Cancer Flashcards
Define tumour 3 types
Any kind of mass forming lesion
May be neoplasticism, hamartomatous or inflammatory
- any mass is a tumour
- hamartomarous - non cancerous
Define neoplasm
The autonomous growth of tissue which have escaped normal constrains on cell proliferation
What are the two types of neoplasms
Benign- remain localised
malignant - invade locally and or spread (metastasis) to distant sites
What are cancers
Malignant neoplasms
The really invasive ones are fixed to the skin
What can you say about malignant tumours and Benign tumours
Some malignant rarely cause death such are skin cancers.
But benign tumours can kill, because of their location eg in the brain
What are hematomas?
-localised benign overgrowth of one of more mature cells types eg in the lung
- architectural but not cytology cal abnormalities
Eg lung hamartomas are composed of cartilage and bronchial tissue
What are heteropias
Normal tissue found in parts of the tissue where it’s not meant to be
Eg pancreas in the wall of the large intestine
What are the two types of classification of neoplasms
Primary - based on the cell origin
Secondary - description of whether benigh or malignant
2 types of cartilage neoplasms and classification
Chondroma - benign
Chondrosarcoma - malignant
Squamous - benign - malignant- examples
Squamous epithelioma or papilloma
Squamous cell carcinoma
Skin oesophagous cervix
Glandular - same drill
Adenoma
Adenocarcinoma
Breast colon pancreas thyroid
Transitional
Transitional papiloma
Transitional cell carcinoma
Bladder
Smooth muscle
Leiomyoma
Leiomyosarcoma
Uterus colon
Bone
Osteoma
Osteosarcoma, osteogenic sarcoma
Arm leg
Lymphocytes
Extremely rare to get benign tumour
Lymphoma
Lymphoma, stomach
Bone marrow
Extremely uncommon for benign tumours
Leukaemia
Acute lymphoblastic leukaemia and chronic myeloid leukaemia
What are teratomas
Tumours derived from germ cells and can contain tissue derived from all 3 germ cell layers (layers formed in the earliest stages of embryonic development)
May contain mature or immature tissue even cancers
Forms a combination of tissue types
In female and male reproductive tract, can give rise to ectoderm, mesoderm and endoderm which come up in embryology
4 differencs between benign and malignant tumours
Invarsion
Metastasis
Differentiation
Growth pattern
What does invarsion mean
Direct extension into the adjacent connective tissue and other structures eg blood vessels
This is what distinguishes dysplasia/ carcinoma in situ (stays in place not invade so not cancer) from cancer
Meaning of metastasis
Spread via the blood vessels to other parts of the body
All tumours which are malignant can metastasise at some point but some identified before they are which is great
What is differentiation
How much the cells of the tumour resemble the cells of the tissue it is derived from
Tumour cells tend to have larger nuclei - higher nuclear cytoplasmic ratio and more mitosis than normal tissue they are derived from
Abnormal mitosis (tripolar) and marked nuclear pleomorphism (variability in nuclear size and shape)
Some features of cancerous cells 5
Large, variably shaped nuclei Many deciding cells Disorganised arrangement Variation in size and shape Loss of normal features
Describe the growth pattern
How much does the architecture of the tumour resembles the architecture of the tissue it is derived fro.
They have less defined architecture than the tissue they are derived from
What are the routes tumours can spread
Direct extension Haematogenous Lymphatic Transcoelomic Perineural
Describe direct extension
Associated with stromal (connective tissue of cells) response to a tumour
Includes fibroblastic proliferation (desmoplastic response) vascular proliferation (angiogenesis) and an immune response.
Describe haematogenous
This is via the blood vessels
Blood vessels usually invaded are venues and capillaries because they have thinner walls
Most sarcomas metastasise via the blood vessels
Describe lymphatic
Via lymphatic to the lymph nodes and more
The pattern of spread is dictated by the normal lymphatic drainage of the organ in question
Most epithelial cancers metastasis via the lymphatics
(Lymphatics drain in the thoracic duct and the. The superior vena cava then the rest of the body)
Describe transcoelomic
Via the body cavities
Common examples are the pleural cavities (for intrathoracic cancers) and the peritoneal cavities (for intra abdominal cancers)
(If reach the surface of the peritoneal cavity they can spread very easily, it is a low resistant zone, moist and can spread very fast)
Situations where the patient has to be shut again, if not spread through lymphatics then cannot operate
Describe perineural
This is via the nerves
How do we access tumour spread 3
Clinically
Radiologically
Pathologically - staging tumours
What is the tumour spread guide
T - tumour - size or extend of local invasion
N - nodes, number of lymph nodes involved
M - metastasis
TNM different for each
What is the grade
How differentiated the tumour is
What is the stage
How far the tumour spread
In terms of prognosis which is more important stage or grade
Stage
But either way the higher the grade or stage the worse the prognosis
