GENPATH Cancer (3) Spread of Cancer Flashcards
Cancer spread to brain tumor explanation.
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Cancer spread to brain tumor explanation.
***BRAIN TUMORS ARE NOT FROM ARTERIAL SPREAD. arteries too thick. venous spread to lungs. then to microcirculation/AV shunt/primary lung cancer to more distant organs like the brain.
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How can benign neoplasms also cause significant clinical morbidity?
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How can benign neoplasms also cause significant clinical morbidity?
**- Meningioma increases ICP
- Insulinoma results in hypoglycaemia
Key idea is that benign neoplasms can be deadly too. Yah I know Im very
Metastatic carcinoma cells are MOST likely to become lodged in which regions of the lymph node?
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Metastatic carcinoma cells are MOST likely to become lodged in which regions of the lymph node?
Subcapular sinus
The subcapsular sinus of a lymph node is where the afferent lymph enters
Patients on stage […] cancer is not going to benefit from surgery.
Patients on stage** 4 **cancer is not going to benefit from surgery.
distant metastasis has occurred.
pre-carcinoma are known as […]
They are not acknowledged as carcinoma because they […]
pre-carcinoma are known as intraepithelial neoplasia
They are not acknowledged as carcinoma because they haven’t penetrated the basement membrane
the older term used is dysplasia. dysplasia is just disordered maturation/growth but when used in context of epithelial dysplasia, has a premalignant connotation
Dysplasia can be low-grade or high-grade. High-grade dysplasia may also be referred to as carcinoma in situ. (in site)
Carcinoma in situ (CIS), also known as in situ neoplasm, is a group of abnormal cells. While they are a form of neoplasm there is disagreement over whether CIS should be classified as cancer.
By definition. there’s no such thing as sarcoma in situ. mesenchymal cells are not bound by basement membrane.
Sarcomas tend to spread via […]
Sarcomas tend to spread via blood vessels
thus usually lungs/livers first
Carcinomas tend to spread via lymphatics.
The TNM system is used for the staging of cancer.
In general a stage 4 cancer is one that […]
while a stage 3 cancer is one that […]
The TNM system is used for the staging of cancer.
In general a stage 4 cancer is one that **has had presence of distant metastasis **
while a stage 3 cancer is one that has had metastasis of regional lymph nodes
What are the 4 ways that cancers can be disseminated?
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Example
[…] - […]
Example:
[…] - […]
Example:
[…] - […]
Example
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What are the 4 ways that cancers can be disseminated?
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Local infiltration (cancer spreading to adjoining organs)
Example
**- rectal cancer a grow and infiltrate through the thickness of the wall and then involve the bladder
- perineural infiltration (tumors infiltrate space around nerves. v painful for patients and v difficult to resect)
- pagetoid spread (spread along epidermis and other epithelial linings) (eg of the nipple in breast cancer. bypass basement membrane) -
Spread through body cavity (abscesses and ascites)
Example:
**- pleural effusion
- pericardial cavities
- subarachnoid
- joint space
- peritoneal cavities (eg of the pancreas)
3.* Lymphatic spread*
Example:
***breast carcinoma to axillary nodes
*
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Hematogenous spread
Example
**Venous:
- GI tract to liver (portal vein)
- other parts of body to lungs (IVC)
- explains spread to vertebral tumor. theory says that goes through paravertebral venous plexus when pt’s movement allows retrogade flow.
Local infiltration:
- malignant tumor usually poorly demarcated from
What does “histopathological type” of tumour mean???
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What does “histopathological type” of tumour mean???
its resemblance to its cell of origin/histogenesis
Whatever la just whack the 9 item recipe LOL
What is a Krukenburg tumour?
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What is a Krukenburg tumour?
A Krukenberg tumor **refers to a malignancy in the ovary that metastasized from a primary site, classically the gastrointestinal tract, although it can arise in other tissues such as the breast. **
Gastric adenocarcinoma, especially at the pylorus, is the most common so
What is the concept of GRADING of cancer? (vvvvvvv IMPT!!)
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How is it done? What are the parameters?
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Grade 1 - […]
Grade 2 - […]
Grade 3 - […]
Grade of the tumour correlates with the degree of maligancy of the of the tumour and therefore with the prognosis of the cancer
What is the concept of GRADING of cancer? (vvvvvvv IMPT!!)
The grade of the cancer refers to its degree of malignancy.
Cancers are graded according to their degree of differentiation and resemblance to its tissue of origin, morphologically and functionally
How is it done? What are the parameters?
This is done histologically. Parameters include architecture, cell morphology and mitotic activity.
Grade 1 - well differentiated
Grade 2 -* moderately differentiated*
Grade 3 -* poorly differentiated*
Grade of the tumour correlates with the degree of maligancy of the of the tumour and therefore with the prognosis of the cancer
which parameter depends on which cell type you’re accessing.
eg. for pr
What is the concept of STAGING of cancer? (vvvvvvv IMPT!!)
The stage of the cancer refers to the
1. […],
2. […], as well as the
3. […]
How is it done?
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T- […]
N- […]
M - […]
The TNM staging is converted to an overall stage of 1 to 4, which determines the clinical management of the cancer. For example,
- a Stage 1 cancer would not have spread extensively, and therefore would be possible to resect completely, while
- a Stage 4 cancer would have metastasised to another organ, and hence complete resection of the tumour is not an option
What is the concept of STAGING of cancer? (vvvvvvv IMPT!!)
The stage of the cancer refers to the
1. **Extent of primary lesion growth, **
2. Extent of spread to regional lymph nodes, as well as the
3. Presence and absence of blood borne metastases
How is it done?
The TNM system
T- Size/depth of Tumor in primary site
N- Regional lymph Node involvement
M -* Distant Metastasis*
FYI:
TX - primary
TMN staging is important for PROGNOSIS and TREATMENT
Why sentinel lymph node enlargement of a cancer does not imply metastatic spread?
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Why sentinel lymph node enlargement of a cancer does not imply metastatic spread?
**enlargement could be due to reactive hyperplasia in response to tumor antigen or other cause. **
Therefore need to do biopsy. eg. for breast carcinoma
