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cancer - year 2 > cell pathology practical > Flashcards

cell pathology practical Flashcards

1
Q

what is the screening test for bowl cancer *

A

check stool for blood using biochemical or immunological methods

do sigmoidoscopy for bowel polyps because most polyps that become cancer are at the bottom of the colon - remove the polyps so the cancer cant develop, or if already cancer - detect it early

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2
Q

possible reasons for blood in stool

A

GI bleeding from oesophagus, small/large bowel, stomach because of ulcers/haemorrhoids

inflammatroy bowel disease eg chron’s

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3
Q

what do you do if a screening test is positive *

A

do full colonoscopy

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4
Q

what are polyps *

A

a mass growth form a tissue wall

any part of body that is hollow can develop a polyp

adenomas are polyps with dysplasia of the glandular epithelium

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5
Q

what do you do if you find polyp in colonoscopy *

A

snip it and send it to a histopathologist

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6
Q

what would the report on this polyp be *

A

high nucleocytoplasmic ratio - polyp is darker than the underlying tissue - shows it is an adenoma (dysplastci tissue)

size of polyp - bigger more likely to be malignant >5cm is high risk

low grade dysplasia - still architecturally correct

is it cancer already

has it invaded

is it completely excised - yes you can see normal mucosa at base

is it a tibular or villus adenoma

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7
Q

consequence of polyp is in the mucosa *

A

definitely invasive - have to go to surgery

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8
Q

what can be seen from this image - polyp *

A

it has gone through the muscularis externa - see because muscle either side of it but not below

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9
Q

what is stage *

A

how far the tumour has spread

either through nodes and vessels, or into the muscle

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10
Q

what lymph system would colon cancer drain into *

A

mysenteric nodes, then thoracic duct, then superior vena carvae

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11
Q

how would colon cancer spread in the blood 8

A

too the liver

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12
Q

how would colon cancer spread locally *

A

through submucosa to muscle to peritoneum

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13
Q

describe the TNM staging for colon cancer *

A

T1 spread into mucosa

T2 into muscle

T3 through muscle

T4 reach peritoneum

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14
Q

what is the TNM staging for this tumour *

A

T3 - because no muscle below it - so gone through the muscle

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15
Q

what is Duke’s staining for colon cancer *

A

through the muscularis externa or not

a is not through muscularis externa

b is

this tumour is b

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16
Q

what is grade *

A

how well differentiated the tumour is - hwo much do teh cells look like the normal tissue that they have come from

well differentiated means look a lot like original tissue and is good prognostically

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17
Q

how do adenocarcinoma’s change the structure of the cells *

A

they form a ball of glandular epithelial cells that secrete mucin

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18
Q

where can you get adenocarcinoma

A

colon

adrenal cortex

lung

pancreas

fallopian tubes

prostate

breast

bowel

stomach

oesophagus

uterus

19
Q

what is teh grade of this adenocarcinoma *

A

well differentiated

20
Q

what can be seen on this mammogram *

A

dense pyramidal area

21
Q

how would a person present with breast cancer *

A

lump on breast

screening program - mammogram - imaging based system

22
Q

what would make a lump less likely to be cancer *

A

if it could be moved - means not attached to muscles/skin (although inflammatory lumps can become attached)

if there are not enlarged lymph nodes

no distant metastises eg liver

23
Q

what lymph nodes would you feel to see if there was an enlargement *

A

axillary if cancer was lateral (most breast cancers are)

medial drain into internal mammary chain behind below sternum and ribs - harder to palpate

24
Q

what would you do if you suspected a lump was cancer *

A

send for a clinically indicated mammogram

biopsy

25
Q

what is a core biopsy *

A

a thin slice of tissue

26
Q

what is a ductal carcinoma in situ *

A

ductal - means of ductual rather than lobular tissue of the breast

in situ - not invasive

therefore it is high end of high grade dysplasia

27
Q

what is a wide local excision *

A

a surgery to remove a small problematic area of breast - dont remove the whole breast because the cell doubling time is 100 days so when you find it, it would already be big so local surgery not going to be curative

28
Q

what is the consistency of a breast tumour *

A

gritty pear

this texture because of the collagen and stroma produced as a result of having cancer

29
Q

what can be seen from this breast tissue *

A

ductal carcinoma in situ

cells have filled the normal duct

there is a high nucleocytoplasmic ratio

it is round so has not invaded tissue - hence in situ

30
Q

describe this sample of breast tissue (

A

normal

has duct with milk secretions

has normal epithelial lining the duct

31
Q

describe this area of breast tissue *

A

proper carcinoma

there are some glands but also areas of single cells

invesive - the pink lines are muscle - so this is invading the underlying muscle

it is invasive ductile cancer

32
Q

what is the system for staging breast cancer *

A

size

T1 is 2cm or less

T2 2-5

T3 >5cm

T4 is invasion of muscle of skin of underlying muscle

33
Q

describe the complication of removing lymoh nodes for breast cancer *

A

should remove them all if have breast cancer

but axillary also drain arm - if remove can get lymphodema - painful swelling so dont take nodes out if you dont need them

sample biggest node in axilla - send to histopath lab and if there is cancer - remove the nodes - this is dond during surgery

34
Q

is there tumour in this node *

A

yes - normally would see lymphoid follicles

35
Q

what does the p in pT2 stand for *

A

pathological TNM

could be c - clinical or r - radiological

36
Q

what are possible ddxs for

A

infection

tumour

37
Q

how would you decide if a finger was infected or tumour

A

give AB see if clear up

38
Q

signs of inflammation

A

loss of function

red

swollen

pain

warmth

39
Q

what are the common types of skin cancer *

A

melanoma

squamous cell carcinoma

basal cell cancer - from hair follicles

angioma - from bv

angiosarcoma

lymphoma

40
Q

describe squamous carcinoma in situ of the skin *

A

bowen’s disease

dysplasia

not invasded

high nucleocytoplasmic ratio

big cells all the way to top

41
Q

describe invasice carcinoma (

A
42
Q

describe staging of non-melaoma skin cancers *

A

depend on size and if it goes into the underlying bone

if goes into bone it is t3

43
Q

describe the difference between low and high grade squamous cell carcinoma *

A

low grade still produces keratin

high grade doesnt

cancer - year 2 (18 decks)

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