CV Tumours and Tumour-like lesions

Question 1

What is a mass?

Answer 1

An aggregate of tissue

Question 2

What is a tumour?

Answer 2

Actually means a swelling but almost always refers to a neoplasm

Question 3

What is a neoplasm?

Answer 3

Autonomous proliferation of cells due to cellular mutations that lead to abnormal/dysregulated growth of cells

Question 4

What is a hamartoma?

Answer 4

A mass formed of cells native to tissue but with disorganised architecture

Question 5

What is a malformation?

Answer 5

A structural defect due to embryological or acquired abnormality

Question 6

What is an ectasia?

Answer 6

Localised dilation of a vessel

Question 7

What is a telendiectasia?

Answer 7

Permanent dilation of a vessel

Question 8

What is a malignant tumour?

Answer 8

A tumour that is capable of causing death. It invades +/- spreads to other tissues

Question 9

How are CV tumours graded?

Answer 9

May be morphology (how far it has changed from normal cells)

May be aggressiveness

Question 10

What does the stage of a cancer refer to?

Answer 10

TNM (Tumour, Nodes, Metastases)

AJCC (Main staging system which relies on TNM staging)

Some others that are system specific

Question 11

On what basis are benign and malignant tumours named?

Answer 11

The tissue types they contain and whether they are benign or malignant.

Question 12

What is a benign tumour of the epithelium called?

Answer 12

Adenoma

Question 13

What is a malignant tumour of epthelium called?

Answer 13

Carcinoma

Question 14

What suffix is used for malignant and benign mesenchymal tumours?

Answer 14

Benign (oma)

Malignant (tissue type) - sarcoma

Question 15

What are melanocyte benign tumours called?

Answer 15

Naevus

Question 16

What are melanocyte malignant tumours called?

Answer 16

Melanoma

Question 17

What are lymphoid malignant tumours called?

Answer 17

Lymphoma

Myeloma

Leukemia

Others

Question 18

What are haemangiomas?

Answer 18

Benign tumours of blood vessels

Question 19

What are the most common haemangiomas?

Answer 19

Capillary

Cavernous

Question 20

What are the intermediate tumours technically?

Answer 20

Malignant but they don’t tend to metastasize

Question 21

What is a lobular capillary haemangioma also called? Is the name accurate?

Answer 21

Pyogenic granuloma. It is neither pyogenic nor a granuloma

Question 22

What is a kaposi sarcoma?

Answer 22

A commonly seen intermediate tumour

Question 23

What is the treatment for benign tumours?

Answer 23

Watch and wait

Surgically excise if harmful

Sclerotherapy (close blood vessels off to it)

Question 24

What are juvenile haemangeoma subtypes?

Answer 24

Infantile (not usually present at birth)

Congenital (present and fully developed at birth)

Question 25

What happens to most infantile haemangiomas?

Answer 25

They usually involute (get smaller and go away)

Question 26

What happens to congenital haemangiomas?

Answer 26

They sometimes involute rapidly. Sometimes they don't resolve

Question 27

Where are capillary angiomas typically located?

Answer 27

Occur in skin or subcutaneous tissues, and mucous membranes of orac cavities and lips as as in the liver, spleen, and kidneys

Question 28

Histologically, what kind of vessels have capillary angiomas?

Answer 28

Thin-walled capillaries with scant stroma

Question 29

Do capillary haemangiomas have any atypical features making them harmful?

Answer 29

No

Question 30

Histologically, what kind of vessels are cavernous haemangiomas located in?

Answer 30

Histologically large, dilated spaces with bland endothelium, no intervening normal tissue between the vessels

Question 31

Why are cavernous angiomas potentially capable of causing issues?

Answer 31

They create breeding ground for thrombosis and then embolism. They are vulnerable to spontaneous haemorrhage Can be found in brain and liver causing issues These are widely sporadic.

Question 32

Where are lobular capillary angiomas typically located?

Answer 32

Located on mucosal membranes or on the skin.

Question 33

When do lobular capillary angiomas occur?

Answer 33

Typically after trauma

Question 34

What kind of problems can lobular capillary haemangiomas (pyogenic granulomas) cause?

Answer 34

They bleed easily and are often ulcerated and grow really fast but involute fast.

Question 35

How are cavernous haemangiomas tissues different to the tissue structure in normal tissues.

Answer 35

No normal tissue between vascular spaces in cavernous haemangiomas.

Question 36

What are the forms of kaposi sarcoma?

Answer 36

Classic Endemic African Transplant-associated KS HIV-associated KS

Question 37

Which demographic is most commonly associated with classic form kaposi sarcoma?

Answer 37

Older men Mediterranean, Middle Eastern, or Eastern European descent

Question 38

What causes Kaposi Sarcoma?

Answer 38

Human Herpes Virus 8 (HHV8)

Question 39

What increases likelihood of Kaposi Sarcoma in Endemic African, Transplant associated, and HIV associated forms?

Answer 39

Being immunocompromised

Question 40

What are the stages of progression of Kaposi Sarcoma?

Answer 40

Starts as a patch -> plaque -> nodule stage | severity depends on how immunocompromised patient is

Question 41

How is Kaposi Sarcoma treated?

Answer 41

Surgery, antiretroviral treatment, angiogenesis inhibitors, radiotherapy

Question 42

What are angiosarcomas?

Answer 42

Blood vessel neoplasms

Question 43

Which tissues are angiosarcomas most common in?

Answer 43

Skin Soft tissue Breast Liver

Question 44

What causes angiosarcomas often in liver?

Answer 44

Associated with carcinogenic exposure, including arsenic, thorotrast, and polyvinyl chloride

Question 45

What is the latency like between initial and eventual tumour development in angiosarcomas?

Answer 45

It is long (like mesothelioma)

Question 46

What causes angiosarcomas often in breast tissue?

Answer 46

Chronic Lymphoedema patients classically following breast cancer due to abnormal lymph vessels in this setting

Question 47

What can potentially cause all angiosarcomas?

Answer 47

Radiation

Question 48

Why are angiosarcomas considered metastatic?

Answer 48

They are locally invasive and can readily spread causing 5-year survival rates to be ~30%

Question 49

How is angiosarcoma treated?

Answer 49

Surgery Radiotherapy Cytotoxic chemotherapy

Question 50

What are the 5 most common types of the heart?

Answer 50

Myxoma Fibroma Lipoma Papillary fibroelastoma Rhabdomyoma

Question 51

What kind of tumours are the 5 most common tumours of the heart? (benign or malignant)

Answer 51

Benign

Question 52

True or False: Angiosarcomas of the heart are relatively common.

Answer 52

False, they are rare

Question 53

What are myxomas?

Answer 53

Most common primary tumour of the heart

Question 54

Where are myxomas commonly located?

Answer 54

In the atrium (left 4 times more common than right often at the region of the fossa ovalis in the atrial septum)

Question 55

What kind of arrangements can myxomas have?

Answer 55

Single Sessile (no stalk) Pedunculated (wrecking ball) Globular hard masses with haemorrhage or soft Translucent Gelatinous papillary Villous lesions

Question 56

What kind of cells make up myxomas?

Answer 56

They are composed of stellate or globular myxoma cells taht are embedded in abundant acid mucopolysaccharide ground substance

Question 57

What familial abnormality is a risk factor for myxoma?

Answer 57

Carney's complex (in 10% of individuals)

Question 58

What issues can myxomas cause?

Answer 58

They can cause issues with blood flow and result in indirect damage to heart tissues

Question 59

What can non-neoplastic tumour-like conditions of blood vessels result in?

Answer 59

Slow flow (capillary, lymphatic or venous): can result in port wine stain or congenital lymphangioma Fast flow (arterial or arteriovenous): example cerebrovascular AVM

Question 60

What is congenital lymphangioma?

Answer 60

Cystic hygroma (bag of fluid forms in a tissue)

Question 61

What do symptoms of fast flow vessel malformations resemble?

Answer 61

Cavernous haemangioma of the brain

Question 62

How are fast flow tumour-like malformatiuons of blood vessels differentiated from cavernous haemangiomas?

Answer 62

The fast flow tumour like malformations have tissue in between them unlike cavernous haemangiomas. (this differential diagnosis results in the same result)

Question 63

Where are varicose veins typically located?

Answer 63

In the legs, anus and the oesophagus

Question 64

What causes varicose veins in oesophagus?

Answer 64

Portal hypertension

Question 65

What causes haemorrhoids?

Answer 65

Dilation of anorectal venous plexus due to repeated straining at stool, pregnancy, or from other complications

Question 66

What are potential complications of haemorrhoids?

Answer 66

Can thrombose and bleed Can be painful Can prolapse