Cellular Pathology of Cancer

Question 1

Metaplasia

Answer 1

A reversible change in which 1 adult cell type is replaced by another
Adaptive i.e. to change in pH

Question 2

2 examples of metaplasia

1 pathological + 1 physiological

Answer 2

Barrett’s Oesophagus: GERD- stratified squamous epithelium to simple columnar
Cervix during pregnancy: cervix opens up, columnar epithelium of endocervical canal is exposed to the acidic uterine fluids making it squamous

Question 3

What are the 2 types of metaplasia that can take place in Barrett’s Oesophagus?

Answer 3

Gastric metaplasia: stratified squamous to simple columnar

Intestinal metaplasia: goblet cells begin to appear

Question 4

State 6 features of cancer that are seen in dysplasia.

Answer 4

Large hyperchromatic nuclei
Increased mitoses  
Abnormal mitoses
Increased nucleo-cytoplasmic ratio  
Loss of architectural orientation 
Loss of uniformity of individual cells

Question 5

What is the difference between low and high-grade dysplasia?

Answer 5

Both show changes of dysplasia but changes are more severe in high-grade dysplasia
Low grade appears lighter because high grade has high nuclear: cytoplasmic ratio
High-grade has high risk of progression to cancer

Question 6

6 main features of benign tumours that separate them from malignant tumours

Answer 6

Don't metastasise  
Don't invade  
Well differentiated
Slow growing
Normal mitoses
Encapsulated (except fibroids in the uterus)

Question 7

6 conditions in which benign tumours become dangerous

Answer 7

If in a dangerous location e.g. meninges
If they secrete something dangerous e.g. insulinoma  
If infected  
If they bleed  
If they rupture  
If they become twisted

Question 8

6 features of malignant tumours

Answer 8

Invade surrounding tissues  
Spread to distant sites  
No capsule
Well or poorly differentiated
Rapidly growing
Abnormal mitoses

Question 9

Metastasis

Answer 9

A discontinuous growing colony of tumour cells, at some distance from the primary cancer

Question 10

What are the 2 different types of benign epithelial tumour?

Answer 10

Papilloma: of surface epithelium
Adenoma: of glandular epithelium

Question 11

Carcinoma

Answer 11

Malignant tumour derived from the epithelium

Question 12

4 different types of carcinoma

Answer 12

Basal cell
Squamous cell
Transitional cell carcinoma (trans. epithelium found in bladder)
Adenocarcinoma

Question 13

State 3 different types of benign soft tissue tumour.

Answer 13

Osteoma: bone
Lipoma: fat
Leiomyoma: smooth muscle

Question 14

Sarcoma

Answer 14

Malignant tumour derived from connective tissue (mesenchymal) cells

Question 15

What are the names given to malignant tumours of striated muscle, smooth muscle and the nerve sheath?

Answer 15

Striated: rhabdomyosarcoma
Smooth: leiomyosarcoma
Nerve sheath: Malignant peripheral nerve sheath tumour

Question 16

Leukaemia

Answer 16

Malignant tumour of bone marrow derived cells, which circulate in the blood

Question 17

Lymphoma

Answer 17

Malignant tumour of lymphocytes (usually) in lymph nodes

Question 18

Teratoma

Answer 18

Tumour derived from germ cells

Can contain tissue from all 3 germ cell layers (ectoderm, mesoderm, endoderm)

Question 19

What is an important difference between teratomas in men compared to women?

Answer 19

Gonadal teratomas in men: all malignant

Gonadal teratomas in women: most are benign

Question 20

Hamartoma

Answer 20

Excessive, localised overgrowth of cells + tissue native to the organ
Cells are mature but architecturally abnormal

Question 21

Which group of the population is hamartoma common in?

Answer 21

Children

Usually stops growing when child stops growing

Question 22

What is the difference between grading and staging?

Answer 22

Grade: degree of differentiation
Stage: how far the cancer has spread
Staging > Grading

Question 23

What is meant by the ‘degree of differentiation’?

Answer 23

How much the tumour cells resemble the cells from which they are derived

Question 24

What are the grading systems for breast and prostate cancer?

Answer 24

Breast: Nottingham scoring system
Prostate: Gleason classification

Question 25

What is the term given to tumours that show little or no differentiation?

Answer 25

Anaplastic

Question 26

Dysplasia

Answer 26

Precancerous cells which show the genetic + cytological features of malignancy but not invading the underlying tissue

Question 27

Neoplasm

Answer 27

an abnormal, autonomous proliferation of cells, unresponsive to normal growth control mechanisms

Question 28

Tumour

Answer 28

Any kind of mass forming lesion

Question 29

Malignancy

Answer 29

abnormal, autonomous proliferation of cells unresponsive to normal growth control mechanisms

Question 30

Carcinogen

Answer 30

Cancer causing substance

Question 31

When trying to assess malignancy of a tumour, what might you look for?

Answer 31

Evidence of normal function still present e.g. production of mucin or hormones