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L8-10 Neoplasia Flashcards

1
Q

What are the differences between benign and malignant neoplasm in terms of gross features? (3)

A
  1. Capsule / No capsule
  2. Compressing / destruction of surrounding tissues
  3. No necrosis / necrosis + haemorrhage
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2
Q

What are the differences between benign and malignant neoplasm in terms of microscopic features?

A
  1. Highly / poorly differentiated cells
  2. Normal / bizarre mitotic activity
  3. No metastasis / metastasis
  4. Normal DNA / increased DNA content
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3
Q

What are the characteristics of malignant cell nuclei? (5)

A
  1. Hyperchromatic
  2. High nuclear to cytoplasmic ratio
  3. Irregular nuclear outline
  4. Coarse clumped chromatin
  5. Enlarged nucleoli
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4
Q

What are the 6 hallmarks of cancer?

A
  1. Evading apoptosis
  2. Self-sufficiency in growth signals
  3. Insensitivity to anti-growth signals
  4. Tissue invasion + metastasis
  5. Limitless replicative potential
  6. Sustained angiogenesis
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5
Q

What is an example of tumour suppressor gene?

A

p53

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6
Q

What are the 3 environmental triggers of genetic changes?

A
  1. Chemical carcinogens (smoking, alcohol, betel nut chewing)
  2. Radiation (X-ray, UV light)
  3. Viruses (HPV, EBV)
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7
Q

How does tumours evade body’s immune system?

A

Tumours exploit PD-1 dependent immune suppression –> limits the activity of T-cell

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8
Q

What is grading in neoplasia and how is it determined?

A

The grade of a malignant neoplasm refers to its degree of malignancy (according to the degree of differentiation). It is determined histologically.

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9
Q

What are the 6 routes of cancer dissemination

A
  1. Local infiltration (Rectum –> bladder)
  2. Spread though body cavities (colon –> ovary)
  3. Lymphatic spread (H&N –> cervical lymph node)
  4. Hematogenous spread (GI –> liver via portal vein)
  5. Perineural infiltration
  6. Pagetoid spread (epithelial lining)
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10
Q

What does T,N,M stand for in cancer staging?

A
  1. T: cancer at primary site
  2. N: regional lymph node spread
  3. M: metastasis to distant organs
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11
Q

What is paraneoplastic syndromes?

A

It is symptom complexes in cancer patients not attributable to local or distant spread of the tumour or hormonal effects indigenous to the tissue from which the tumour arose (basically the clinical symptoms don’t match the site of tumour)

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12
Q

Examples of paraneoplastic syndromes

A
  1. Cushing’s syndrome due to increased ACTH, but the underlying cancer is small cell carcinoma of lung / pancreatic carcinoma
  2. Inappropriate antidiuretic hormone secretion due to increased secretion of ADH, but the underlying cancer is small cell carcinoma of lung / intracranial neoplasms
  3. Hypercalcemia due to increased secretion of parathyroid hormone, but the underlying cancer is squamous cell carcinoma of lung, breast carcinoma, renal carcinoma, etc

Moral of the story: lung cancer can have weird weird unpredictable symptoms lol

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13
Q

What is the tumour marker for liver cell cancer?

A

alpha Fetoprotein

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14
Q

What is an example of a malignant tumour that commonly has differentiated cells?

A

Endocrine tumours

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15
Q

What are the 3 sampling techniques for cancer detection?

A
  1. Excision / biopsy
  2. Cytologic smears (PAP smear)
  3. Fine needle aspiration

All of those above is followed by cytologic examination under a microscope

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16
Q

What do we expect to see in cytologic examination a microscope for cancer cells?

A
  1. Decreased cohesiveness amongst tumour cells
  2. Exhibition of a range of morphologic changes (anaplasia)
17
Q

What can we discover from immunohistochemistry?

A
  1. Categorisation of undifferentiated malignant tumours
  2. Determination of the site of origin of secondary neoplasm
  3. Detection of molecules with prognostic or therapeutic significance
18
Q

What can be identified by the use of flow cytometry?

A

Rapid and quantitative measure of several individual cell characteristics, useful for the classification of tumours of T/B lymphocytes

19
Q

What are the 5 molecular diagnostic techniques?

A
  1. PCR-based detection
  2. Fluorescence in-situ hybridisation (FISH)
  3. Cytogenic analysis
  4. Spectral karyotyping
  5. DNA microarrays
20
Q

Uses of molecular diagnostic techniques (3)

A
  1. Malignancy
  2. Relapse
  3. Hereditary predisposition to certain cancer
21
Q

What tumour doesn’t have staging

A

Brain tumour

22
Q

What are the common sites of metastasis? (5)

A

LBLBL

Lung
Brain
Liver
Bone
Lymph nodes

23
Q

What are the 4 sites of body cavity?

A
  1. Peritoneum
  2. Pleural space
  3. Pericardial space
  4. Subarachnoid spaces

Pathology (13 decks)

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