CV Tumours and Tumour-like lesions Flashcards
What is a mass?
An aggregate of tissue
What is a tumour?
Actually means a swelling but almost always refers to a neoplasm
What is a neoplasm?
Autonomous proliferation of cells due to cellular mutations that lead to abnormal/dysregulated growth of cells
What is a hamartoma?
A mass formed of cells native to tissue but with disorganised architecture
What is a malformation?
A structural defect due to embryological or acquired abnormality
What is an ectasia?
Localised dilation of a vessel
What is a telendiectasia?
Permanent dilation of a vessel
What is a malignant tumour?
A tumour that is capable of causing death. It invades +/- spreads to other tissues
How are CV tumours graded?
May be morphology (how far it has changed from normal cells)
May be aggressiveness
What does the stage of a cancer refer to?
TNM (Tumour, Nodes, Metastases)
AJCC (Main staging system which relies on TNM staging)
Some others that are system specific
On what basis are benign and malignant tumours named?
The tissue types they contain and whether they are benign or malignant.
What is a benign tumour of the epithelium called?
Adenoma
What is a malignant tumour of epthelium called?
Carcinoma
What suffix is used for malignant and benign mesenchymal tumours?
Benign (oma)
Malignant (tissue type) - sarcoma
What are melanocyte benign tumours called?
Naevus
What are melanocyte malignant tumours called?
Melanoma
What are lymphoid malignant tumours called?
Lymphoma
Myeloma
Leukemia
Others
What are haemangiomas?
Benign tumours of blood vessels
What are the most common haemangiomas?
Capillary
Cavernous
What are the intermediate tumours technically?
Malignant but they don’t tend to metastasize
What is a lobular capillary haemangioma also called? Is the name accurate?
Pyogenic granuloma. It is neither pyogenic nor a granuloma
What is a kaposi sarcoma?
A commonly seen intermediate tumour
What is the treatment for benign tumours?
Watch and wait
Surgically excise if harmful
Sclerotherapy (close blood vessels off to it)
What are juvenile haemangeoma subtypes?
Infantile (not usually present at birth)
Congenital (present and fully developed at birth)
What happens to most infantile haemangiomas?
They usually involute (get smaller and go away)
What happens to congenital haemangiomas?
They sometimes involute rapidly.
Sometimes they don’t resolve
Where are capillary angiomas typically located?
Occur in skin or subcutaneous tissues, and mucous membranes of orac cavities and lips as as in the liver, spleen, and kidneys
Histologically, what kind of vessels have capillary angiomas?
Thin-walled capillaries with scant stroma
Do capillary haemangiomas have any atypical features making them harmful?
No
Histologically, what kind of vessels are cavernous haemangiomas located in?
Histologically large, dilated spaces with bland endothelium, no intervening normal tissue between the vessels
Why are cavernous angiomas potentially capable of causing issues?
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.
Where are lobular capillary angiomas typically located?
Located on mucosal membranes or on the skin.
When do lobular capillary angiomas occur?
Typically after trauma
What kind of problems can lobular capillary haemangiomas (pyogenic granulomas) cause?
They bleed easily and are often ulcerated and grow really fast but involute fast.
How are cavernous haemangiomas tissues different to the tissue structure in normal tissues.
No normal tissue between vascular spaces in cavernous haemangiomas.
What are the forms of kaposi sarcoma?
Classic
Endemic African
Transplant-associated KS
HIV-associated KS
Which demographic is most commonly associated with classic form kaposi sarcoma?
Older men
Mediterranean, Middle Eastern, or Eastern European descent
What causes Kaposi Sarcoma?
Human Herpes Virus 8 (HHV8)
What increases likelihood of Kaposi Sarcoma in Endemic African, Transplant associated, and HIV associated forms?
Being immunocompromised
What are the stages of progression of Kaposi Sarcoma?
Starts as a patch -> plaque -> nodule stage
severity depends on how immunocompromised patient is
How is Kaposi Sarcoma treated?
Surgery, antiretroviral treatment, angiogenesis inhibitors, radiotherapy
What are angiosarcomas?
Blood vessel neoplasms
Which tissues are angiosarcomas most common in?
Skin
Soft tissue
Breast
Liver
What causes angiosarcomas often in liver?
Associated with carcinogenic exposure, including arsenic, thorotrast, and polyvinyl chloride
What is the latency like between initial and eventual tumour development in angiosarcomas?
It is long (like mesothelioma)
What causes angiosarcomas often in breast tissue?
Chronic Lymphoedema patients classically following breast cancer due to abnormal lymph vessels in this setting
What can potentially cause all angiosarcomas?
Radiation
Why are angiosarcomas considered metastatic?
They are locally invasive and can readily spread causing 5-year survival rates to be ~30%
How is angiosarcoma treated?
Surgery
Radiotherapy
Cytotoxic chemotherapy
What are the 5 most common types of the heart?
Myxoma
Fibroma
Lipoma
Papillary fibroelastoma
Rhabdomyoma
What kind of tumours are the 5 most common tumours of the heart? (benign or malignant)
Benign
True or False:
Angiosarcomas of the heart are relatively common.
False, they are rare
What are myxomas?
Most common primary tumour of the heart
Where are myxomas commonly located?
In the atrium (left 4 times more common than right often at the region of the fossa ovalis in the atrial septum)
What kind of arrangements can myxomas have?
Single
Sessile (no stalk)
Pedunculated (wrecking ball)
Globular hard masses with haemorrhage or soft
Translucent
Gelatinous papillary
Villous lesions
What kind of cells make up myxomas?
They are composed of stellate or globular myxoma cells taht are embedded in abundant acid mucopolysaccharide ground substance
What familial abnormality is a risk factor for myxoma?
Carney’s complex (in 10% of individuals)
What issues can myxomas cause?
They can cause issues with blood flow and result in indirect damage to heart tissues
What can non-neoplastic tumour-like conditions of blood vessels result in?
Slow flow (capillary, lymphatic or venous): can result in port wine stain or congenital lymphangioma
Fast flow (arterial or arteriovenous): example cerebrovascular AVM
What is congenital lymphangioma?
Cystic hygroma (bag of fluid forms in a tissue)
What do symptoms of fast flow vessel malformations resemble?
Cavernous haemangioma of the brain
How are fast flow tumour-like malformatiuons of blood vessels differentiated from cavernous haemangiomas?
The fast flow tumour like malformations have tissue in between them unlike cavernous haemangiomas. (this differential diagnosis results in the same result)
Where are varicose veins typically located?
In the legs, anus and the oesophagus
What causes varicose veins in oesophagus?
Portal hypertension
What causes haemorrhoids?
Dilation of anorectal venous plexus due to repeated straining at stool, pregnancy, or from other complications
What are potential complications of haemorrhoids?
Can thrombose and bleed
Can be painful
Can prolapse
