Cancer 1 - Cellular Pathology of Cancer Flashcards
Define metaplasia
- Reversible change
2. When one adult cell type (usually epithelial) is replaced by another cell type
Give examples of pathological metaplasia and physiological metaplasia
Pathological = Barrett’s oesophagus. Gastro-oesophageal reflux causes oesophageal epithelium to change from (stratified) squamous to (simple) columnar
Physiological = Acidic uterine fluids in the endocervical canal cause the columnar epithelium to become squamous. Cell type reverses to normal when cervix closes up again
Is metaplasia adaptive?
Yes
Contrast gastric and intestinal metaplasia
Gastric - stratified squamous to simple columnar
Intestinal - goblet cells appear
Define dysplasia
- Abnormal pattern of growth
2. Where some cellular and architectural features of malignancy are present
What is the key feature of dysplasia?
INTACT BASEMENT MEMBRANE
Dysplasia is not cancer - preinvasive stage
List 4 features of cancer
- Increased nuclear:cytoplasmic ratio
- Large nuclei
- Abnormal mitoses
- Increased mitoses
What can dysplasia be used for?
Screening for cancer
Which 2 things is there a loss of in dysplasia?
- Loss of architectural orientation
2. Loss of uniformity of individual cells
2 words to describe nuclei that are dysplasic
Hyperchromatic and enlarged
List 6 places where dysplasia is common in, and what can cause them
Cervix - HPV infection Bronchus - smoking Colon - Ulcerative colitis Larynx - smoking Stomach - pernicious anaemia Oesophagus - acid reflux
What is the difference between low grade and high grade dysplasia?
Low grade = low risk of progression to cancer
High grade = high risk of progression to cancer
More severe changes in high grade
Which grade dysplasia has larger nuclei and a higher nuclear:cytoplasic ratio?
High grade dysplasia
What is a neoplasia
Any new (benign or malignant) growth
What is a tumour
Swelling (nasal polyps = tumours)
What is a malignancy
- Abnormal
- Autonomous cell proliferation
- Unresponsive to normal growth control mechanisms
What is the main diagnostic point of benign tumours?
They DO NOT METASTASISE OR INVADE
What are 4 features of benign tumours
- Encapsulated
- Normal mitoses
- Well differentiated
- Slowly growing
Name 6 situations when benign tumours may be fatal
- Are in a dangerous location
- Secrete something dangerous
- Gets infected
- Bleeds
- Ruptures
- Torts
What is the main definitive feature of a malignant tumour?
It invades surrounding tissues and spreads to different sites
Give 4 features of a malignant tumour
- Not encapsulated
- Abnormal mitoses
- Well to poorly differentiated
- Rapidly growing
What is a metastasis
Discontinuous growing colony of tumour cells, at some distance form the primary cancer
What does the sites of metastasis depend on?
Lymphatic and vascular drainage at the primary site
Lymph node involvement = worse prognosis (e.g. colon cancer w/ Dukes staging)
Differentiate Dukes A and Dukes C in colon cancer
Dukes A = colon cancer confined to bowel wall - 90% survival
Dukes C = colon cancer spread via lymph node - 30% survival
What are the different types of tumours (7)
- Benign epithelial tumours
- Carcinoma
- Benign soft tissue tumours
- Sarcoma
- Leukaemia/lymphoma
- Teratoma
- Hamartoma
What are the 2 types of benign epithelial tumour?
Benign epithelial tumour on:
- Surface epithelium = PAPILLOMA (e.g. skin, bladder)
- Glandular epithelium = ADENOMA (e.g. stomach, thyroid, colon, kidney, pituitary, pancreas)
What is a carcinoma
Malignant epithelial tumour
Tumours are classified based on the tissues they come from. List the types of carcinoma
- Squamous cell carcinoma
- Adenocarcinoma
- Transitional cell carcinoma (transitional epithelium in the bladder)
- Basal cell carcinoma
(Adenomas can become malignant and carcinomas)
Give examples of benign soft tissue tumours
- Osteoma - bone
- Lipoma - fat
- Leiomyoma - SM
Define sarcoma
Malignant tumour derived from connective tissue (mesenchymal cells)
What are the types of sarcoma
- Fat - liposarcoma
- Bone - osteosarcoma
- Cartilage - chondrosarcoma
- Striated muscle (SkM) - rhabdomyosarcoma
- SM - leiomyosarcoma
- Nerve sheath - Malignant Peripheral Nerve Sheath Tumour
Leukaemias and lymphomas are both tumours of what?
WBC.
It is possible to get both a lymphoma and leukaemia mix
What is a leukaemia
Malignant tumour of bone marrow derived-cells that circulate in blood
What is a lymphoma
Malignant tumour of lymphocytes in lymph nodes
What is a teratoma
- Tumour derived from germ cells
2. Potential to develop into tumours of all 3 germ cell layers
What are the 3 germ cell layers
- Ectoderm
- Mesoderm
- Endoderm
Distinguish gonadal teratomas in males and females
Male gonadal teratomas = usually malignant
Female gonadal teratomas = mostly benign
Define hamartoma
Localised overgrowth of cells and tissues NATIVE TO THE ORGAN
i.e. appropriate tissues for that organ/part of body but architectural arrangement is inappropriate
Hamartomas are common in?
Children
Give an example of a hamartoma
Bile duct in the liver- should only be 1, but sometimes there can be loads of misshapen bile ducts
2 ways in which tumours are differentiated
- Graded (how well differentiated)
2. Staged (how far they’ve spread)
Which tumour differentiation technique is more important
Staging
High grade tumours usually have a ______ stage?
HIGH
How to determine if a tumour is primary or secondary?
Inspect tumour histologically - see if evidence of normal function still present
What is the grading system for breast cancer?
Nottingham scoring system
What is the grading system for prostate cancer?
Gleason classification
What is meant by anaplastic?
Tumours with little/no differentiation
What does staging describe?
How far tumour has spread
What does grading describe?
Degree of differentiation
