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Y2 - CANCER > Cellular Pathology of Cancer > Flashcards

Cellular Pathology of Cancer Flashcards

1
Q

Define metaplasia

A
  • A reversible change in which one adult cell type (usually epithelial) is replaced by another
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2
Q

What happens in gastric metaplasia?

A
  • Stratified squamous epithelium → simple columnar epithelium
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3
Q

What characteristic feature can be seen histologically in intestinal metaplasia?

A
  • You will see the metaplasia
  • But you must see goblet cells to confirm its intestinal
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4
Q

Give one example of pathological metaplasia

A
  • Barret’s oesophagus
  • Gastro-oesophageal reflux causes oesophageal epithelium to change from squamous to columnar
  • This is reversible if gastro-oesophageal reflux ceases
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5
Q

Give one example of physiological metaplasia

A
  • In pregancy, the cervix opens up and this causes the more acidic uterine fluid to enter the endocervical canal
  • This converts the columnar epithelium in the endocervical canal into squamous epithelium
  • When the cervix closes up again, this effect is reversed
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6
Q

What is dysplasia and what features might you see in dysplastic tissue?

A
  • Pre-invasive stage with intact basement membrane but showing signs of early cancerous properties
  • Such as:
  1. Increased nucleo-cytoplasmic ratio
  2. Hyperchromatic nuclei
  3. Increased and abnormal mitoses / mitotic figures
  4. Pleiomorphy - loss of individuality
  5. Of course, INTACT BM
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7
Q

Give 6 sites that dysplasia is common in and why they occur here / in what conditions

A
  1. Cervix - HPV
  2. Larynx - Smoking
  3. Oesophagus - Barret’s oesophagus
  4. Colon - ulcerative colitis associated with IBD… UC → dysplasia → cancer
  5. Bronchus - smoking (psuedostratified columnar → squamous also occurs)
  6. Stomach - pernicious anaemia (chronic stomach inflammation)
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8
Q

This is a cervical biopsy - how can you tell the tissue is dysplastic here?

A
  • Because on the left you see normal maturation with high cellular density towards the bottom and more spaced out lower density of cells layering towards the luminal side
  • However on the right side, there is abnormal development - very dense towards the luminal side and dark, dense (hyperchromatic) nuclei can be seen
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9
Q

What is high grade and low grade dysplasia, and what are some histological differences between them?

A
  • High grade dysplasia = likely to turn into cancer
  • Low grade dysplasia = unlikely to turn into cancer

Histological differences:

  • Larger nuclei : cytoplasmic ratio in high grade dysplasia
  • Higher hyperchromaticity of nuclei
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10
Q

Define malignancy

A
  • Abnormal, autonomous growth of cells that are unresponsive to normal growth mechanisms
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11
Q

Define neoplasia

A
  • Any new growth, benign or malignant
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12
Q

What is a tumour?

A
  • A swelling
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13
Q

What happens in endometrial hyperplasia?

A
  • In the oestrogenic phase of the menstrual cycle, there is endometrial epithelia proliferation
  • When oestrogen levels drop, the proliferation should start to stop
  • In cancer, these endometrial epithelial cells have become autonomous of this mechanism and continue to proliferate despite the normal growth / proliferation signalling mechanism
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14
Q

Give 6 characteristic properties of benign tumours, that also make them different from malignant tumours

A
  1. DO NOT INVADE SURROUNDING TISSUE
  2. DO NOT METASTASISE
  3. Encapsulated
  4. Slow growing
  5. Well differentiated - i.e. they resemble the tissue they arise from
  6. Normal mitoses
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15
Q

Give 6 characterisitic properties of malignant tumours, these also make them different to benign tumours

A
  1. INVADE SURROUNDING TISSUE
  2. METASTASISE
  3. Rapidly growing
  4. Abnormal mitoses
  5. Poorly differentiated - i.e. do not resemble the tissue they arise from
  6. Unencapsulated
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16
Q

What could a benign tumour in the meninges cause?

A

Epilepsy

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17
Q

Give an example of a benign adenoma secreting something which is dangerous

A
  • Insulinoma
  • Secretes spikes of insulin which can cause dangerous hypoglycaemic episodes
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18
Q

How might benign tumours of the kidneys lead to infection?

A
  • Because they obstruct the ureters and infection of the tumour and surrounding areas occurs
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19
Q

Why are liver adenomas quite dangerous?

A
  • Because they can rupture and cause bad haemoperitoneum
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20
Q

Why can benign tumours in the stomach be dangerous?

A
  • Bleeds
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21
Q

What can torted ovarian cysts (benign tumour form) cause?

A
  • Ischaemic necrosis (infarction due to lost blood supply and thus cell death)
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22
Q

Define metastasis

A
  • Discontinuous colony of tumour cells, at some distance from the primary site
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23
Q

What is a common metastasis of pancreatic carcinomas and what is the basis for this?

A
  • Pancreatic carcinoma → liver metastasis
  • Because the pancreas is drained by the splenic vein and into the hepatic portal vein so it can access the liver if a little cancerous tissue embolises from the primary site
24
Q

1) What is the Duke’s staging system?
2) What does Duke’s A mean?
3) What does Duke’s C mean?

A

1)

  • A system used to measure the prognosis for colon cancer

2)

  • Cancer has remained stuck to the bowel wall - 90% survival prognosis

3)

  • Cancer has metastasised via lymph node involvement - 30% survival prognosis
25
Q

List 7 types of tumour

A
  1. Benign epithelial tumour (papilloma / adenoma)
  2. Malignant epithelial tumour (carcinoma)
  3. Benign soft tissue tumour
  4. Malignant soft tissue tumour (sarcoma)
  5. Leukaemias and lymphomas
  6. Teratomas
  7. Hamartomas
26
Q

What type of tumour does a papilloma describe?

A
  • Benign surface epithelial cell tumour = papilloma
  • E.g. on the skin, bladder
27
Q

What type of tumour does an adenoma describe?

A
  • Benign glandular epithelial tumour
  • E.g. on stomach, thyroid, kidney, pituitary, pancreas
28
Q

What type of tumour does a carcinoma describe?

A
  • Malignant epithelial tumour
29
Q

What is a squamous cell carcinoma?

A
  • Malignant epithelial tumour of skin / oesophagus
30
Q

What is an adenocarcinoma?

A
  • Malignant epithelial glandular tissue
31
Q

What is a transitional cell carcinoma? Also what are transition cells and give a place they can be found

A
  • Malignant epithelial tumour of transition cells
  • Transition cells are stratified cell layers, the surface layer of which contains cell whose morphologies are dependent on the stretch they are exposed to
  • E.g. in the bladder - useful for when the bladder fills with urine that there is a morphological change
32
Q

What is a basal cell carcinoma?

A
  • A malignant surface epithelial tumour of the skin
33
Q

What are the 2 types of epithelia?

A
  1. Surface epithelia
  2. Glandular epithelia
34
Q

What is the formula for naming benign soft tissue tumours?

A
  • Like some sort of predictable stem
  • Then immediately -oma (note other types of tumour end in -oma but not directly, they’re like set types of -omas like adenomas, whereas benign soft tissue tumours have the -oma suffix added directly on)
  • E.g. Osteoma = benign soft tissue tumour of the bone
35
Q

What is an osteoma?

A
  • Benign soft tissue tumour of the bone
36
Q

What is a chondroma?

A
  • A benign soft tissue tumour of the cartilage of bone
37
Q

What is a lipoma?

A
  • Benign soft tissue tumour of fat
38
Q

What is a leiomyoma?

A
  • A benign soft tissue smooth muscle tumour
39
Q

What is the suffix in the nomenclature for malignant soft tissue tumours?

A
  • Sarcomas
40
Q

What is a liposarcoma?

A
  • Malignant soft tissue tumour of fat
41
Q

What is an osteosarcoma?

A
  • Malignant soft tissue tumour of bone
42
Q

What is a chondrosarcoma?

A
  • Malignant soft tissue tumour of the cartilage
43
Q

What is a rhabdomysarcoma?

A
  • Malignant soft tissue tumour of striated muscle
44
Q

What is a lieiomyosarcoma?

A
  • Malignant soft tissue tumour of the smooth muscle
45
Q

What is a malignant soft tissue tumour of the nerve sheath called?

A
  • Peripheral nerve sheath tumour
46
Q

Outline what a teratoma is and where you can expect to find them

A
  • A tumour derived from germ cells, which have the potential to develop into tumours of all 3 germ cell layers:
    1. Ectoderm
    2. Mesoderm
    3. Endoderm
  • Gonadal teratomas are common in both male and females
47
Q

Outline what a hamartoma is and give 2 examples of hamartomas

A
  • Mostly benign but some malignant
  • Localised overgrowth of cells and tissues native to the organ whose cells are mature but architecturally abnormal
  • E.g:
  1. Bronchial hamartoma
  2. Bile duct hamartoma
48
Q

When staging a tumour, how can you tell whether a particular tumour at a site is a primary or secondary tumour (i.e. if it originated there or is a metastasis)?

A
  • Because there will be some evidence of function still in the primary tumours
  • E.g. in adenocarinomas (malignant epithelial glandular tumours) there will still be mucin production
49
Q

What is the grading system for breast cancer called?

A

Nottingham system

50
Q

What is the grading system for prostate cancer called?

A
  • Gleason system
51
Q

What does grading a tumour describe?

A
  • The degree of differentiation - higher grade = poor differentiation
52
Q

What does staging a tumour describe?

A
  • The degree of spread - higher stage = greater spread
53
Q

What is more important, staging or grading in determining prognosis?

A
  • Staging is more important than grading in determining prognosis
54
Q

What is the TNM system?

A
  • Tumour - extent of tumour involvement
  • Node - extent of node involvement
  • Metastasis - extent of metastasis
  • TNM grading / staging system
55
Q

Well-differentiated tumours are characterised by all of the following, except:

  1. A small numbers of mitoses
  2. Lack of nuclear pleomorphism
  3. A high nuclear-cytoplasmic ratio
  4. Relatively uniform nuclei
  5. Close resemblance to the corresponding normal tissue
A
  • 3 - a high nuclear cytoplasmic ratio

Y2 - CANCER (14 decks)

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