Disorders of Growth (Cancer) Flashcards
What’s a NEOPLASM
It’s an abnormal mass of tissue which grows faster and unco-ordinated compared to normal tissues. It keeps growing at the same rate/manner after cessation of the stimuli which evoked the change.
What’s NEOPLASIA?
It’s the process which forms a NEOPLASM
What’s the definition of TUMOUR?
- It means swelling.
- But unconventionally is used as a synonym for neoplasm.
What sort of factors are taken into account in order to classify a tumour/neoplasm.
- The behaviour (is it benign/malignant)
- What does it look like (site of it/ conformation of it)
- Histological factors (What tissue does it look like, how close does it resemble)
- Cell of origin of the cancer (Histogenesis)
- How did it come about:Aetiological (inheritance v Environmental)
What are the properties of a benign tumour?
- It grows by expansion
- Displaces adjacent tissue
- Cannot metastasise
- Can be harmful if compresses organs/ parts of the body (eg- in the brain)
What are the properties of malignant tumours?
- Malignant tumours grow by infiltration of local tissues
- Has the ability to spread to other parts of the body and metastasise
What is the difference between a primary and secondary tumour?
Primary tumours are the ORIGINAL malignant tumour.
Secondary tumours are the ‘offspring’ of a primary malignant tumour.
Give some examples of possible routes of metastasis…
- Blood
- Lymph
- Transcoelomic (the spread of tumour through bodily cavities)
- Along epithelial-lines space
- Within epithelium
What does Transcoelomic mean?
It mean the spread of a tumour through bodily cavities (ie peritoneal/pleural)
How does a tumour metastasise through lymphatics?
- May directly invade lymphatics.
- And emboli can be filtered out then grow in lymph nodes.
How does a tumour spread through blood?
- May invade blood vessles
- Emboli may be filtered out by capillary beds - lung, liver
What is an example of how a tumour may spread within the epithilium:
- Peritoneal or pleural
- Bronchiolo-alveolar carcinoma of the lung
- Paget’s disease of the nipple, vulva and anus
An example of a tumour spreadingWITHIN EPITHELIUM is:
Paget’s disease of nipple, vulva and anus
What is an example of how a tumour may metastesize through blood:
- Stromal (connective tissue) malignancy and later stages of epithelial malignancy
- Bronchiolo-alveolar carcinoma of lung
- Peritoneal/ pleural
METASTASIS VIA BLOOD is:
Typical of stromal (connective tissue) malignancy and later stages of epithelial malignancy
Name some particular sights of metastases
- Lymph nodes
- Liver (GIT carcinoma, bronchus, breast)
- Lungs (thyroid, breast, kidney)
- Bone (breast, thyroid, bronchus, prostate, uterus)
- Brain (bronchus carcinoma)
- Endocrines (Bronchus carcinoma)
- Skin (melanoma, kidney)
What factors affect the naming of cancers?
The name of cancers depends on:
- Their site
- Behaviour
- Histogenesis (cell type)
What names are given to benign epithelial tumours?
The names given to benign epithelial tumours are:
- Adenoma
- Papilloma
- Cystadenoma
- Polyp
Adenoma, Papilloma, Cystadenoma and Polyps are all what type of tumour
Adenoma, Papilloma, Polyp and Cystadenoma are all BENIGN EPITHELIAL TUMOURS
What is the definition of a Polpy
A polyp is a mass attached to a surface which may or may not be a neoplasm
What is the term ‘Cancer’
It means any malignant tumour
What does the term ‘Carcinoma’ mean?
It’s a malignant tumour of epithelial tissue
What is a ‘Sarcoma’
It’s a malignant tumour of stromal tissue (connective tissue)
What name is given to the cancer of connective tissue (STROMAL tissue)
SARCOMA is the name given to a malignant stromal tissue (connective tissue)
_________ is the name given to a malignant epithelial tumour?
CARCINOMA is the name given to a malignant tumour of the epithelial tissue
Is a mesenchymal tumour likely to be malignant if it ends in
-OMA
or
-SARCOME
OMA is if it’s benign. SARCOMA if it’s malignant
eg:
-Lipoma (benign)
-Liposarcoma (malignant)
True or false…
Not all leukaemia are malignant
FALSE!!! All leukaemia are regarded as malignant.
What is Leukaemia
It’s a neoplasm (origional tumour) if the haemopoietic stem cells, which spill over into the blood stream.
What is LYMPHOMA
Hint- it’s an exception to the ending rule
It’s malignant growth of the cells of the lymphoid tissue (cancer of tissues supporting the immune system)
2 Types- Hodgkin’s and non-Hodgkin’s
What is needed for a tumour to be classed as ‘Hodgkin’s disease’? (lymphoma)
A mixture of cells including Reed-sternberg cells
Whereas non-hodgkin’s lymphoma there is NO cellular mixture
What is needed to characterise Non-Hodgkin’s Lymphoma?
Non-Hodgkin’s lymphoma is characterised by a LACK of cellular mixture.
Compared to Hodgkin’s lymphoma where there is a mixture of cells including Reed-sternberg cells
What is a TERATOMA?
It’s a tumour that arises from ‘totipotential’ cells producing all three germ cell layers (ovary, testes and midline)
So can cause strange tissue to grow in odd places.
What would be classed as a Premalignant condition?
Premalignant condition can be lesions with an increased risk of the development of invasive tumours.
Can be either non-neoplastic or neoplastic.
- Chronic Inflammation
- Cirrhosis of the liver
- Chronic ulcerative colitis
Are all example of non-neoplastic or neoplatic premalignant conditions?
There are all Non-Neoplastic
because there is no tumour there
- Familial Polyposis coli
- Intra-epithelial neoplasia
Are all examples of what premalignant condition:
- Neoplastic
- Non-neoplastic
These are NEOPLASTIC as there is already a tumour in place.
What is Familial polyposis coli?
It’s a condition by which there are 1000s of large intestinal adenomas and carcinoma is inevitable. it’s inhereted (autosomal dominant)
What’s the difference between Grading and Staging a tumour
Grading is how bad it looks (subjective) and staging is how far its got (objective)
What’s the TNM system for grading tumours stand for?
It stands for :
T- Size of tumour (T1-T4)
N-extent of lymph NODE involvement (n0-N3)
M- Distal Metastesis (M0-M1)
What are some effects of benign tumours
- Mechanical pressure (eg on brain)
- Obstruction
- Ulceration
- Infarction of growing tumour
- Infection (bladder papilloma)
- Rupture of cyctic neoplasm (eg appendix)
- Hormones (pacreas tumour)
- Malignant change
What are some effects of Malignant tumours?
They have all the physical effects of benign tumours but also:
- Tissue degredation
- Haemorrhage
- Secondary Infection
- Cachexia (sever weight loss)
- Pain
- Amaemia (haemorrhage, bone marrow depletion)
- Paraneoplastic syndromes (disorder of altered immune system from the cancer)
What’s Para-neoplastic Syndrome?
It’s a disorder of altered immune system from the cancer. Causes eptopic hormone production. eg:
- carcinoma of bronchus may cause cushing’s syndrome, over ADH secretion, secretion of PTH
- Fibrosarcoma - hypoglycaemia
- Renal carcinoma - EPO
- ACANTHOSIS NIGRICANS - epidermal growth factor analogue
What’s ACANTHOSIS NIGRICANS?
It’s a category of paraneoplastic syndrome where the body produces hormones as a result of the tumour. In this case- darkening of the skin (neck, underarms) caused by epidermal growth factor analogue.
