How tumours behave

Question 1

What is neoplasm?

Answer 1

• Abnormal mass of tissue that exceed normal coordinated growth
• Proliferates purposelessly and does not respond to normal growth signals
• Squamous cell carcinoma- breach to basement membrane

Question 2

Define tumour

Answer 2

Swelling neoplasm

Question 3

Define cancer

Answer 3

Malignant neoplasm

Question 4

Define benign tumour

Answer 4

Localised, no spreading, expansion

Question 5

Define malignant tumour

Answer 5

Infiltration and metasasis

Question 6

How does neoplasm arise?

Answer 6

• Squamous metaplasia
• Dysplasia (intraepithelial neoplasia)
• Squamous cell carcinoma (invasive)
• Epithelial dysplasia- lung cancer, without squamous metaplasia
• Dysplasia- adenocarcinoma

Question 7

Describe the potential pathways from normal epithelium to carcinoma

Answer 7

• Normal epithelium -> metaplasia -> intraepithelial neoplasia (dysplasia) -> carcinoma
• OR normal epithelium -> intraepithelial neoplasia -> carcinoma

Question 8

Describe metastasis

Answer 8

• Shifting of disease from one part of the body to another- cancer away from the primary tumour

Question 9

What does haematogenous mean?

Answer 9

Spread of tumour by the bloodstream

Question 10

What does lymphatic mean?

Answer 10

Spread of tumour by regional lymph nodes

Question 11

Define metastases

Answer 11

Any effect of neoplasm

Question 12

Describe tumour grading

Answer 12

1: well differentiated (look normal)
2: moderately differentiated
3: poorly differentiated (look abnormal)

Question 13

Describe tumour staging

Answer 13

TNM: tumour size, number of regional lymph nodes and presence of metastasis

1: Early stage
4: late stage

Question 14

Describe paraneoplastic syndromes

Answer 14

• Clinical effects of malignant diseases not directly related to the local mass
• Commonest- peptide/hormones from tumour- systemic effects

Question 15

Describe the non-specific systemic effects of cancer

Answer 15

• Weight loss and malaise

- Due to circulating mediators: cytokines, inflammatory cells, neoplastic cells

Question 16

Describe hypercalcaemia

Answer 16

• Secretion of parathyroid hormone-related protein- activated PTH receptors (by tumour cells)
• Hyperplasia- dysplasia (dysplasia of glandular epithelium- adenocarcinoma)

Question 17

Describe bleeding from the surface

Answer 17

• Chronic blood loss- anaemia
• Ulceration of tumour surface- loss of epithelium
• Granulation of tissue and blood vessels/blood loss in bowels

Question 18

What is a perineural invasion?

Answer 18

• Tumour spreads to nerve and causes damage

- E.g. hoarse voice- damage to laryngeal nerve

Question 19

What are the general rules about carcinomas?

Answer 19

• Tend to resemble cells found in originating tissue- normal for organ/metaplastic
• Develop from pre=malignant intraepithelial lesion (dysplasia)
• Metastases can affect other organs- also have same properties as primary tumour

Question 20

Describe the localised effects of carcinomas

Answer 20

• Pressure
• Infiltration
• Space-occupying

Question 21

Describe the systemic effects of carcinomas

Answer 21

Paraneoplastic syndromes