General pathology of cancer Flashcards
4 normal classes of regulatory genes:
- Tumor suppressor
- Proto-oncogenes
- Genes that regulate apoptosis (Bcl-2)
- Genes that repair DNA
Predisposition to cancer can be:
Hereditary
Sporadic
Sporadic factors increasing cancer susceptibility:
- Environment
- Age
- Lifestyle (UV, smoking, obesity)
- Chronic inflammatory conditions (H.pylori, IBS, HepB)
Breast cancer genetic mutation
BRCA 1/2
APC gene is involved in
Familial adenomatous polyposis
HNPCC
Herediatary non-polyposis colorectral cancer
Carcinogens =
Agents that cause genetic damage and induce neoplastic transformation
Carcinogens can be
Chemical, radiation, microbial organisms
Chemical agents which are carcinogenic:
- polycyclic aromatic hydrocarbons
- Aromatic amines and azo dyes
- Asbestos
- Naturally occuring alflatoxin B1
Nitrosamines and amides
Direct-acting alkylating agents
Nitrosamines and amides are found in…
Preservatives
Polycyclic aromatic hydrocarbons are found it…
Cigarette smoking
Cancer caused by polycyclic aromatic hydrocarbons
Lung, bladder
Cancer caused by aromatic amines and azo dyes
Liver cancer, bladder cancer
Cancer caused by asbestos
Mesothelioma
Cancers caused by direct-acting alkylating agents
Lymphoid neoplasms
Leukaemia
In-direct acting agent:
Require metabolic activation to convert into carcinogens
Radiation involved in carcinogenesis
- UV rays
- Ionisng radiation
Cancers caused by UV
Squamous cell carcinoma
Basal cell carcinoma
Malignant melanoma
Cancers caused by ionising radiation
Solid organ malignancies
Leukaemias
Viruses/bacteria which are carcinogens
- Epstein-Barr virus
- HPV
- HepB
- H.pylori
High-risk strains HPV:
HPV-16
HPV-18
H.pylori -
Curved, Gr- rod shaped bacteria.
Metaplasia =
Cell adaptation to change in environment altering morphological apperance.
Barret’s oesophagus =
Metaplasia in oesophagus. Squamous turns to columnar due to reflex.
Dysplasia =
Disordered growth in which cells undergo morphological transformation with increased cell division and loss of architecutal relationship.
The evolution from a benign neoplasm to malignant is a
Step wise progression
Neoplasms have a … origin
Monoclonal
Cells in a neoplasm are what in relation to eachother
Heterogenous
heterogenous =
Cells have different abilities
Tumors that re-occur are…
More resistant to chemotherapy
Naming benign tumours of epithelial origin =
Papilloma or adenoma prefixed with cell of origin or tissue of origin (e.g. squamous papilloma of skin, thyroid follicular adenoma)
Malignant neoplasms of epithelial origin =
Carcinoma (e.g. adenocarcinoma, squamous cell carcinoma)
Benign tumours of connective tissue origin
-oma
Malignant tumours of connective tissue origin
-sarcoma
Neoplasm which contains elements of all 3 embryological germ cell layers
Teratoma
Lymphoma vs leukemia
Lymphoma = tumour mass Leukemia = circulating cell
can have both
3 routes of metastasis:
- Haematogenous
- Lymphatic
- Trancoelomic
Is spread via arteries or veins more common?
Veins
Anaplasia =
Malignant neoplasms composed of undifferentiated cells
Pleomorphism =
Variation in size and shape
Ex of local effects of neoplasms
- compression
- obstruction
- intussuception
- displacement
- ulceration/destruction of natural surfaces
Cachexia =
Wasting syndrome. Catabolic state resulting in profound loss of body fat, mass, weakness and anorexia
Tumour grade vs stage
Grade = pathological definition, describes appearance under microscope. Stage = assesses agree of spread
Why do we stage cancers?
- spread
- prognosis
- guide treatment
Ex of tumor grading
TNF
TNF =
Tubule formation
Nuclear atypia
Frequency of mitoses
Ex of tumour staging
TNM
TNM =
Tumour grade (T1-T4) Nodal involvement (N0-N3) Metastasis (Mx, M0, M1)