperplasia of prostate with age

Question 7

What are the complications associated with hyperplasia

Answer 7

It can cause obstruction and so infarction, or over-secretion of hormones

Question 8

Define hypertrophy

Answer 8

Increase in size due to increase in cell size - the cells dont divide as they dont have the proliferative capacity and so cannot regenerate

Question 9

Give examples of hypertrophy

Answer 9

Athletes muscles and the heart - this can cause cardiomayopathy where there is obstruction due to narrowing in the heart as a result of increased muscle causing subendocardial MI

Question 10

What is metaplasia

Answer 10

Change from one fully mature tissue type to another fully mature tissue type

Question 11

Outline the different types of metaplasia

Answer 11

1. Squamous to glandular = Barrett’s oesophagus
2. Glandular to squamous = in bronchi due to smoking
3. Stomach to intestinal type = stomach acid reflux

Question 12

How does metaplasia lead to neoplasm

Answer 12

Metaplasia is not pre-neoplastic but it may go on to cause dyspladia which will cause neoplasm

Question 13

Describe the appearance of cells in dysplasia

Answer 13

1. Pleomorphic = multiple different shapes
2. Increased mitosis
3. Disorganised

Question 14

What is dysplasia

Answer 14

The premalignant changes causing atypia in epithelium

There is no invasion into the basement membrane

Question 15

What is an adenoma

Answer 15

Benign glandular tumour

Question 16

What is an adenocarcinoma

Answer 16

Malignant glandular tumour

Question 17

What is squamous cell carcinoma

Answer 17

Malignant

Question 18

What is squamous cell papilloma

Answer 18

Benign

Question 19

Why do tumours arise in epithelia

Answer 19

Because these are areas of high proliferation; most common -

Breast
Prostate
Bowel 
Lung 
Skin

Question 20

Outline the pathogenesis of cancer in a smoker

Answer 20

Smoking causes bronchi irritation 
Metaplasia from glandular to squamous epithelium
Continued smoking causes DNA changes
Dysplasia 
More DNA changes 
Invasive cancer

Question 21

How is proliferation in tissues regulated

Answer 21

Cell division and apoptosis

Question 22

How do abnormally switched on genes cause cancer

Answer 22

Normal proto-oncogenes can be switched on to give oncogenes when abnormal and these cause cancer

Question 23

How do abnormally switched off genes cause cancer

Answer 23

When tumour supressor genes are turned off e.g. P53 meaning that damaged cells will not apoptose

Question 24

What is HPV and what does it cause

Answer 24

Human Papiloma Virus causes cervical cancer

• introduces DNA into cells which interferes with gene function
• inactivates tumor supressor gene so no p53 produced

Question 25

How can hepatitis B cause cancer

Answer 25

It is a DNA virus which causes long term cirrhosis of the liver on infection - the fibrous nodules formed can undergo cancerous changes, leading to hepatocellular carcinoma