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Pathology > Disorders of Growth > Flashcards

Disorders of Growth Flashcards

1
Q

NEOPLASM

A

“A NEOPLASM is an abnormal mass of tissue, the growth of which exceeds and is unco-ordinated with that of normal tissues, and which persists in the same excessive manner after cessation of the stimuli which evoked the change.”

    - Sir Rupert Willis, 1960
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2
Q

NEOPLASIA

A

NEOPLASIA is the process by which a neoplasm is formed.

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3
Q

TUMOUR

A

TUMOUR literally means swelling, but conventionally is used as a synonym for neoplasm

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4
Q

BEHAVIOUR of Tumours

A

A benign tumour grows by expansion, displacing adjacent tissue
A malignant tumour grows by infiltration of local tissues, and spreads to other parts of the body
Primary tumour
original malignant tumour
Secondary tumours
“offspring” of a primary malignant tumour

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5
Q

SPREAD OF MALIGNANT TUMOURS

A

Local - direct invasion

Distant – metastasis

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6
Q

ROUTES OF METASTASIS

A 
lymphatics
  blood
  transcoelomic
  along epithelial-lined spaces
  within epithelium
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7
Q

METASTASIS VIA LYMPHATICS

A

tumour may directly invade lymphatics
tumour emboli filtered out, then grow, in lymph nodes
typical of epithelial malignancy

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8
Q

METASTASIS VIA BLOOD

A

tumour may invade blood vessels
emboli filtered out by capillary beds, eg liver, lung
typical of stromal malignancy and later stages of epithelial malignancy

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9
Q

METASTASIS VIA TRANSCOELOMIC SPREAD

A

peritoneal, pleural

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10
Q

METASTASIS VIA EPITHELIAL-LINED SPACES

A

bronchiolo-alveolar carcinoma of lung

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11
Q

METASTASIS WITHIN EPITHELIUM

A

Paget’s disease of nipple, vulva and anus

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12
Q

PARTICULAR SITES OF METASTASES - LIVER

A

liver: GIT carcinomas, GUS, bronchus, breast

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13
Q

PARTICULAR SITES OF METASTASES - LUNG

A

lungs: sarcoma; carcinoma of thyroid, breast, kidney, bronchus, etc.

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14
Q

PARTICULAR SITES OF METASTASES - BONE

A

bone: carcinoma of breast, thyroid, bronchus, prostate, uterus

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15
Q

PARTICULAR SITES OF METASTASES - BRAIN

A

brain: carcinoma of bronchus

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16
Q

PARTICULAR SITES OF METASTASES - ENDOCRINES

A

endocrines: carcinoma of bronchus often goes to adrenals

17
Q

PARTICULAR SITES OF METASTASES - SKIN

A

skin: malignant melanoma; clear cell carcinoma of kidney

18
Q

BENIGN EPITHELIAL TUMOURS

A

Adenoma
Papilloma
Cystadenoma
Polyp - a mass attached to a surface, which may or may not be a neoplasm

19
Q

MALIGNANT TUMOURS

A

Cancer - any malignant tumour
Carcinoma - a malignant tumour of epithelial tissue
Sarcoma - a malignant tumour of stromal tissue

20
Q

MESENCHYMAL TUMOURS

A

are named according to the cell type, with a suffix

- oma    		if benign
	- sarcoma		if malignant

e.g. lipoma and liposarcoma

21
Q

LEUKAEMIA

A

neoplastic proliferation of haemopoietic stem cells
neoplastic cells spill over into the blood stream
all regarded as malignant

22
Q

LYMPHOMA

A

malignant proliferation of cells of lymphoid tissue
Two types
Hodgkin’s disease
mixture of cells, including Reed-Sternberg cells
non-Hodgkin’s lymphoma
lacks the cellular mixture of Hodgkin’s disease

23
Q

TERATOMA

A

arises from “totipotential” cells, producing tissues representing all three germ cell layers
ovary (usually benign)
testes (usually malignant)
midline (sequestered primitive cells)

24
Q

PRECURSORS OF MALIGNANCY

A

PREMALIGNANT CONDITIONS
lesions with an increased risk of the development of invasive tumour
can be non-neoplastic or neoplastic

25
Q

PREMALIGNANT CONDITIONS NON-NEOPLASTIC

A 
chronic inflammation 
  varicose leg ulcers can lead to skin cancer 
   cirrhosis of the liver 
   hepatocellular carcinoma
   chronic ulcerative colitis 
   adenocarcinoma of the large intestine
   xeroderma pigmentosum 
   squamous cell carcinoma of the skin
26
Q

PREMALIGNANT CONDITIONS NEOPLASTIC

A 
familial polyposis coli
   autosomal dominant 
   1000s of large intestinal adenomas
	 carcinoma inevitable
   intra-epithelial neoplasia:
	nuclear changes of carcinoma, without breaching basement membrane - "dysplasia" or "carcinoma-in-situ" - important in uterine cervix, vulva, bronchus, etc.
27
Q

TUMOUR GRADING

A

an assessment of the degree of differentiation of a tumour
correlates with how aggressive the tumour behaves
only relevant for malignant tumours
usually define 3 or 4 grades

28
Q

TUMOUR STAGING

A 
based on three main features
   size of primary tumour
   extent of lymph node disease
   any blood-borne metastasis
   sometimes quoted as "TNM" 
 The TNM system
	T = size of tumour (T1 to T4)
	N = extent of lymph node involvement (N0 to N3)
	M = distant metastasis (M0 to M1)
   criteria different for each tumour
   better prediction of outcome than grade, for most tumours
29
Q

THE EFFECTS OF TUMOURS

A

displacement or destruction of normal structures
excess “normal” function
paraneoplastic phenomena

30
Q

EFFECTS OF BENIGN TUMOURS

A

Mechanical pressure

Obstruction

Ulceration

Infection

Rupture of cystic neoplasm

Hormone production

Malignant change

31
Q

EFFECTS OF MALIGNANT TUMOURS

A

All the physical effects of benign tumours
Tissue destruction

Haemorrhage
   any cancer breaching a vessel wall 
Secondary infection
   bacterial invasion of necrotic tumour
   Cachexia
   severe weight loss
   increased metabolic rate
  tissue necrosis factor
Pain
   Anaemia
   haemorrhage
   bone marrow replacement
   haemolysis
   Paraneoplastic syndromes
32
Q

PARANEOPLASTIC SYNDROMES

A

Ectopic hormone production
carcinoma of bronchus may cause Cushing’s syndrome, inappropriate ADH secretion, secretion of PTH analogue
fibrosarcoma can produce hypoglycaemia
renal carcinoma can release erythropoetin
Peripheral neuropathy, cerebellar degeneration, myopathy
Thrombophlebitis migrans
carcinoma of bronchus (5%) and pancreas (30%)
Acanthosis nigricans
caused by epidermal growth factor analogue
Nephrotic syndrome
proteinuria, hypoalbuminaemia, generalised oedema
complexes of tumour antigen and host antibody deposited in glomerulus
Finger clubbing
Hypertrophic pulmonary osteoarthropathy
Non-bacterial thrombotic endocarditis

Pathology (22 decks)

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