General pathology of cancer Flashcards
What is cancer?
Disease of the genome for cell replication due to inhibition of the tumour repressor gene or increased activity of the oncogene
What is clonality?
Cell being derived from a source
What is an oncogene?
Mutated which causes a cell to become -> tumour cell.
What is a tumour?
Abnormal mass of cells in the body, which produce markers that can be detected.
What is the mechanism of oncogenesis?
Mutation, gene amplification and chromosomal rearrangement
What is SBS?
Single base substitutions in cancer
Which factors contribute to oncogenesis?
UV light, tobacco smoke/chewing
What type of tissue is the most common origin of adult cancers?
Epithelial tissue
What is paraneoplastic syndrome?
Signs and symptoms caused by the presence of cancer in the body outside of the tumour region. This may cause production of ectopic hormones and induce inflammation. Cachexia is a common type
What is an ectopic hormone?
Hormones produced in tissues that does not normally occur at this site due to tumour
What is cachexia?
A type of paraneoplastic syndrome with muscle and fat loss due inflammatory cytokine driving utilisation of protein from muscle stores in the body
How does paraneoplastic syndrome manifest?
Skin rashes
Abnormal blood count, thrombosis
Cushing’s syndrome, calcium deficiency, carcinoid syndrome
Fluid retention
Any neurological abnormality
What is carcinoid syndrome?
Tumour of the neuroendocrine cells which produce bradykinin and serotonin. It typically metastasises to the liver and causes liver dysfunction.
Serotonin will cause lung bronchoconstriction and affects R side of heart for pulmonary regurgitation.
Bradykinin will cause vasodilation and flushed skin.
Where do carcinoid tumours occur?
Liver
Small and large intestine
Pancreas
Stomach
How does cancer present?
Organ failure, thrombosis, organ compression, cons
How is cancer treated?
Radiotherapy, surgery cytotoxic chemotherapy.
Immune therapies such as checkpoint inhibitors, chimeric T cell receptors, ex vivo T cell expansion, antibody therapy
What is a chimeric T cell?
T cell taken from the patient and undergoes genetic engineering to express chimeric receptors that specifically recognise cancer cells.
How is cancer classified?
Organ of origin
Tissue of origin
Benign vs malignant
Degree of differentiation
Genomic/biomarker featurees
What are the features of a benign tumour?
They have an intact basement membrane and well differentiated so they resemble tissue origin. They have a fibrous connective tissue capsule with clear borders and do not metasases
What are the features of a malignant tumour?
The basement membrane is breached, may be poorly/no differentiation with little resemblance to origin tissue, no clear borders and may metasases
What is an adenoma?
A type of benign tumour of the epithelial tissue with glandular origin. These aren’t always harmless, such as pituitary adenoma that cause hormone imbalances.
What is a polyp?
Benign tumour which projects from the mucous membrane and may have malignant potential
What is a carcinoma?
Malignant tumour from the epithelial tissue, identified by the nature of the cells it contains because of little resemblance to origin tissue
What is anaplasia?
Loss/ no differentiation of tissues
How are brain tumours classified?
All are malignant tumours.
What is Rhabdomyoma?
Benign Skeletal muscle tumour
What is Rhabdomyosarcoma?
Malignant skeletal muscle tumour
What is Leimyosarcoma?
Smooth muscle malignant tumour
What is a terotoma?
Embryological tumour origin from pluripotent germline cells that occur in the gonads like the testes or ovaries. They involve all 3 of the embryological layers, and can differentiate to form skin, hair and teeth.
What are the features of teratomas?
In the ovaries, they are typically benign. In the testes, they are malignant.
What is a synovial sarcoma?
Malignant tumour of connective tissue
What is a hamartoma?
Neither a benign or malignant tumour. It is a non-neoplastic growth of disorganised tissue in its native site and uncapsulated, involving 1 or all 3 embryological layers.
They have the potential to undergo malignant transformation.
What is differentiation?
Relationship to normal tissue architecture and graded based on this.
What is poor differentiation?
Little resemblance to origin tissue and is typically an aggressive cancer.
What is acute in terms of cancer?
Large cells
What is chronic in terms of cancer?
Small cell
What is leukemia?
Cancer of the WBC which begins in the bone marrow
What is lymphoma?
Cancer of the lymphatic system
What is grade?
Degree of differentiation
What is a cancer stage?
Amount of spread around the body
What is a primary tumour?
Tumour growing at the anatomical site where it began
What is used to characterise cancer severity?
The TNM system
What is T in the TNM system?
Size of tumour from 0-4
What is N in the TNM system?
Lymph node involvement, number and location of tumour from 0-3
What is M in the TNM system?
Metasasis, present or absent from 0-1.
What is variable penetrance?
Proportion of individuals carrying a genetic variant
What are the mutated genes in breast cancer?
BRCA1 and BRAC2 in triple negative breast cancer
ERBB2 in HER-2 positive breast cancer
What is dysplasia?
Loss of normal cell architecture with abnormal growth and maturation of tissue. This can become malignant
What is neoplasia?
Abnormal mass of tissues with disordered cell growth where cells are undifferentiated.
What is tumour progression?
Normal tissue -> dysplasia -> adenoma -> carcinoma -> in-situ -> local spread -> distant spread with increasing genomic damage
