Cancer

Question 1

Define tumour 3 types

Answer 1

Any kind of mass forming lesion
May be neoplasticism, hamartomatous or inflammatory

• any mass is a tumour
• hamartomarous - non cancerous

Question 2

Define neoplasm

Answer 2

The autonomous growth of tissue which have escaped normal constrains on cell proliferation

Question 3

What are the two types of neoplasms

Answer 3

Benign- remain localised

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

Question 4

What are cancers

Answer 4

Malignant neoplasms

The really invasive ones are fixed to the skin

Question 5

What can you say about malignant tumours and Benign tumours

Answer 5

Some malignant rarely cause death such are skin cancers.

But benign tumours can kill, because of their location eg in the brain

Question 6

What are hematomas?

Answer 6

-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

Question 7

What are heteropias

Answer 7

Normal tissue found in parts of the tissue where it’s not meant to be
Eg pancreas in the wall of the large intestine

Question 8

What are the two types of classification of neoplasms

Answer 8

Primary - based on the cell origin

Secondary - description of whether benigh or malignant

Question 9

2 types of cartilage neoplasms and classification

Answer 9

Chondroma - benign

Chondrosarcoma - malignant

Question 10

Squamous - benign - malignant- examples

Answer 10

Squamous epithelioma or papilloma
Squamous cell carcinoma
Skin oesophagous cervix

Question 11

Glandular - same drill

Answer 11

Adenoma
Adenocarcinoma
Breast colon pancreas thyroid

Question 12

Transitional

Answer 12

Transitional papiloma
Transitional cell carcinoma
Bladder

Question 13

Smooth muscle

Answer 13

Leiomyoma
Leiomyosarcoma
Uterus colon

Question 14

Bone

Answer 14

Osteoma
Osteosarcoma, osteogenic sarcoma
Arm leg

Question 15

Lymphocytes

Answer 15

Extremely rare to get benign tumour
Lymphoma
Lymphoma, stomach

Question 16

Bone marrow

Answer 16

Extremely uncommon for benign tumours
Leukaemia
Acute lymphoblastic leukaemia and chronic myeloid leukaemia

Question 17

What are teratomas

Answer 17

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

Question 18

4 differencs between benign and malignant tumours

Answer 18

Invarsion
Metastasis
Differentiation
Growth pattern

Question 19

What does invarsion mean

Answer 19

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

Question 20

Meaning of metastasis

Answer 20

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

Question 21

What is differentiation

Answer 21

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)

Question 22

Some features of cancerous cells 5

Answer 22

Large, variably shaped nuclei
Many deciding cells
Disorganised arrangement 
Variation in size and shape 
Loss of normal features

Question 23

Describe the growth pattern

Answer 23

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

Question 24

What are the routes tumours can spread

Answer 24

Direct extension 
Haematogenous 
Lymphatic 
Transcoelomic 
Perineural

Question 25

Describe direct extension

Answer 25

Associated with stromal (connective tissue of cells) response to a tumour

Includes fibroblastic proliferation (desmoplastic response) vascular proliferation (angiogenesis) and an immune response.

Question 26

Describe haematogenous

Answer 26

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

Question 27

Describe lymphatic

Answer 27

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)

Question 28

Describe transcoelomic

Answer 28

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

Question 29

Describe perineural

Answer 29

This is via the nerves

Question 30

How do we access tumour spread 3

Answer 30

Clinically
Radiologically
Pathologically - staging tumours

Question 31

What is the tumour spread guide

Answer 31

T - tumour - size or extend of local invasion
N - nodes, number of lymph nodes involved
M - metastasis

TNM different for each

Question 32

What is the grade

Answer 32

How differentiated the tumour is

Question 33

What is the stage

Answer 33

How far the tumour spread

Question 34

In terms of prognosis which is more important stage or grade

Answer 34

Stage

But either way the higher the grade or stage the worse the prognosis