Introduction To Benign And Malignant Diseases

Question 1

In adult tissues, what determines the size of the cell population?

Answer 1

Rate of cell proliferation, differentiation and death by apoptosis

Question 2

What controls the cell cycle?

Answer 2

The cell cycle is controlled by chemical factors in the micro-environment of the cell, including stimulators and inhibitors

Question 3

What does quiescence mean?

Answer 3

A state of reversible growth arrest in which cells have exited the cell cycle but remains capable of renewed division upon stimulation

Question 4

what are terminally differentiated cells not capable of doing?

Answer 4

not capable of replicating

Question 5

In the liver/kidney what state are their differentiated cells in?

Answer 5

differentiated cells are normally quiescent but can proliferate if needed

Question 6

In the epithelia of the oral cavity, gut and skin what state of differentiation are their mature cells in?

Answer 6

The mature cells are terminally differentiated, short-lived and incapable of replicating but may be replaced by new cells arising from stem cells

Question 7

what can conditions can decrease apoptosis

Answer 7

neoplasia and auto-immune diseases

Question 8

what conditions can increase apoptosis

Answer 8

AIDS, neurodegenerative disorders, reperfusion injury

Question 9

what are the inhibitors of apoptosis

Answer 9

growth factors, cell matrix components, viral proteins

Question 10

what are the inducers of apoptosis?

Answer 10

withdrawl of growth factors, loss of matrix attachment, viruses, free radicals, ionising radiation, DNA damage, Fas ligand/CD95 interaction

Question 11

What are the molecular mediators and regulators if apoptosis

Answer 11

extrinsic pathways
intrinsic pathways
caspases - cascade
p53

Question 12

What is hypertrophy?

Answer 12

Hypertrophy is an increase in volume of an organ/tissue due to an increase in cell SIZE

Question 13

What is hyperplasia?

Answer 13

Hyperplasia is an increase in volume of an organ/tissue due to an increase in cell NUMBER

Question 14

What organs is hyperplasia commonly seen in?

Answer 14

hormonally sensitive organs - endometrium
- breast
- thyroid

Question 15

what is gingival hyperplasia

Answer 15

Enlargement of the gingival tissues due to an increase in cell number of epithelium and underlying connective tissue
Various causes, including certain drugs

Question 16

What is atrophy?

Answer 16

Atrophy is the decrease in size of an organ/tissue due to a decrease in cellular size

Question 17

What are some of the many causes of atrophy

Answer 17

Physiological (thyroglossal duct - disappears during embryonic development
pathological
ageing
lack of use/stimulation
mechanical
functional

Question 18

What is hypoplasia?

Answer 18

Incomplete development/underdevelopment of an organ or tissue
It is a developmental/congenital defect

Question 19

What is metaplasia?

Answer 19

Metaplasia refers to the replacement of a mature, differentiated cell type by another mature differentiated cell type that does not typically occur in tissue in which it is found.
This is a reversible change

Question 20

What can cause metaplasia?

Answer 20

Can be part of an adaptive response to stress such as:
- smoking
- alcohol
- acid reflux
- trauma

Question 21

Name 3 examples of metaplasia

Answer 21

Barrett’s oesophagus - non-keratinised squamous epithelium is replaced by nonclilated columnar epithelium (the type found in your intestines)
Bronchus
Salivary ducts

Question 22

Metaplasia itself is a neoplastic disorder, what can cause it to progress to malignancy

Answer 22

If the environmental changes that lead to metaplasia are persistant and lead to further changes that can manifest as dysplasia may progress to malignancy

Question 23

What are mesenchymal tissues

Answer 23

Mesenchymal tissues - a type of undifferentiated connective tissue

Question 24

What is the only one of these disorders of growth that is not potentially reversible

Answer 24

hypoplasia - congenital/ developmental defect

Question 25

what is dysplasia?

Answer 25

A broad term used to describe the presence of abnormal cells within a tissue or organ It is not cancer but can be a pre-malignant process

Question 26

What are the different degrees of dysplasia?

Answer 26

The different degrees of dysplasia - dependent of severity Mild moderate Severe (also termed carcinoma in situ) Progression from dysplasia to malignancy can be seen in any of the grades of severity, the more severe the higher the risk

Question 27

what is the definition of a neoplasm

Answer 27

a neoplasm is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of the stimuli that evoked the change

Question 28

neoplasia results from aberration of what normal mechanisms that control cell number?

Answer 28

cell production by cell division cell loss by apoptosis

Question 29

what are the 2 main classifications of tumours

Answer 29

behaviour and histogenesis

Question 30

what are the 2 behaviours of a tumour

Answer 30

benign and malignant

Question 31

explain the growth pattern of benign tumours

Answer 31

they expand and remain localised typically well circumscribed often encapsulated

Question 32

is the growth rate of a benign or malignant tumour faster

Answer 32

malignant tumour

Question 33

what is the treatment of a benign tumour

Answer 33

local excision

Question 34

what are the clinical effects of benign tumours

Answer 34

local pressure effects: hormone secretions

Question 35

what is the most common type of benign salivary gland tumour and what salivary gland is it most commonly found in?

Answer 35

pleomorphic adenoma most commonly presents in the parotid gland

Question 36

what is the histology of a benign tumour

Answer 36

resembles the tissue of origin

Question 37

what are the nuclei of a benign tumour cells like

Answer 37

small, regular and uniform

Question 38

what the mitoses pattern of benign tumours like

Answer 38

few, normal

Question 39

what is the growth pattern of a malignant tumour like?

Answer 39

infiltrate locally, metastasise (spread to distant sites)

Question 40

what is metastasis

Answer 40

The spread of cancer cells from the place where they first formed to another part of the body. Cancer cells break away from their original tumour and form a secondary tumour in a secondary site

Question 41

What are the clinical effects of a malignant tumour

Answer 41

local pressure and destruction inappropriate hormone secretion distant metastases

Question 42

what is the treatment for malignant tumours

Answer 42

excision +/- additional therapy

Question 43

what is the histology of a malignant tumour

Answer 43

variable, many differ from tissue of origin

Question 44

what are the nuclei of malignant tumour cells like?

Answer 44

larger, pleomorphic (variable shapes and size)

Question 45

What are the mitoses of malignant tumours

Answer 45

increased, often numerous and abnormal forms

Question 46

true or false: all benign tumours progress to become malignant

Answer 46

false some benign tumours can progress to become malignant. For example the longer the tumour is left untreated it has an increasing risk of becoming malignant

Question 47

what is the histogenetic classification of tumours

Answer 47

tumour can be classified according to the cell type they resemble - their differentiation most tumours resemble to some extent the tissue from which they arise

Question 48

what is the name for a covering epithelial benign tumour

Answer 48

papilloma

Question 49

what is the name for a covering epithelial malignant tumour

Answer 49

carcinoma

Question 50

what is the name for a glandular epithelial benign tumour

Answer 50

adenoma

Question 51

what is the name for a glandular epithelial malignant tumour

Answer 51

adenocarcinoma

Question 52

what is the name for a smooth muscle benign tumour

Answer 52

lelomyoma

Question 53

what is the name for a smooth muscle malignant tumour

Answer 53

lelomyosarcoma

Question 54

what is the name for a bone forming benign tumour

Answer 54

osteoma

Question 55

what is the name for a bone forming malignant tumour

Answer 55

osteosarcoma

Question 56

what is the name for a cartilage benign tumour

Answer 56

chondroma

Question 57

what is the name for a cartilage maligant tumour

Answer 57

chondrosarcoma

Question 58

what is the name for a fibrous benign tumour

Answer 58

fibroma

Question 59

what is the name for a fibrous malignant tumour

Answer 59

fibrosarcoma

Question 60

what is the name for a blood vessel benign tumour

Answer 60

(haem)anginoma

Question 61

what is the name for a blood vessel malignant tumour

Answer 61

angiosarcoma

Question 62

what is the name for an adipose benign tumour

Answer 62

lipoma

Question 63

what is the name for an adipose malignant tumour

Answer 63

liposarcoma

Question 64

what is the name for a malignant lymphoid tumour

Answer 64

lymphoma

Question 65

what is the name for a malignant haematopoietic tumour

Answer 65

leukaemia

Question 66

what is the name for a benign primitive nerve cell tumour

Answer 66

ganglioneuroma

Question 67

what is the name for a malignant primitive nerve cell numour

Answer 67

neuroblastoma, retinoblastoma

Question 68

what is the name for a malignant glial cell tumour

Answer 68

glioma (e.g. astrocytoma)

Question 69

what is the name for a benign melanocyte tumour

Answer 69

naevi

Question 70

what is the name for a malignant melanocyte

Answer 70

malignant melanoma

Question 71

what is the name for a malignant mesothelium tumour

Answer 71

mesotheioma

Question 72

what is the name for a benign germ cell tumour

Answer 72

teratoma

Question 73

what is the name for a malignant germ cell tumour

Answer 73

teratoma, seminoma

Question 74

true or false: not all malignant tumours are equally malignant

Answer 74

true

Question 75

what is a prognosis

Answer 75

the prediction of the probable course and outcome of disease - gives an indication for appropriate treatment and estimate survival

Question 76

true or false: less differentiated tumours tend to have a better prognosis

Answer 76

false - well differentiated tumours tend to have a better prognosis

Question 77

explain tumour staging

Answer 77

"anatomical extent of disease" clinical, radiological and pathological findings major determinant of appropriate treatment and prognosis

Question 78

what are the gradings of "oral cancer" - squamous cell carcinoma

Answer 78

- well differentiated tumour cells - very obviously squamous with 'prickles' and keratinisation - moderately differentiated - poorly differentiated, may be difficult to identify tumour cells as epithelial

Question 79

what is used for malingant tumour staging

Answer 79

TMN staging

Question 80

what are the TMN components of staging

Answer 80

T = extent of primary tumour