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MoD > L18 - Characteristic of tumours > Flashcards

L18 - Characteristic of tumours Flashcards

1
Q

What is the definition of ‘differentiation’ in terms of tumours?

A

The extent that neoplastic cells resemble the corresponding normal parenchymal cells, morphologically and functionally

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2
Q

What are the characteristics of benign tumours in terms of differentiation?

A
  • usually well-differentiated

- mitoses are rare

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3
Q

What are the characteristics of malignant neoplasms in terms of differentiation?

A
  • wide range of parenchymal differentiation

- most exhibit morphologic alterations showing malignant nature

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4
Q

What is anaplasia?

A

Poorly-differentiated cells

A condition whereby cells lose the morphological characteristics of mature cells

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5
Q

How are neoplasms comprised of poorly-differentiated cells described?

A

Anaplastic

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6
Q

What condition is a “telltale sign of malignancy”

A

Anaplasia

Neoplasms comprised of poorly-differentiated cells

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7
Q

What are some possible morphological changes in cells?

A
  • pleomorphism
  • abnormal nuclear morphology
  • mitoses
  • loss of polarity
  • other changes
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8
Q

What is pleomorphism?

A

Describes variability in the size, shape and staining of cells and/or their nuclei

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9
Q

Give some examples of the huge differences shown in pleomorphism

A
  • small cells with little differentiation
  • large cells with one massive nucleus
  • large cells with multinucleation
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10
Q

Cells can have abnormal nuclear morphology. Give some examples of this

A
  • nuclei appear too large for the cell
  • variability in nuclear shape
  • chromatin distribution
  • hyperchromatism
  • abnormally large nucleoli
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11
Q

In abnormal nuclear morphology, there can be hyperchromatism. What does this look like?

A

Dark colour

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12
Q

What are mitoses an indication of and what are they seen in?

A

An indication of proliferation

Therefore seen in normal tissues with a rapid turnover and in hyperplasias

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13
Q

In malignancy, atypical bizzare mitotic figures are seen. Give examples

A
  • tripolar division
  • quadripolar division
  • multiple spindles
    etc
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14
Q

What occurs in loss of polarity in cells?

A
  • orientation of cells disturbed

- disorganised growth

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15
Q

what are characteristics of well differentiated tissues?

A
  • closely resembles normal tissue or origin
  • little or no evidence of anaplasia
  • benign and occasional malignant
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16
Q

what are the main characteristics of poorly differentiated tissues?

A
  • little resemblance to tissue of origin

- highly anaplastic appearance

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17
Q

what are characteristics of undifferentiated/anaplastic tissues?

A
  • cannot be identified by morphology alone

- need molecular techniques

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18
Q

what does a low grade refer to?

A

well differentiated = low grade/grade 1

moderately differentiate = intermediate/grade 2

poorly differentiated = high grade/grade 3

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19
Q

What is ‘stage’ in terms of classification of tumours?

A

A measure of extent of disease [How far the tumour goes]

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20
Q

Better differentiation = ?

A

Better retention of normal function

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21
Q

How can benign and well-differentiated carcinomas of the endocrine glands be detected?

A

They frequently secrete hormones characteristic of origin

Increased levels in the blood can be used to detect and to follow up tumours

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22
Q

Can benign tumours invade other areas of the body?

A

No, they are localised to their site of origin and cannot infiltrate, invade or metastasise

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23
Q

What is encapsulation? (in terms of benign tumours)

A

The tumour grows in a contained area usually surrounded by a fibrous connective tissue capsule

24
Q

In benign tumours, what are the characteristics of the tissue plane?

A
  • discrete, moveable
  • easily palpable
  • easily excised
25
Q

What is pseudoencapsulation?

A

Happens in slow-growing malignant tumours

Looks like encapsulation but microscopically there are actually rows of cells penetrating the margin

26
Q

Do malignant tumours respect anatomical boundaries?

A

No

Penetration of organ surfaces and skin

27
Q

Is surgical resection easy in malignant tumours?

A

No

Requires resection of adjacent macroscopically normal tissue (margin)

28
Q

What is metastasis?

A

Spread of a tumour to sites physically discontinuous with the primary tumour

29
Q

What are the 3 pathways for metastasis?

A
  • direct seeding
  • lymphatic spread
  • haematogenous spread
30
Q

What is direct seeding?

A

The neoplasm penetrates a natural open field without physical barriers

31
Q

In direct seeding, a neoplasm penetrates a natural open field without physical barriers. Give some examples of these

A
  • peritoneal cavity
  • pleural cavity
  • pericardial space
  • subarachnoid space
  • joint spaces
32
Q

What is the most common pathway for metastasis?

A

Lymphatic spread

33
Q

Describe lymphatic spread

A
  • lymphatic vessels at the tumour margins

- pattern of lymph node involvement follows the routes of lymphatic drainage

34
Q

What is haematogenous spread seen in?

A

Typical of sarcomas

But also seen in carcinomas!

35
Q

Describe haematogenous spread

A

Bloodborne cells follow the venous flow drainage site of the neoplasm

Often come to rest in the first encountered capillary bed

36
Q

In haematogneous spread, the cells often come to rest in the first encountered capillary bed, what is most frequently involved?

A

Liver (portal)

Lungs (caval)

37
Q

In haemotogenous spread, why are veins involved?

A

They are more easily penetrated because they have thinner walls

38
Q

What is the stroma?

A

Connective tissue framework that neoplastic cells are embedded in

39
Q

What does the stroma provide?

A
  • mechanical support
  • intercellular signalling
  • nutrition
40
Q

What is a desmoplastic reaction?

A

Fibrous stroma formation due to induction of connective tissue fibroblast proliferation by growth factors from the tumour cells

41
Q

What does the stroma contain? (in a desmoplastic reaction)

A
  • cancer-associated fibroblasts
  • myofibroblasts (see puckering of skin)
  • blood vessels (blood to tumour)
  • lymphatics
42
Q

What are the clinical complications of tumours dependent on?

A
  • location
  • cell of origin
  • behaviour
43
Q

In what general classifications can effects of tumours be?

A
  • local
  • metabolic
  • due to metastases
44
Q

What are some LOCAL complications of tumours?

A
  • compression

- destruction

45
Q

Compression is a local complication of tumours. Describe this

A

Displacement of adjacent tissue

  • benign eg. pituitary adenomas obliterate adjacent functioning pituitary tissue leading to hypopituitarism
46
Q

Destruction is a local complication of tumours. Describe this

A

Invasion

Rapidly fatal is vital structures are invaded e.g. artery

Mucosal surfaces - ulceration eg. GI - anaemia

47
Q

Give some non-specific METABOLIC complications of tumours

A
  • cachexia
  • warburg effect
  • neuropathies
  • myopathies
  • venous thrombosis
48
Q

What is cachexia?

A

Profound weight-loss despite apparently adequate nutrition

Tumour-derived humoral effects that interfere with protein metabolism

49
Q

what does a low grade refer to?

A

Poorly differentiated = high grade / grade 3

50
Q

what is the definition of cancer?

A

The uncontrolled growth of cells, which can invade and spread to distant sites of the body

51
Q

what is a neoplasm?

A

Lesion resulting from the autonomous growth or relatively autonomous
abnormal growth of cells that persists in the absence of the initiating stimulus

52
Q

what is histogenesis?

A

The differentiation of cells into specialised tissues and organs during growth from undifferentiated
cells

53
Q

what are the most common cancers in males?

A

lung; colon and rectum; prostate

lung most common

54
Q

what are the most common cancers in females?

A

lung; colon and rectum; breast

lung most common

55
Q

what is the definition of differentiation?

A

The extent that neoplastic cells resemble the corresponding normal parenchymal cells, morphologically and functionally

56
Q

how do you definite the rate of growth? (in relation to malignancy)

A

Doubling time of tumour cells; Fraction of tumour cell in replicative pool; Rate at which cells are shed or die

MoD (19 decks)

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