Cancer

Question 1

What are benign cancers?

Answer 1

Cancers which remain localised, do not spread - however can still kill due to their location eg a benign brain tumour could raise intracranial pressure and cause problems

Question 2

What is the definition of a tumour?

Answer 2

A mass forming lesion of any kind

Question 3

What are neoplasms?

Answer 3

Autonomous outgrowths of tissues which have escaped the normal constraints of cell proliferation

Question 4

How do cells become cancerous?

Answer 4

Through the accumulation of mutations through the cell cycle which control the process of cell division

Question 5

what are malignant tumours?

Answer 5

Those which invade local side/ spreads to distant sites

Question 6

What are hamartomas?

Answer 6

Localised, benign overgrowths of one or more mature cell types eg lungs - they are tumours, but not neoplasms

Question 7

What is the main problem associated with hamartomas?

Answer 7

They display architectural abnormalities

Question 8

Where do hamartomas commonly form?

Answer 8

In the lungs

Question 9

What are three types of tumours?

Answer 9

Neoplastic, hamartomatous or inflammatory

Question 10

What is a heterotopia?

Answer 10

When normal tissue is found in parts of the body where they are not normally found

Question 11

A 51-year-old male underwent an endoscopy during colon screening. An erythematous flat lesion, measuring about 2.5 cm in its greatest diameter was noted in the rectum and biopsies were obtained. Histological examination (shown below) revealed multiple fragments of gastric mucosa with associated with mild chronic inflammation. How is this tumour best described?

Answer 11

Heterotopia - usually associated with inflammation as well but generally harmless

Question 12

Which type of tumour invades connective tissue?

Answer 12

Malignant tumours often invade connective tissue, whereas benign tumours do not.

Question 13

In the “TNM” system of tumour grading, what do the letters T, N and M represent?

Answer 13

Tumour
Nodes
Metastasis

Question 14

What is a cancer?

Answer 14

A malignant neoplasm

Question 15

What does the suffix “sarcoma” mean?

Answer 15

Malignant (soft tissue) tumour

Question 16

What does the suffix “oma” mean?

Answer 16

Benign tumour

Question 17

What is the name of a benign tumour of the squamous epithelium cells?

Answer 17

Squamous papilloma

Question 18

What is the name of a malignant and benign tumour of glandular epithelial cells?

Answer 18

Malignant = Adenocarcinoma

Benign = Adenoma

Question 19

What is the name of a malignant and benign tumour of transitional epithelial cells?

Answer 19

benign = transitional papilloma

malignant = transitional cell carcinoma

Question 20

What is the name of a malignant and benign tumour of squamous epithelial cells?

Answer 20

benign = squamous papilloma

malignant = squamous cell carcinoma

Question 21

what is the name given to a benign and malignant tumour of smooth muscle?

Answer 21

Leiomyoma = benign

leiomyosarcoma = malignant

Question 22

What is the name given to benign and malignant tumours of the bone?

Answer 22

Osteoma = benign

Osteosarcoma = malignant

Question 23

What is a lymphoma?

Answer 23

A malignant neoplasm of the lymphocytes

Question 24

What is leukaemia?

Answer 24

A malignant neoplasm of the bone marrow

Question 25

What are teratomas?

Answer 25

Tumours derived from germ cells and can contain tissue from all three germ layers

Question 26

What does invasion mean?

Answer 26

The direct extension into the adjacent connective tissue or other structures like blood vessels

Question 27

What are the four main differences between benign and malignant tumours?

Answer 27

1. invasion 2. metastasis 3. growth patterns 4. differentiation

Question 28

What is meant by metastasis?

Answer 28

The spread of cancer via the blood vessels

Question 29

What is meant by the degree of differentiation?

Answer 29

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

Question 30

How do tumour cells differ from the cells they are derived from?

Answer 30

-They have a larger nuclei (so higher nuclear:cytoplasm ratio) -more mitoses than the normal tissue they are derived from -abnormal mitoses (e.g. tripolar) -marked nuclear pleomorphism

Question 31

What is meant by growth pattern?

Answer 31

how much does the architecture of the tumour resembles the architecture of the tissue it is derived from.

Question 32

How does the growth pattern of tumours differ from that of the tissue it is derived from?

Answer 32

less well defined architecture than the tissue they are derived from

Question 33

Describe how a benign tumour becomes malignant?

Answer 33

1. hyperproliferation 2. adenomatous polyps form 3. when the polyps undergoes dysplasia - becomes pre cancerous 4. then forms an adenocarcinoma and then becomes an invasive cancer

Question 34

By which routes do tumours spread?

Answer 34

Direct extension. Haematogenous. Lymphatic Transcoelomic Perineural

Question 35

What are three stages involved in the direct extension of a tumour?

Answer 35

fibroblastic proliferation (“ a desmoplastic response”), vascular proliferation (angiogenesis) and an immune response.

Question 36

which blood vessels are usually invaded in haematogenous invasion and why?

Answer 36

The blood vessels usually invaded are the venules and capillaries because they have thinner walls.

Question 37

By what route do most sarcomas metastasize through?

Answer 37

Haematogenous

Question 38

Which cancers metastasize via the lymphatics first?

Answer 38

Epithelial cancers

Question 39

How is the pattern of lymphatic spread dictated?

Answer 39

dictated by the normal lymphatic drainage of the organ in question

Question 40

What is meant by transcoelomic spread?

Answer 40

This is via seeding of body cavities.

Question 41

Which cavities are common sites for transcoelomic spread?

Answer 41

pleural cavities for intrathoracic cancers and peritoneal cavities for intra-abdominal

Question 42

What is perineural spread?

Answer 42

Spread of cancer via nerves

Question 43

How do we assess tumour spread?

Answer 43

1. Clinically 2. Radiologically 3. Pathologically

Question 44

How do we describe tumour spread (stage)?

Answer 44

T = Tumour: the tumour size or extent of local invasion N = Nodes: number of lymph nodes involved M = Metastases: presence of distant metastases  This is called the “TNM" system and the details are different for each kind of cancer

Question 45

What is meant by grade and stage?

Answer 45

Grade = how differentiated is the tumour Stage = how far has the tumour spread - TNM