Clinical Lecture: Lumps And Bumps

Question 1

Benign Mass

Answer 1

Not harmful

Question 2

Malignant Mass

Answer 2

Evil in nature

Question 3

What do we want to know about a lump bump

Answer 3

Benign or malignant

Question 4

What do we want to know

Answer 4

Can we leave it alone or do we need to do something

Question 5

Haywood’s 3 rules to making medicine easy

Answer 5

! Establish the diagnosis ◦ History
◦ Examination ◦ Investigations
! Establish the Extent of the disease ◦ History
◦ Examination ◦ Investigations
! Establishes the management plan

Question 6

What could the mass be?

Answer 6

Congenital or acquired

Question 7

Congenital mass

Answer 7

Malformation (from birth )

Question 8

Acquired

Answer 8

Occurs after birth
Infective
Neoplastic
inflammatory

Question 9

What could the lump be?

Answer 9

! Anatomy ◦ Skin - Epidermis, skin appendages in the dermis
◦ Fat
◦ Connective tissue ◦ Muscles
◦ Bones
◦ Joints - Swelling, osteophytes, ganglions
◦ Nerves
◦ Blood vessels - Arteries and veins
◦ Lymphatic system - Lymph nodes, lymph vessels, lymphoma, metasteses ◦ Organs- Organomegaly, herniation
◦ Metasteses

Question 10

Acquired - infective

Answer 10

! Rubor ! Calor ! Tumor ! Dolor

Question 11

Acquired- inflammatory

Answer 11

! History of inflammatory conditions ◦ Rheumatoid arthritis etc
! Pain
! Tenderness
! Symmetry
! Other lesions

Question 12

Acquired- Neoplastic

Answer 12

– new growth

Benign vs malignant.

Question 13

Benign vs malignant

Answer 13

Benign -! A mass of cells that grows in an uncontrolled manner but does not have the ability to invade local structures or spread to other parts of the body

Malignant - A mass of cells that grows in an uncontrolled manner that has the ability to invade local structures and has the ability to spread to other parts of the body. Also has the ability to kill the host if growth and spread is not controlled
! Cancer

Question 14

Cancer

Answer 14

Latin for crab
Central body with out growths - like cancer

carcinoma - Greek far crab

Question 15

Benign suffix

Answer 15

• Oma

Question 16

Malignant suffix

Answer 16

• Carcinoma - is from ectoderm germ layer
• Sarcoma - from connective tissues

Question 17

Benign

Answer 17

! History
◦ Slow rate of growth
◦ Other long term masses ◦ Painless
◦ Local pressure effects

! Investigation ◦ Ultra sound
◦ MRI
◦ Biopsy

Question 18

Malignant

Answer 18

! History
◦ Fast rate of growth
◦ Other new masses / lesions
◦ Painful
◦ Local invasive effects
◦ Associated lumps
◦ Associated symptoms of metastasis / systemic spread

! Investigation
◦ Ultra sound
◦ MRI
◦ Biopsy
◦ Staging CT
◦ Imaging / blood tests looking for primary of metastesis or working up for operation

Question 19

Examination

Answer 19

6 S’s:

Site
! Size
! Shape ! Surface
! Substance
!Consistency, sof t, firm, hard
! Surrounding structures- Local tissue Lymph nodes Nerves Blood vessels Other organs