Cancer

Question 1

What is a tumour?

Answer 1

Any kind of mass forming lesion

May be neoplastic, hamartomatous or inflammatory

Question 2

What is meant by neoplasm?

Answer 2

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

Question 3

What are the two types of neoplasm?

Answer 3

Benign- localised

Malignant- has potential to spread to distant site

Question 4

Can benign tumours cause death?

Answer 4

Yes, because of location e.g. brain

Question 5

Can malignant tumours not be harmful?

Answer 5

Many malignant tumours rarely cause death e.g. skin cancers

Question 6

What are hamartomas?

Answer 6

Localised benign overgrowths of one or more mature cell types e.g. in the lung\Represent architectural but not cytological abnormalities
e.g. lung hamartomas are composed of cartilage and bronchial tissue
Not a cause for concern

Question 7

What is heterotopia?

Answer 7

Normal tissue found in the wrong place

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

Question 8

What is the primary classification of a neoplasm?

Answer 8

Based on cell origin

Question 9

Whats is the secondary description of a neoplasm?

Answer 9

Benign or Malignant

Question 10

What is the suffix for benign tumours?

Answer 10

‘oma’

Question 11

What is the suffix for malignant tumours?

Answer 11

‘sarcoma’

Question 12

What is a teratoma?

Answer 12

Tumours derives from germ cells and can contain tissue derive from all three germ cell layers
May contain immature and/or mature tissue and even cancers

Question 13

Give some examples of malignant tumours that end in ‘Oma’?

Answer 13

Lymphoma
Melanoma
Hepatoma
Teratoma (not all)

Question 14

What are the differences between benign and malignant tumours?

Answer 14

Invasion
Metastasis
Differentiation
Growth pattern

Question 15

What is meant by invasion?

Answer 15

Direct extension into the adjacent connective tissue and/or other structures e.g. blood vessels
Distinguishes dysplasia from cancer

Question 16

What is meant by metastasis?

Answer 16

Spread via blood vessels to other parts of the body

All malignant tumours have the capacity to metastasise although they may be diagnoses before they have done so

Question 17

What is meant by differentiation?

Answer 17

How much do the cells of the tumour resemble the cells of the tissue it is derived form 
e.g. Tumour cells have larger nuclei 
Greater mitosis 
Greater variation in size and shape 
Loss of normal features

Question 18

Whats is meant by growth pattern?

Answer 18

Hoe much does the architecture of the tumour resembles that of the tissue it is derived from
Tumours have less well defined architecture

Question 19

Can benign tumours become malignant?

Answer 19

Yes

Question 20

By which routes do tumours spread?

Answer 20

Direct extension 
Haematogenous
Lymphatic
Transcoelomic
Perineural

Question 21

What is meant by direct extension?

Answer 21

Associated with a stromal response to the tumour

Includes fibroblastic proliferation, vascular proliferation and an immune response

Question 22

What is meant by haematogenous?

Answer 22

This is via blood vessels
Usually venules and capillaries because they have thinner walls
Most sarcomas

Question 23

What is meant by lymphatic?

Answer 23

Via lymphatics to lymph nodes and beyond
Pattern of spread dictated by the normal lymphatic drainage of organ in question
Most epithelial cancers

Question 24

What is meant by transcoelomic?

Answer 24

Via seeding of body cavities

E.g pleural cavities and peritoneal cavities

Question 25

What is meant by perineal?

Answer 25

Via nerves

Question 26

How do we assess tumour spread?

Answer 26

Clinically
Radiologically
Pathologically

Question 27

How do we describe tumour spread?

Answer 27

TMN
T: Tumour size/extent of local invasion
N: Nodes- number of lymphnodes involved
M: Metastases

Question 28

What is meant by grade?

Answer 28

How differentiated is the tumour

How bad does it look down the microscope?

Question 29

What is meant by stage?

Answer 29

How far has the tumour spread (TMN)