Cancer 1: Cellular pathology of cancer Flashcards
Define Metaplasia
- reversible change in which one adult cell type is replaced by another adult cell type
e. g squamous –> columnar epithelium (barrett’s esophagus)
Define Dysplasia
- abnormal pattern of growth in which some of the cellular + architectural features of malignancy is present
- pre-invasive stage with intact basement membrane
- IT IS NON INVASIVE
What happens in dysplasia?
to the:
a) architectural orientation
b) uniformity in individual cells
c) nuclei
d) mitotic figures
- loss of architectural orientation
- loss of uniformity in individual cells
- nuclei: hyper chromatic enlarged
- mitotic figures: abundant + abnormal
(INCREASE MITOSIS
INCREASE in NUCLEAR-CYTOPLASMIC RATIO)
When/ where might you find dysplasia?
CERVIX - HPV infection BRONCHUS - Smoking COLON - UC LARYNX - Smoking STOMACH -Pernicious anaemia OESOPHAGUS- Acid reflux
How would you distinguish benign/malignant tumors?
i.e how does it differ from malignant tumors ?
BENIGN
- doesn’t invade/ metastasise (local tissue) –> cant spread
- encapsulated
- well differentiated
(i. e they look like the tissue from which they come from) - slowly growing
- normal mitosess
MALIGNANT
- invades surrounding tissues
- spread to distant sites
- no capsule
- poorly differentiated
- rapidly growing
- abnormal mitoses
When might benign tumor be fatal?
- if its in a dangerous place
(e. g pituitary/meninges) - if it secretes something dangerous
(e. g insulinoma- tumor of beta cells of pancreas) - if it gets infected
(e. g bladder) - if it bleeds
(e. g stomach) - if it ruptures
(e. g liver adenoma) - if it gets twisted/torsion
(e. g ovarian cyst)
define metastasis
discontinuous growing colony of tumour cells, at some distance from the primary cancer
What factors does metastasis depend on?
depends on:
lymphatic + vascular drainage of primary site
e.g breast cancer can –> axillary lymph nodes
What do you call benign epithelial tumors of surface epithelium?
give some examples
Papilloma
e.g skin/ bladder
What do you call glandular epithelial tumors of surface epithelium?
give some examples
Adenoma
e.g stomach, thyroid, colon, kidney, pituitary, pancreas
What do you call malignant tumors of the epithelium?
Carcinoma
note: qualified/classified by “kind” of epithelium
What do you call malignant tumor derived from connective tissue (mesenchymal) cells
Sarcoma
what do you call sarcoma of the
a) fat
b) bone
c) cartilage
d) muscle
e) nerve sheath
what do you call sarcoma of the
a) fat = liposarcoma
b) bone = osteosarcoma
c) cartilage = chondrosarcoma
d) muscle = (striated) Rhabdomyosarcoma // (smooth) leiomyosacoma
e) nerve sheath = malignant peripheral nerve sheath tumor
Distinguish between Leukemia + Lymphoma
- Leukaemia = malignant tumour of bone marrow derived cells which circulate in the blood
- -> mainly blood based
- Lymphoma = malignant tumour of lymphocytes (usually) in lymph nodes
- -> mainly tissue based
define a teratoma
- tumour derived from germ cells, which have the potential to develop into tumours of all three germ cell layers:
1. ectoderm,
2. mesoderm,
3. endoderm - -> any tissue can be found in a teratoma
- -> large mixture of tissues
(common in ovaries/ testes)
Gonadal teratomas in male =
malignant/ benign
Gonadal teratomas in female = malignant / benign
Gonadal teratomas in male = ALL malignant
Gonadal teratomas in female = mostly benign
Define hamartoma
localised overgrowth of cells and tissues native to the organ, which are normally found in the organ.
- -> cytologically normal
- -> arrangement/ architecture is abnormal
e. g bile duct hamartomas/ bronchial hamartomas
How would you differentiate malignant tumors?
i.e whats the criteria
Evidence of normal function still present production of:
- keratin, - mucin - bile - hormones
TNM - Stage/ grade is more important when determining prognosis
Stage is more important when determining prognosis
In TNM system ,
what is meant by:
a) grade
b) stage
TNM system (tumor, node, metastasis)
a) grade = degree of differentiation of tumour
b) stage = how far it has spread
- -> invades other structures
define neoplasia
any new growth benign or malignant
Lymph node / vascular involvement has worse prognosis with reference to metastasis
Lymph node has worse prognosis with reference to metastasis
note:
dysplasia - lowest nuclear cytoplasmic ratio
benign tumors - lower nuclear cytoplasmic ratio
malignant tumors - higher nuclear cytoplasmic ratio
-
Lymphoma = almost always malignant / benign
Lymphoma = almost always malignant
What is anaplastic carcinoma?
no differentiation at all
