Cell pathology 3 - Cancer Flashcards

1
Q

Define a tumour

A

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

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2
Q

Define neoplasm

A

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

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3
Q

How can neoplasms be classified?

A
  • Benign (remain localised)

- Malignant (invade locally/spread to distant sites)

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4
Q

What are cancers?

A

Malignant neoplasms

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5
Q

Do malignant tumours always cause death?

A

No, especially not skin cancers

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6
Q

Can benign tumours kill?

A

Yes, usually due to their location

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7
Q

What is a hamartoma?

A
  • Localised benign overgrowths of one of more mature cell types e.g. in the lung.
  • Represent architectural but not cytological abnormalities.
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8
Q

What are heterotopias?

A

These are normal tissue being found in parts of the body where they are no normally present.

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9
Q

How are neoplasms classified?

A

The primary description of a neoplasm is based on the cell origin and the secondary description is whether it is benign or malignant.

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10
Q

What are teratomas?

A
  • These are tumours derived from germ cells and can contain tissue derive from all three for 3 germ cell layers.
  • They may contain mature and / or immature tissue and even cancers.
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11
Q

What are suffixes generally in malignant or benign tumours?

A

Malignant ends in -sarcoma

Benign ends in -oma

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12
Q

Which malignant tumours end in -oma?

A
  • (Malignant) Lymphoma
  • (Malignant) Melanoma
  • Hepatoma (better called liver cell cancer).
  • Teratoma (not all)
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13
Q

List the 4 possible differences between benign and malignant tumours

A
  • Invasion
  • Metastasis
  • Differentiation
  • Growth pattern
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14
Q

What is invasion?

A

This means direct extension into the adjacent connective tissue and /or other structures e.g. blood vessels.

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15
Q

What is metastasis?

A

This means spread via blood vessels etc to other parts of the body.

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16
Q

What is differentiation?

A

This means how much do the cells of the tumour resemble the cells of the tissue it is derived from.

17
Q

What is the difference in differentiation between malignant and benign tumours?

A
  • Tumour cells have larger nucleus (and nuclear-cytoplasmic ratio) and more mitoses.
  • May have abnormal mitoses and marked nuclear pleomorphism (variability in nuclear size and shape).
18
Q

What is the growth pattern?

A

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

19
Q

How does the growth pattern of tumours differ to normal cells?

A

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

20
Q

Can benign tumours become malignant?

A

Yes

21
Q

By which routes to tumours spread?

A
  • Direct extension.
  • Haematogenous.
  • Lymphatic
  • Transcoelomic
  • Perineural
22
Q

What is direct extension?

A
  • This is associated with a stromal response to the tumour.
  • This includes fibroblastic proliferation (desmoplastic response), vascular proliferation (angiogenesis) and an immune response.
23
Q

What is the haematogenous route of tumours spreading?

A
  • This is via blood vessels.

- Usually the venules and capillaries as they have thinner walls.

24
Q

Where do most sarcomas first metastasise?

A

Most sarcomas metastasise first via the blood vessels.

25
Q

What is the lymphatic route of tumours spreading?

A
  • This is lymphatics to lymph nodes and beyond.

- The pattern of spread is dictated by the normal lymphatic drainage of the organ in question.

26
Q

Where do most epithelial cancers metastasise first?

A

The lymphatics

27
Q

What is the transcoelomic route of tumours spreading?

A
  • This is via seeding of body cavities.
  • Examples are the pleural cavities (for intrathoracic cancers) and the peritoneal cavities (for intra-abdominal cancers)
28
Q

What is the perineural route of tumours spreading?

A

Through nerves

29
Q

How is tumour spread assessed?

A
  • Clinically
  • Radiologically
  • Pathologically
30
Q

What is the TNM system?

A
  • A method of describing tumour spread
  • T is the tumour size/extent of local invasion
  • N is nodes - the number of lymph nodes involved
  • M is metastases - presence of distant metastases
31
Q

What is the grade and stage in cancer?

A

Grade is how differentiated the tumour is.

Stage is how far the tumour has spread

32
Q

Is grade or stage more important in tumour prognosis?

A

Stage