Intro to Neoplasia

Question 1

An abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of normal tissues and persists in the same excessive manner after cessation of the stimuli that envoked the change.

Answer 1

Neoplasia

Used interchangeably with tumor.

Both DO NOT equal cancer.

Question 2

Describe the differences between benign and malignant tumors.

Answer 2

Benign: usually resemble normal tissue, slow growth rate, non-invasive, encapsulated; do not metastasize

Malignant: vary from resembling normal tissue to extremely different, variable growth rate, usually invasive, capable of metastasizing. -carcinoma or -sarcoma.

Question 3

Epithelial

Answer 3

arise from ecto- or endoderm

squamous, glandular/ductal, respiratory and transitional epithelium, liver cells, and basal cells of skin/adnexa

Question 4

Mesenchymal

Answer 4

arise from mesoderm

fibroblasts, adipocytes, smooth/skeletal muscle, bone, cartilage, blood vessels

Question 5

Hematolymphoid

Answer 5

Lymphoma, leukemias, plasmacytoma, pseudolymphoma, malignant tumors

Question 6

Melanocytes

Answer 6

neural crest origin

Question 7

Pleomorphic adenoma

Answer 7

Benign mixed tumors
Epithelial and mesenchymal components
Commonly in parotid gland

Question 8

Teratoma

Answer 8

Predominately benign

Composed of tissue derived from multiple germ layers – totipotent cells

Question 9

Mass of disorganized, mature tissue which is specific to the site of development

Answer 9

Hamartoma

Lung hamartoma

Question 10

Ectopic tissue in a foreign location

Answer 10

Choriostoma

Gastric heterotopia

Question 11

Extent to which tumor cells morphologically and functionally resemble the normal tissue counterpart

Answer 11

Differentiation/grade

Well-differentiated: resembles normal tissue
Moderately differentiated
Poorly-differentiated: primitive, vague resemblance
Anaplastic: complete lack of differentiation

Benign tumors are well-differentiated; malignant tumors vary from well- to poorly-differentiated/anaplastic

Question 12

What are some characteristic features of anaplasia?

Answer 12

Ugly!
Pleomorphism 
Hyperchromatic nuclei
High N/C ratios
Coarsely clumped chromatin
Large nucleoli 
Atypical, bizarre mitoses (tripolar) 
Loss of polarity
Tumor giant cells

Question 13

Carcinoma in situ (CIS)

Answer 13

Pre-invasive lesion
Seen in proximity to invasive tumor
Malignant cells do not penetrate beyond basement membrane
Full thickness dysplasia (disordered growth)

Question 14

Characteristics of dysplasia

Answer 14

Loss of polarity
Loss of maturation
Loss of architecture/organization
Abnormally located mitoses 
Varies from mild to severe (CIS) 
Mild to moderate may spontaneously resolve

Question 15

Local invasion

Answer 15

1. loosening of intracellular junctions
2. attachment at different sites
3. degradation
4. migration

Question 16

Malignant tumors metastasize except for…

Answer 16

Basal cell carcinoma and gliomas

Question 17

Pathways for metastatic spread

Answer 17

Hematogenous (most common for sarcoma spread)
Lymphatics (most common for carcinoma spread)
Seeding of body cavities and surfaces (peritoneal cavity)–Tumor cells displace from mass and implant and/or invade serosal surfaces

Question 18

Sentinel node

Answer 18

First LN to drain the tumor

Question 19

TNM system for clinical stage

Answer 19

T= tumor size
N= nodal involvement 
M= metastasis

Question 20

Host reactions to cancer

Answer 20

Local effects
Cachexia
Hematologic abnormalities (anemia, hypercoagulability)
Paraneoplastic syndromes: non-hormonal or hormonal effects of a tumor, unrelated to local spread or metastasis