CH 8-NEOPLASIA--3 Q'S Flashcards
_______: abnormal swelling
________: new growth (Neos=new; Plasia=growth)
_______: denotes malignant growth (Karkinos=crab)
Oncology: study of tumors (oncos=tumor; logos=study of)
Tumor
Neoplasia
Cancer
Neoplasia
- _________ cell proliferation i.e. escapes normal control mechanisms of cell growth
- Autonomous (Auto=self; Nomas=self governing) functions independently, replicated steadily and competes with _____ cells for their metabolic needs
Uncontrollable
normal
Tumor Shape and Texture
1–Polypoid is usually benign
2–_______ is more associated with aggressive behavior
Ulcerated
All tumors have 2 basic components:
1- the parenchyma “______ or neoplastic cells”
2- the supporting stroma (of non-transformed elements) as connective tissue & blood vessels
transformed
Nomenclature of tumors depends on:
- Cell of ______
- Behavior of tumor (benign or malignant)
origin
_______ Tumor:
Cell type from which tumor arises
e.g. fibroma, chondroma
Benign
______ Tumor: (often called cancer)
I. Carcinomas
- arises from epithelial cells
- named by type of epithelium
Malignant
I I . Sarcomas
- arises from _______ tissues
- named by cell component of tumor
e. g. fibrosarcoma, chondrosarcoma
mesenchymal
Mixed Tumor:
- composed of cells arising from _____ & mesenchymal tissues
e. g. fibroadenoma, teratoma - either benign or malignant
epithelial
Benign tumors that arise from germ cells and contain derivatives of different germ layers are labeled ____________
teratoma
- Hepatoma suggests benign tumor arising from hepatocytes, but is definitely
__________ - melanoma: suggests _____ tumor arising from melanocytes, but is highly malignant
- Hamartoma:suggests tumor but is a mass of mature disorganized tissue related to an organ
malignant
benign
A ______
is a neoplasm in an organ that is composed of tissue elements normally found at that site, but growing in a haphazard mass.
hamartoma
Benign: Histologically : - fully differentiated cells,\_\_\_\_\_\_\_ very closely normal ones - rare mitoses - normal structural pattern Functionally : - well differentiated
resemble
Malignant:
Histologically:
Wide range of cell differentiation, either:
i. differentiated
ii. completely undifferentiated , cells have NO
morphologic resemblance to normal tissue (anaplastic):
1. pleomorphism
2. giant cells
3. loss of normal orientation
4. Nuclei:- high nuclear cytoplasmic ratio
- variable size & shape
5. 5. mitosis:- numerous & - atypical
Know
Squamous cell carcinoma, differentiated,
=”keratin pearls”
Know
Pleomorphism
cells are highly pleomorphic (vary in size & shape) , with hyperchromatic nuclei
Know
Rate of Growth
Benign: - grow slowly over several years
Malignant: - grow rapidly, growth rate correlates with degree of malignancy (and differentiation)
- angiogenesis factor stimulates growth of new capillaries
Know
Ex. This adenoma is a well- differentiated neoplasm because it closely resemble normal tissue
Encapsulation and invasiveness
Benign:= - Encapsulated:
i. NO invasion or active destruction of surrounding
ii. movable
iii. easily enucleated during surgical removal
iv. NO spread to distant sites
- –Capsule derived from tumor & surrounding CT
Know no no
Malignant:
- Never develop capsules!!
- -Infiltrate & destroy tissue around (not clearly separated from normal tissue)
Never caps
metastasis—–Transfer of malignant cells from one site to another not directly connected with it.
–Most important difference from benign tumors!!!
Major cause of death (difficult to eradicate)
Transfer is bad!!
Routes of Spread:
- Direct seeding of body cavities
- -Tumors invade serous sacs
- -Tumors of C.N.S. cells carried by C.S.F. re-implant on meningeal surface of brain & spinal cord - Lymphatic spread—Most common route of metastasis for carcinomas (sarcomas spread mainly by blood)
- Hematogenous spread–Sarcomas metastasize earlier and more readily by blood than carcinomas
- –VEINS are more readily penetrated than arteries = malignant cells follow VENOUS flow to reach liver, lung
Know
Grading Detects level of malignancy based on:
i. degree of cell differentiation
ii. number of mitoses
Know
TYPES OF GRADING
_________: graded numerically :I,II,III,IV in order of increasing anaplasia
______ : graded descriptively:
low, intermediate, or high-grade malignancy
Carcinoma
Sarcoma
Grading is imperfect because: x 2
- different parts of the same tumor may display different degrees of differentiation
- the grade of the tumor may change as the tumor grow
Staging:
- Detects stage of cancer = indicates course of treatment & prognosis of the condition
Know
Size of primary lesion:
T1
Extent of regional ______ to lymph nodes:
N0 = not involved
N1 = involved, mobile
N2 = involved, fixed
Spread
Presence or absence of distant metastases:
M0 = absent M1 = present (one organ) M2 = present (more than one organ)
Distant!!
- Geographic, environmental, & regional factors:
- The 2nd leading cause of death in USA (22% of all deaths):
Male: lung (_____%), prostate and colon (10%) Female: lung (_____%), breast (15%), colon (11%) - Age:
—More common between 55-75 years
–Some types are common in children e.g. acute leukemia and WILMS TUMOR - Heredity:
- Pre-neoplastic disorders:
e.g. liver cirrhosis & hepatocellular carcinoma, - Carcinogenic agents:
- Oncogenes—genes whose products are associated with neoplastic transformation.
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Clinical effects of tumors–1
- Obstruction– of lumen of hollow organs e.g. bronchial wall, bile duct
- Destruction –of tissue due to local invasiveness
- Bleeding –from ulcerated area or eroded vessel
- Erosion & ulceration
- Infarction
- compression of blood supply
- torsion of pedicle of organ e.g. testis or ovary
Clinical effects of tumors–2
- Space-occupying lesion
- raised intracranial tension by brain tumor
- anemia due to replacement of hemopoietic
- Hormone production by tumors of endocrine glands e.g. insulinoma in tumors of pancreas
- Cachexia:
Progressive loss of weight & profound weakness:
- loss of appetite
- bleeding
- repeated infections (immunosuppression)
- production of cachectin (by activated
macrophages) = depletion of fat depot
Paraneoplastic disorders
Manifestations distant from primary lesion that are not directly related to metastases:
Ex.
i. ectopic production of hormones
e. g. ACTH by oat cell carcinoma of lung
ii. hypercalcemia:osteolytic bone tumors
iii. hypertrophic pulmonary osteoarthropathy in lung cancer: clubbing of fingers, subperiosteal bone deposition & arthritis.
