cancer

Question 1

• What is a tumour?

- What are the three types of tumour?

Answer 1

Any kind of mass forming lesion

May be neoplastic, hamartomatous or inflammatory

Question 2

• Give an example of a non-neoplastic tumour?

Answer 2

Nasal polyps (nothing to do with cancer → they are inflammatory)

Question 3

• Define a Neoplasm

- What are the 2 types of Neoplasm?

Answer 3

Autonomous growth of tissue which have escaped normal constraints of cell proliferation

Benign - remain localised 

Malignant - invade locally and/or spread to distant sites (metastasis)

Question 4

• What is cancer?

- What is a Fibroadenoma?

Answer 4

Malignant neoplasms

Common benign breast tumours made up of both glandular tissue and connective tissue

Question 5

• Why might some malignant tumours only rarely cause death?

- Why do some benign tumours cause death?

Answer 5

They have a very low chance of metastasis

Usually because of their location e.g. brain

Question 6

• What are Hamartomas?

Answer 6

Localised benign overgrowths of one of more mature cell types e.g. in the lung

Represent architectural rather than cytological abnormalities e.g. lung hamartomas are composed of cartilage and bronchial tissue

Question 7

• Define Heterotopia

Answer 7

These are normal tissue being found in parts of the body where they are not normally present

e.g. pancreas in the wall of the large intestine

Question 8

• What is the primary description of a neoplasm based on?

- What is the secondary description of a neoplasm based on?

Answer 8

Cell origin

whether it is malignant or benign

Question 9

• What does the ‘chondra’ stem mean?

- What does the suffix ‘sarcoma’ refer to?

Answer 9

Derived from cartilage

malignant (soft tissue) tumour

Question 10

• What does the suffix ‘sarcoma’ refer to?

- What does the suffix ‘oma’ refer to?

Answer 10

malignant (soft tissue) tumour

Benign tumour

Question 11

• What is the name for a glandular benign tumour?
• What is an adenocarcinoma?
• Examples of where this would be?

Answer 11

Adenoma

malignant glandular tumour

breast, pancreas, thyroid, colon

Question 12

• What are teratomas?

Answer 12

Tumours derived from germ cells and can contain tissue derived from all 3 germ cell layers

May contain mature/immature tissue and even cancers

Question 13

• What does invasion mean?

Answer 13

Means direct extension into the adjacent connective tissue and/or other structures

This is what distinguishes dysplasia / carcinoma in situ from cancer

Question 14

• What is dysplasia?

Answer 14

Presence of abnormal cells within a tissue or organ

Question 15

• What does differentiation mean in relation to tumours?

- What organelle tends to be larger in tumour cells and why is it larger?

Answer 15

How much the cells of the tumour resemble cells of tissue it is derived from

Nuclei → so that more mitosis can occur than the tissue the tumour was originally derived from

Question 16

• Define nuclear pleomorphism

Answer 16

Variability in nuclear size and shape

Question 17

• What does growth pattern in tumour cells refer to?

Answer 17

How much the architecture of the tumour resembles the architecture of the tissue it is derived from

Tumours have less well defined architecture than the tissue they are derived from

Question 18

• What are the 4 differences between benign and malignant neoplasms?

Answer 18

Invasion

Metastasis 

Differentiation 

Growth pattern

Question 19

4 differences between normal and cancerous cell

Answer 19

larger and variably shaped nuclei- nuclear pleomorphism (higher nuclear to cytoplasmic ratio) 
loss of function
variably shaped and sized cells
disorganised arrangement 
many dividing cells
abnormal mitoses eg tripolar

Question 20

• List routes by which tumours spread

Answer 20

Direct extension

Haematogenous - bloodstream

Lymphatic

Transcoelomic- seeding of body cavities

Perineural

Question 21

• What type of spread is associated with a stromal response? (give examples)

Answer 21

Direct extension

stromal responses eg e.g. fibroblastic proliferation (desmoplastic) and vascuclar proliferation (angiogenesis) and an immune response

Question 22

• By what route do most sarcomas spread?

Answer 22

Haematogenous → blood vessels usually invaded are the venules and capillaries due to thinner walls

Question 23

• Why is it easier for cancers to spread through capillaries and veules than arteries?
• By what route do most epithelial cancers metastasise first?

Answer 23

They have thinner walls

Via the lymphatic to lymph nodes and beyond

Question 24

• What are the most common examples of transcoelomic spread?

- How do our tumours spread via the perineural route?

Answer 24

Pleural cavities (intrathoracic cancers)
    Peritoneal cavities (intra-abdominal cancers)

Via nerves

Question 25

• How do we assess tumour spread?

Answer 25

Clinically

Radiologically

Pathologically - very definitive

Question 26

• Describe the TNM system to describe tumour spread?

Answer 26

T = Tumour size or extent of local invasion

N = Nodes: number of lymph nodes

M=  Metastases: presence of distant metastases

Question 27

• What does grade and stage refer to?

Answer 27

Grade → how differentiated is the tumour

Stage → how far has the tumour spread (TNM)

Question 28

• What is the name for a squamous epithelial benign tumour?

- What is the name for a squamous epithelial malignant tumour?

Answer 28

squamous epithelioma or papilloma

squamous cell carcinoma

Question 29

• What is an osteoma?

- What does the term, ‘Leiomyo-‘ refer to?

Answer 29

Benign tumour in bone

Smooth muscle

Question 30

• What is the name for a malignant bone tumour?
• What is the name for a benign smooth muscle tumour?
• What is the name for a malignant smooth muscle tumour?

Answer 30

Osteosarcoma (osteogenic sarcoma)

Leiomyoma

Leiomyosarcoma

Question 31

• What is a leukaemia?

- What is a lymphoma?

Answer 31

Malignant tumour in bone marrow → ALL, CML etc.

Malignant tumour (exception) in lymphocytes e.g. lymphoma, stomach

Question 32

• What are the 3 germ cell layers?

Answer 32

Ectoderm - the outermost layer of cells or tissue of an embryo in early development

Mesoderm - the middle layer of cells or tissues of an embryo

Endoderm - the innermost layer of cells or tissue of an embryo in early development

Question 33

• Name some malignant tumours with the suffix ‘oma’

Answer 33

Malignant lymphoma

Malignant melanoma 

Hepatoma → liver cell cancer 

Teratoma (not all are malignant however)