CSIM 1.4 Neoplasia 1 and Case 39 Launch Flashcards
Which cancer is the most lethal?
Lung cancer
Describe colorectal cancer mortality
All mortality occurs in the first 5 years. If patient is alive after 5 years since diagnosis, they’re all good.
Recall the adaptations of cells.
Which of these is never physiological
- Atrophy
- Hypertrophy
- Hyperplasia
- Metaplasia
- Dysplasia
All can be pathological or physiological except for dysplasia, which is always pathological
What are the types of atrophy?
Define each
Cell atrophy
• Decrease in cell size
Organ atrophy
• Decrease in organ size due to EITHER a decrease in cell size OR a decrease in cell number
Loss of supply of what can cause atrophy?
- Innervation
- Oxygen
- Nutrients
- Endocrine stimulation
What is hypertrophy and hyperplasia?
What are the types of each?
Hypertrophy
• An increase in SIZE of INDIVIDUAL cells
Hyperplasia:
• An increase in NUMBER of cells
Each can be pathological or physiological
Is cancer a type of hyperplasia?
No - it is neoplasia
Hyperplasia is the same cell type, e.g. endometrial proliferation in response to oestrogen
What is dysplasia?
Abnormal-looking cells and loss of uniformity, characterised by:
• Pleomorphism (varying size and shape)
• Hyperchromasia (darker staining nuclei)
• Increase in nucleus to cytoplasm ratio
• Chaotic, disorderly proliferation which is no longer confined to the basal layer
Is dysplasia reversible?
Yes, if the inciting cause is removed and cancer stage has not been reached
How is dysplasia graded?
Mild, moderate, severe - depending on likelihood to become a carcinoma
(can also be 2-tiered as well ‘low grade’ and ‘high grade’)
What are the gradings of cervical dysplasia called?
Mild is called CIN1
Moderate is called CIN2
Severe is called CIN3
NB: CIN = cervical intra-epithelial neoplasia
Which of the adaptations causes an increased risk of cancer?
No increased risk:
• Atrophy
• Hypertrophy
Slight increased risk:
• Hyperplasia
• Metaplasia
Greatly increased risk:
• Dysplasia
Why does hyperplasia cause an increased risk of cancer?
Increased number of divisions presents more propensity for some of those divisions to generate errors during copying DNA
Why is metaplastic tissue more likely to generate a carcinoma?
The poorly-located cell is more susceptible to insult in the environment it is not designed for
What is the strict definition of a tumour
An abnormal swelling (not necessarily a neoplasm, although this is how it is commonly used)
What is the definition of a neoplasm?
An abnormal, uncoordinated proliferation of a section of tissue, which persists in the same excessive manner after cessation of the causative stimulus
How are neoplasms classified?
Classified by behaviour: 1)Benign • Stay in one place and are non-fatal 2)Malignant • Spread around the body and are aggressive in local behaviour 3)Borderline
Also classified by histogenesis (cell of origin):
• Epithelial
• Mesenchymal (CT)
• Lymphoid
Describe the differences between benign and malignant neoplasms
Malignant (brackets represent benign characteristics):
• Faster growth rate
• Numerous mitotic figures (few)
• Variable differentiation (similar differentiation to parent)
• Hypochromic, pleomorphic nuclei (normal)
• Ill-defined border with no capsule (circumscribed and encapsulated IMG 25)
• Invasive (non-invasive)
• Frequently metastasise (do not metastasise)
What are the types of benign neoplasms that affect epithelial cells?
Adenoma:
• Benign neoplasm of glandular epithelium
Papilloma:
• Benign neoplasm of non-glandular epithelium
What is a localised overgrowth of tissue of benign neoplastic type often called?
A polyp
Why are benign adenomas worth removing?
They have a risk of progressing to a malignant neoplasm
How can you tell if a benign adenoma of the adrenal gland comes from the medulla or cortex?
Because of the colour (IMG 26 = cortex, for example)
Benign neoplasms of what can cause hypertension?
Adrenal cortex (aldosterone production)
What are carcinomas?
What are the types of carcinomas?
Malignant neoplasms of EPITHELIA: • Glandular: Adenocarcinoma • Squamous: Squamous cell carcinoma • Transitional: Transitional cell carcinoma • Urothelium: Urothelial carcinoma
Describe briefly the cell adaptations in lung cancer caused by cigarette smoke
Metaplasia -> Dysplasia -> Neoplasia
Give the name for:
1) A malignant neoplasia of an epithelial tissue
2) A malignant neoplasia of a connective tissue
3) A benign neoplasia of an epithelial tissue
4) A benign neoplasia of a connective tissue
1) Carcinoma
2) Sarcoma
3) Adenoma or papilloma depending on if the tissue is glandular
4) Depends on the specific connective tissue
What are the types of benign neoplasms that affect connective tissue?
Fat • Lipoma Smooth muscle • Leiomyoma Striated muscle • Rhabdomyoma Blood vessel • Haemangioma Cartilage • Chondroma Bone • Osteoma
What are the types of malignant neoplasms that affect connective tissue?
Fat • Liposarcoma Smooth muscle • Leiomyosarcoma Striated muscle • Rhabdomyosarcoma Blood vessel • Angiosarcoma Cartilage • Chondrosarcoma Bone • Osteosarcoma
