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Year 2 - Cancer > Cellular pathology of cancer > Flashcards

Cellular pathology of cancer Flashcards

1
Q

What is metaplasia?

A

A reversible change in which one adult cell type is replaced by another adult cell type

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2
Q

Give an example of metaplasia

A
  • Gastric Metaplasia (stratified squamous to simple columnar)
  • Intestinal metaplasia (goblet cells appear)
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3
Q

What are the 2 types of metaplasia?

A

Pathological and physiological

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4
Q

Give an example of pathological metaplasia

A

Gastro-oesophageal reflux causes the oesophageal epithelium to change from squamous to columnar (Barrett’s oesophagus)

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5
Q

Give an example of physiological metaplasia

A

In pregnancy the cervix opens up and the columnar epithelium of the endocervical canal is exposed to the acidic uterine fluids making it become squamous
When the cervix closes up again, the cell type changes back to normal (metaplasia is reversible)

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6
Q

What is dysplasia?

A

Pre-invasive stage of cancer development

- abnormal pattern of growth in which some cellular and architectural features of malignancy are present

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7
Q

What is found in dysplasia?

A
  • intact basement membrane
  • increased nucleo-cytoplasmic ratio
  • loss of architectural orientation
  • hyperchromatic, enlarged nuclei
  • abundant mitotic figures in abnormal locations too
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8
Q

What are the features of cells in cancer?

A
  • Large nuclei
  • Increased and abnormal mitoses
  • Increased nucleo-cytoplasmic ratio (nuclei bigger than normal)
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9
Q

What is dysplasia used for?

A

To screen for cancer before individuals develop cancer - cancer is a multi step process and there are stages in between

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10
Q

Where is dysplasia common?

A

Cervix – HPV infection

Bronchi – Smoking (pseudostratified columnar -> squamous)

Colon – UC associated with IBD

Layrnx– Smoking

Stomach – Pernicious anaemia (chronic stomach inflammation)

Oesophagus– Acid reflux (Barrett’s oesophagus)

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11
Q

What is high grade and low grade dysplasia?

Difference between the two?

A

Low grade - unlikely to go on to cancer

High grade - very likely to develop into cancer. Changes are more severe in high-grade dysplasia. The nuclei are bigger and the nucleo-cytoplasmic ratio is higher.

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12
Q

What is malignancy?

A

An abnormal, autonomous proliferation of cells unresponsive to normal growth control mechanisms. These cells grow on their own.

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13
Q

What is neoplasia?

A

Any new growth, benign or malignant

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14
Q

What is a tumour

A

swelling

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15
Q

What is the difference between benign and malignant?

A

Benign:

  1. Do not invade (so do not metastasise)
  2. Encapsulated
  3. Usually well differentiated
  4. Slowly growing
  5. Normal mitoses
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16
Q

When can benign tumours be fatal?

A
  • If they are in a dangerous place: a benign tumour in the meninges
  • Secretes something dangerous: insulinoma – leads to hypoglycaemic episodes
  • Gets infected
  • Bleeds
  • Ruptures: liver adenoma (can cause massive haemoperitoneum)
  • Torts (twisted): ovarian cyst -> infarction due to lost blood supply (ischaemic necrosis)
17
Q

What is metastasis?

A

A discontinuous growing colony of tumour cells, at some distance from the primary cancer. Cells can break off and embolise around the body.

18
Q

How are benign epithelial tumours named?

A

papilloma or adenoma

papilloma: surface epithelium e.g. skin
adenoma: glandular epithelium e.g. stomach

19
Q

How are malignant epithelial tumours named?

A

CARCINOMA

  • if from squamous cells then squamous cell carcinoma
  • if from glandular epithelium then adenocarcinoma
  • if from transitional epithelium then transitional cell carcinoma
  • basal cell carcinoma
20
Q

How are benign soft tissue tumours named?

A
  • osteoma: benign bone tumour
  • lipoma: benign fat tumour
  • leiomyoma: benign smooth muscle tumour
21
Q

How are malignant soft tissue tumours named?

A

Derived from connective tissue (mesenchymal cells)
SARCOMA

  • prefix is the site of the tumour e.g. fat would be liposarcoma
  • bone: osteosarcoma
  • cartilage: chondrosarcoma
  • striated muscle: rhabdomyosarcoma
  • smooth m: leiomyosarcoma
  • nerve sheath: malignant peripheral nerve sheath tumour
22
Q

What are leukaemias and lymphomas?

A

Tumour of WBCs

leukaemia: malignant tumour of bone marrow derived cells which circulate in blood
lymphoma: malignant tumour of lymphocytes in lymph nodes

23
Q

What is a teratoma?

A

A teratoma is a tumour derived from germ cells, which have the potential to develop into tumours of all three germ cell layers: ectoderm, mesoderm and endoderm

  • have mutiple components
  • gonadal teratomas in males are almost always malignant
  • females almost always bengin and have teeth/hair
24
Q

What is a hamartoma?

A
  • Mostly benign but risk of malignancy
  • Localised overgrowth of cells and tissues native to the organ
  • Cells are mature but architecturally abnormal
  • Common in children, and should stop growing when they stop
  • E.g. bile duct hamartomas, bronchial hamartomas
  • E.g. may have many bile ducts, weird shapes, arranged abnormally etc
  • Normal cells, but architecture is abnormal
25
Q

How can a tumour be distinguished as primary or secondary?

A
  • Done by inspecting the tumour and looking for evidence of normal function still present:
  • Keratin is made by squamous cells
  • Mucin is produced by glandular epithelium (adenocarcinoma)
  • Bile is made by hepatocytes
  • Hormones e.g. insulin is made by the pancreas
26
Q

What are some examples of grading systems for malignant tumours?

A

Breast - Nottingham scoring system

Prostate - Gleason

27
Q

What is anaplastic?

A

tumours that show little or no differentiation

28
Q

What is TNM?

A
  • Cancer staging

- The Tumour, Node, Metastasis (TNM) system can be applied, and individualised, to tumour in all sites

29
Q

What is the stage and grade of a tumour?

A
  • The grade of a tumour describes its degree of differentiation (higher grade = poor differentiation)
  • The stage of a tumour describes how far it has spread (higher stage = greater spread)
  • Overall, stage is more important than grade in determining prognosis

Year 2 - Cancer (9 decks)

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