Cellular Pathology Flashcards
Define metaplasia
A REVERSIBLE change in which one adult cell (usually epithelial) is
REPLACED
by another adult cell type
How is the change seen in metaplasia normally described?
ADAPTIVE
• i.e. in response to regurgitated stomach acid
• e.g. Barratt’s Oesophagus
Give 2 types of metaplasia’s?
GASTRIC metaplasia
• columnar epithlium & NO goblet cells
INTESTINAL metaplasia
• columnar epithelium & goblet cells
Define dysplasia
An ABNORMAL PATTERN of GROWTH in which the cellular & architectural features of malignancy are present
How is the change seen in dysplasia normally described?
‘Pre-invasive’ changes
• intact BM
• can NOT spread
• loss of architecture & loss of uniformity of individual cells
Features that can be seen in dysplasia?
Nuclei
• HYPERchromic
• enlarged
Mitotic figures (condensed DNA material)
• abundant
• abnormal (in places not normally found)
Where is dysplasia common in?
CERVIX
• HPV infection
BRONCHUS
• smoking
COLON
• UC (ulceritive collitis)
LARYNX
• smoking
STOMACH
• pernicious anaemia
OESOPHAGUS
• acid reflux
How can dysplasia be described?
HIGH-grade (darker nuclei)
vs.
LOW-grade
Define neoplasia
An abnormal, AUTONOMOUS PROLIFERATION of cells UNRESPONSIVE to normal growth control mechanisms
Difference of benign tumours compared to malignant tumours?
• Do NOT invade (do NOT metastasise)
• Encapsulated
- NOT always like this i.e. Leiomyomas are NOT but ARE benign
- Usually well differentiated
- Slow-growing
- Normal mitotic figures
Benign tumours are not often fatal unless?
• In a dangerous place
- i.e. pituitary
• Secretes dangerous chemicals
- i.e. insulinoma
• Gets infected
i.e. bladder infection from obstruction of ureter
• Bleeds
- i.e. stomach tumours
• Ruptures
- i.e. liver adenoma
• Torts (twisted)
- i.e. ovarian cyst (twists and cuts off own blood supply)
Define metastasis
A DISCONTINOUS growing colony of tumour cells at SOME DISTANCE from the 1o cancer
What does the occurrence of metastasis depend on?
Depends on
• local vascular supply
AND
• local lymphatic drainage
What does it mean if lymph nodes are involved in metastasis?
Has a WORSE prognosis
e.g. Dukes A is a confined colon cancer with a 90% cure rate
vs.
Dukes C which metastasises and has a 30% cure rate
Characteristics of malignant tumours?
- Invade surrounding tissue
- Metastasise
- No capsule (BUT not always)
• Well –> poorly differentiated
- but tend to be poorly differentiated
- Rapidly growing
- Abnormal mitotic figures
7 nomenclature of tumours?
- Benign epithelial tumours
- Carcinoma
- Benign soft tissue tumours
- Sarcoma
- Leukaemia & lymphoma
- Teratoma
- Harartoma
BET (cancer type)
Benign Epithelial Tumours
• SURFACE epithelial
- PAPILLOMA
- e.g. skin, bladder
• GLANDULAR epithelial
- ADENOMA
- e.g. stomach, thyroid, colon, kidney, pituitary, pancreas
Define C (cancer type)
Carcinoma
A malignant tumour derived from epithelium
Different types of C (cancer type)
Carcinoma
• Squamous cell
- squamous cell malignancy
• Adenocarcinoma
- glandular epithelium malignancy
• Transitional cell carcinoma
- transitional cells line the URINARY tract
• Basal cell carcinoma
- arise from the skin
BSTT (cancer type)?
Benign Soft Tissue Tumours
e. g. Osteomas
i. e. just suffix -oma to the descriptor
Define S (cancer type)
Sarcoma
A malignant tumours derived from CT (mesenchymal) cells
Types of S (cancer type)?
- Liposarcoma (fat derived)
- Osteosarcoma
- Chondrosarcoma (cartilage)
• Rhabdomyosarcoma
- striated muscle tumour
• Leiomyosarcoma
- smooth muscle tumour
• Malignant Peripheral Nerve Sheath Tumour
- nerve sheath tumour
Define L&L (cancer types)
Tumours of WBCs
Leukaemia
• malignant tumour of BONE MARROW-derived cells
• in the PERIPHERAL BLOOD
Lymphoma
• malignant tumour of LYMPHOCYTES (usually)
• in the LYMPH NODES
Define T (cancer type)?
Teratoma
Tumour derived from GERM CELLS, which have the potential to develop into tumours of all three germ cell layers
- Ectoderm
- Mesoderm
- Endoderm
e.g. Dermoid cysts
• can contain anything such as teeth, bone, eyes etc.
Example of T (cancer type)?
Gonadal teratomas
• in Males = all are malignant
• in Females = most are benign
Define H (cancer type)?
Hamartoma
Localised overgrowth of cells/tissues native to the organ
e.g. Bile duct hamartoma
Features of H (cancer type)?
Cells are MATURE but architecturally abnormal
• i.e. expect to find the same types of tissues expected to grow in the organ BUT not in the right place in the organ
Within which cohort is H (cancer type) common in?
Common in CHILDREN
• but often stops growing when the child stops growing
A benign tumour of glandular tissue is…
- An adenoma
- A leiomyoma
- An adenocarcinoma
- A squamous papilloma
- A lymphoma
A malignant tumour derived from soft tissue is a….
- Carcinoma
- Sarcoma
- Teratoma
- Lymphoma
- Melanoma
Criteria for assessing differentiation of a malignant tumour?
- Evidence of normal function is still present
- i.e. production of keratin, mucin, etc.
- e.g. an ectopic squamous cell cancer of the lung produces PTH-rp
- If no evidence of normal function
• high-grade or anaplastic carcinoma - If no evidence of differentiation
• anaplastic carcinoma - Presence of abnormal mitoses
• some tumours have a mitotic count
• i.e. Tumour with 15 mitoses/mm2 behaves worse than one with 5 mitoses/mm2 - Various grading systems
• for cancer of breast, prostate & colon
What is the TNM?
Tumour, Node, Metastasis (TNM) system
can be applied and individualised to tumour in all sites
Grade of a tumour?
Describes if DEGREE OF DIFFERENTIATION
Stage of a tumour?
Describes HOW FAR it has SPREAD
Which is more important - grade or stage of a tumour?
STAGE is more important in determining the prognosis
Tumours of HIGHER GRADE (i.e. more poorly differentiated) tend to be of HIGHER STAGE (i.e. spread further)
