Disorders of growth

Question 1

What is neoplasm?

Answer 1

abnormal mass of tissue

Question 2

What is neoplasia?

Answer 2

the process by which neoplasm is formed

Question 3

what does tumour mean?

Answer 3

swelling

Question 4

How does a benign tumour grow?

Answer 4

• by expansion, displacing adjacent tissue

Question 5

How does a malignant tumour grow?

Answer 5

• infiltrates local tissue and spreads to other parts of the body

Question 6

What is meant by primary tumour?

Answer 6

• original malignant tumour

Question 7

What is meant by secondary or offspring/met tumour?

Answer 7

offspring of primary malignant tumour

Question 8

How can malignant tumours spread?

Answer 8

Local - direct invasion (pancreas to stomach )

Distant - metastasis (vis lymph nodes or blood)

Question 9

What two meanings can metastasis mean?

Answer 9

• a secondary tumour

- process by which secondary tumour is formed (distant spread)

Question 10

Ways of which metastasis can spread by?

Answer 10

• lymphatics
• blood
• transcoelomic (through peritoneal cavity)
• along epithelial-lined spaces (common in lung)
• within epithelium (common in lung)

Question 11

How might the tumour spread via lymphatics?

Answer 11

• directly invade

- tumour emboli filtered out

Question 12

Lymphatic spread is classical of ..

Answer 12

epithelial malignancy ( carcinoma)

Question 13

How might the tumour spread via the blood?

Answer 13

• directly invade blood vessels
• emboli filtered out by capillary bed eg. liver, lung
• typical of stromal malignancy and later stage of epithelial malignancy

Question 14

How does transcoelomic spreas

Answer 14

• via the body cavities such as peritoneal and pleural

Question 15

In Paget’s disease of the nipple, vulva and anus where does the route of metastasis happen?

Answer 15

Within the epithelium

Question 16

What is an example of spread via epithelial-lined spaces?

Answer 16

• bronchiolo-alveolar carcinoma of the lung

- thickened, dark cells along the alveolar spaces

Question 17

Where can you get lymph nodes metastases from?

Answer 17

• the primary tumour can go anywhere

Question 18

A met found in the liver where is the primary tumour most likely to be?

Answer 18

• GIT carcinomas
• bronchus
• breast
• anywhere from the anus to the GI tract can go to the liver

Question 19

If a met is found in the lungs where is its likely primary tumour found?

Answer 19

• sarcomas
• carcinomas
• carcinoma of thyroid
• breast
• kidney
• bronchus

Question 20

Mets found in the bone are common of which primary tumours?

Answer 20

• carcinoma of breast, thyroid, bronchus and prostate

- this is why people are asked to report any pain in the bone

Question 21

Mets found in the brain are common of which primary tumours?

Answer 21

• carcinoma of bronchus

Question 22

Mets found in endocrines are likely to come from ?

Answer 22

• carcinoma of bronchus often goes to adrenal

Question 23

Mets found on the skin are common of what primary tumours?

Answer 23

• malignant melanoma

- clear cell carcinoma of kidney

Question 24

what does adenoma mean?

Answer 24

aden - glandular

oma- non malignant

Question 25

What is a polyp?

Answer 25

a mass attached to a surface, which may or may not be a neoplasm

Question 26

What does cancer mean?

Answer 26

any malignant tumour

Question 27

what does carcinoma mean?

Answer 27

a malignant tumour of epithelial tissue

Question 28

what does sarcoma mean?

Answer 28

a malignant tumour of stromal tissue

Question 29

what does the suffix oma mean

Answer 29

if benign

Question 30

what does the suffix sarcoma mean?

Answer 30

if malignant

Question 31

What is leukaemia?

Answer 31

neoplastic proliferation of haemopoietic stem cells | - all regarded as malignant

Question 32

What is the difference between Hodgkins disease and non-Hodgkins disease?

Answer 32

- hodgkins lymphoma has mixture of cells including Reed-Sternberg cells

Question 33

What is lymphoma

Answer 33

- Cancer with in lymph nodes

Question 34

Where do teratomas classical resign?

Answer 34

- ovary (usually benign) - testes (usually malignant) - midline ( rare)

Question 35

What are teratomoa's and what do they arise from?

Answer 35

- tumours arises from totipotential cell or germ cells | - can reproduce any part of the body

Question 36

What are the non-neoplastic precursors of malignancy?

Answer 36

- chronic inflammation (varicose veins) - cirrhosis of the liver - chronic ulcerative colitis - xeroderma pigmentosum

Question 37

What are the neoplastic prescursors of malignancy?

Answer 37

- FAP (Familial polyposis coli)- these people will get colon cancer, effects their children - Intra-epithelial neoplasia

Question 38

What are the stages of grading cervical intra-epithelial neoplasia?

Answer 38

``` normal CIN I CIN II CIN III -next step is cancer ```

Question 39

What is the difference between grading and staging of cancer?

Answer 39

- grading is how bad it looks | - staging is how far its gone

Question 40

In TNM staging what does each of the symbols stand for?

Answer 40

T -size of primary TUMOUR N - extent of lymph NODE involvement M - distant METASTASIS

Question 41

What are the general effects of tumours?

Answer 41

- displacement or destruction of normal structures - excess of normal function - paraneoplastic phenomena

Question 42

What paraneoplastic phenomenas?

Answer 42

-

Question 43

What are the effects of benign tumours?

Answer 43

- Mechanical pressure - obstruction - ulceration - infarction of pedunculated tumour ( can cause pain and bleeding) - infection - rupture of cystic neoplasm - hormone production - become malignant

Question 44

What are the effects of malignant tumours?

Answer 44

- all the physical effects of benign tumours - tissue destruction ( eg. cancer of stomach infiltrating the pancreas) - haemorrhage (any cancer breaching a vessel wall ) - secondary infection (bacteria invasion of necrotic tumour) - cachexia (severe weight loss) - pain - anaemia - paraneoplastic syndromes

Question 45

In benign tumours one of their effects could be infection give an example.

Answer 45

- bladder papilloma. | causes a site where bacteria can stay and cause urinary infect.

Question 46

In benign tumours one of their effects could be hormone production give an example.

Answer 46

islet cell tumour of pancreas | - cause excess insulin and cause hypoglycaemia

Question 47

Why do paraneoplastic syndromes commons happen ?

Answer 47

- ectopic hormone production

Question 48

What are examples of what can happen in paraneoplastic syndromes?

Answer 48

- excess of hormone production - peripheral neuropathy, cerebellar degeneration, myopathy - Thrombophlebitis migrans (inflammation of blood vessels - acanthosis nigrican (black under arm pits and neck ) - finger clubbing