Lec 1 - Neoplasia & cancer Flashcards
AUCOM
Pathogenesis of the transformed cell
iPUT
- Immortality
- Persistent & useless growth.
- Uncontrolled (autonomy growth)
- Transplantability .
Pathology of the transformed cell
pUAE
1-Persists in the same excessive manner after the cessation of the stimuli which evoked the change.
2-Uncoordinated with that of normal tissues (unlike non neoplastic proliferations like (hyperplasia , regeneration, repair).
3-Virtually autonomous
4-Exceeds that of normal tissue.
The growth of neoplastic cells is independent of growth factors ,regarding mechanism operating inside normal cells.
Autonomous growth
define autonomous growth
The growth of neoplastic cells is independent of growth factors ,regarding mechanism operating inside normal cells.
the replacement of one adult cell type by another one adult cell type. (reversible).
Metaplasia
Tumors are classified by:
- histological
- clinical
- gross
- grades
cell of origin; epithelial or stromal
histological classification
benign, borderline, malignant
clinical classification
infiltrative or localized
gross classification
depending on the degree of differentiation and anaplasia
grading classification
classification by origin: epithelial
classified into:
- Benign tumors of epithelial cells
Adenoma, Papilloma, Cystadenoma, Papillary Cystadenoma. - Malignant tumors of epithelial cells
carcinoma
Benign tumors of epithelial cells include:
Adenoma, Papilloma, Cystadenoma, Papillary Cystadenoma.
Tumor of glandular epithelium
eg. follicular adenoma of thyroid, fibroadenoma of breast.
Adenoma
type of tumor: follicular adenoma of thyroid
(Adenoma) benign tumor of glandular epithelium
type of tumor: fibroadenoma of breast
(Adenoma) benign tumor of glandular epithelium
type of tumor: Tubular adenoma of colonic mucosa
(Adenoma) benign tumor of glandular epithelium
Tumor arising from surface epithelium
e.g skin or mucosal surface
Papilloma
finger-like epithelial processes overlying fibrovascular core (connective tissue with blood vessels) e.g Squamous papilloma of skin, Transitional Papilloma of bladder
Papilloma
type of tumor: Squamous papilloma of skin
(Papilloma) benign tumor of arising from surface epithelium (of skin or mucosa)
type of tumor: Transitional Papilloma of bladder
(Papilloma) benign tumor of arising from surface epithelium (of skin or mucosa)
adenoma with cystic components.
Cystadenoma
adenoma with cystic components and with papillary finger like projections
Papillary cystadenoma
papilla having a core of vascularized connective tissue (fibrovascular core)
papilloma
Malignant tumors of epithelial cells
carcinoma include:
Squamous cell carcinoma
Adenocarcinoma
Transitional cell carcinoma
Small cell carcinoma
malignant tumors that arise in organs with squamous epithelial lining :
e.g. skin, mouth, cervix, bronchus, etc..
Squamous cell carcinoma
malignant tumors that arise from glandular origin
e.g. G.I.T., endometrium, breast, kidney, thyroid, etc..
Adenocarcinoma
malignant tumors that arise from epithelial lining of urinary bladder
Transitional cell carcinoma
malignant tumors that arise from neuroendocrine cells.
(mainly in lung , although can arise in other tissue & organs)
so it considered a systemic disease
Small cell carcinoma
neuroendocrine cells tumor =
Small cell carcinoma
tumors of mesenchymal (connective tissue) cell origin
- Benign
- Malignant (Sarcoma)
tumors that have more than one parenchymal cell type origin (from germ cells)
(germ cells are able to differentiate ectoderm, mesoderm & endoderm)
TERATOMA
Term applied for tumor with recognized mature or immature cells or tissue represented in more than one germ cell layer & some time all three (ectoderm , mesoderm & endoderm).
Teratoma
Teratomas are: benign, malignant, either?
Either (they may be benign or malignant)
a tumor that may contain skin, sebaceous & mucus glands, hair, cartilage, bone, respiratory epithelium, glial tissue
teratoma
teratomas are usually found in
ovary or testes (contain totipotent cells = primitive cells)
ovarian teratoma with predominant thyroid tissue
(may undergo pathological change, may produce thyroxine)
Stroma ovarii
these tumors are derived from ONE germ cell layer, and differentiate into more than one paranchymal cell type
e.g. Pleomorphic adenoma of salivary gland
Mixed tumors
type of tumor: Pleomorphic adenoma of salivary gland
Mixed tumors
T or F
All tumors of blood cells & lymphocytes are malignant (leukemia, lymphoma, polycythemia rubra vera).
True
tumor of small primitive cells
Blastoma
T or F
Nephroblastoma, Neuroblastoma, Medulloblastoma Hepatoblastoma are seen in children and infants
true
T or F
the majority of blastomas are benign
False! the majority of blastomas are in fact malignant //and they happen in kids :( //
Non neoplastic masses include:
Hamartoma
Choristoma
T or F
Hamartoma is a cancer
False
it’s a non neoplastic mass
T or F
Choristoma is not a cancer
True
it’s a non neoplastic mass
a tumor like malformation (mass or nodule) in which there is abnormal mixing of normal native tissue components of the organ. Usually develop during fetal life
Hamartoma
change in:
quantity of tissue elements
or
arrangement of tissue elements
result in:
Hamartoma
most haemangiomas are:
hamartomas -not cancer-
melanocytic nevi is what type of mass?
hamartoma (not a cancer)
Lung Hamartoma
most haemangioma,
melanocytic nevi
are all:
hamartomas
-not cancer-
A mass composed of normal cells or tissue found in a wrong location (Ectopia)
Choristoma
t or f
choristomas are non malignant
true
they’re just masses composed of normal cells or tissue found in a wrong location
Meckle’s Diverticulum
(ectopic pancreatic & gastric tissue) , Salivary tissue in lymph nodes
t or f
hamartomas and choristomas do not have malignant potential
true.
they’re just not cancers and wont be cancers.
tumor of primitive germ cells.
Seminoma & dysgerminoma
(in seminiferous tubules and ovary respectively)
malignant tumor of lymphoid tissue
Lymphoma
malignant tumor of melanocytes
Melanoma
**Melanoma’s are always cancerous and melanocytic nevi are always benign.
how will u remember that? :P
melanoma is a cancer in the melanocyte.
melanocytic nevi are a bunch of friendly melanocytes that decided to live somewhere else, they’re still friendly! lol
What are aspects of tumors that can help us differentiate between benign and malignant tumors?
depending on: (DR LuDwiG)
1. Differentiation & anaplasia
2. Rate of growth
3. Local invasion
4. Distant metastases
5. Gross features
**How will you remember the aspects that help differentiate between benign and malignant tumors?
Does it grow or not?
Does it grow fast or slow?
Does it visit neighbors or stay at home?
Does it visit far away people and sit there?
What does it look like?
depending on: (DR LuDwiG)
1. Differentiation & anaplasia
2. Rate of growth
3. Local invasion
4. Distant metastases
5. Gross features
Rate of growth:
slow =?
fast =?
slow = well differentiated
fast = poorly differentiated
Local invasion:
benign tumors = ?
Malignant tumors = ?
benign tumors = remain localized
Malignant tumors = invade surrounding tissue
development of secondary tumor implants in site that anatomically discontinuous with primary malignant tumor,
possibly in remote tissue
Distant metastases
feature of malignancy
absolute feature of malignant tumor
distant metastasis
Gross features :
▫ Benign= ?
▫ Malignant= ?
▫ Benign: smooth, capsulated, uniform color.
▫ Malignant: irregular, no capsule, variegated color.
true/false
benign tumor cells LOOK very similar (/identical) to the normal cells
true
t/f
Cells of a lipoma may look exactly like normal fat cells
true
_____ tumors display a range of differentiation, which form the basis of tumor grading (well , moderate , poorly)
Malignant tumors
Differentiation of malignant cells
Malignant tumor can be
extremely well differentiated -e.g. a well differentiated liposarcoma
or
anaplastic in which tumor cells lack of differentiation
Abnormal growth (disorganization of tissue structurally & cytologically) which may precede malignancy.
Dysplasia
Process of gradual loss of differentiation
Dysplasia
Complete loss of differentiation
ANAPLASIA
Differentiation features include:
functional & morphological features
Type of differentiation:
Formation of glands
morphology
Type of differentiation:
Formation of squamous nest
morphology
Type of differentiation:
Production of keratin
Functional
Type of differentiation:
Formation of mucin secretion
functional
Type of differentiation:
Formation of osteoid
functional
Dysplasia involving an epithelial surface
Intraepithelial Neoplasia
limited by intact epithelial basement membrane = CARCINOMA IN SITU
High grade dysplasia
t/f
dysplasia can regress
true
t/f
all carcinomas in situ progress to invasive cancer
false
_________ indicates the degree of resemblance of tumor cells to cell of origin and is always based on microscopic criteria
Grade of tumor (level of differentiation)
grades of tumors
Grade I : Well differentiated tumor.
Grade II :Moderately differentiated tumor.
Grade III : Poorly differentiated tumor.
Grade IV : Anaplastic tumor.
it gets worse as we go down
what grows faster, benign or malignant tumors?
Most cancers grow faster than benign tumors
which tumors frequently have a capsule?
benign
do all benign tumors have capsules?
no. eg. lieomyoma = non encapsulated
All tumors can potentially metastasize except:
BASAL CELL carcinoma (skin)
GLIAL TUMORS
Routes of metastases:
1-Lymphatics.
2-Blood vessels.
3-Seeding within body cavities. (transcoelomic)
the type of spread that is more characteristic in Carcinoma than sarcoma
epithelial > mesenchymal
Lymphatic Spread
the type of spread that is more characteristic in sarcoma than carcinoma
although in later stages of carcinoma they also use it
epithelial < mesenchymal
Hematogenous spread (via blood)
common areas of lymphatic spread
breast
common areas of hematogenous spread
liver and lung -dual circulation-
bones and brain
Certain carcinomas invade veins early e.g.
RENAL Carcinoma = renal vein > IVA
Hepatocellular Carcinoma = Portal & Hepatic v.
type of spread:
CA of upper lobe of lung to lower lobe
transcoelomic spread (seeding)
type of spread:
CA of stomach to ovary (krukenburge tumor)
transcoelomic spread (seeding)
type of spread:
CA of colon across peritoneum to small intestine & colon
transcoelomic spread (seeding)
type of spread:
CA of ovary spread widely through peritoneal surface
*(mucinous adenocarcinoma spread to peritoneal cavity to give pseudomyxoma peritoni )
transcoelomic spread (seeding)
_______ indicates the extent of spread of the tumor
Staging of Tumor
Staging of a tumor depends on
T- Size of tumor (local infiltrations). (1-4)
N- Regional lymph node involvement (0-3)
M- Metastases to distant organs
«TNM Staging System»
which is more valuable for prognosis, grading or staging?
staging
Both staging & grading of tumors are valuable for:
1- Determination of prognosis.
2- Planning of therapy .
Tumor Therapy :
1- Surgical excision .
2- Radiotherapy .
3- Chemotherapy .
4- Immunotherapy .
5- MULTIMODALITY of treatment
____ indicates the final outcome of the disease in terms of 5year or 10 year survival.
Prognosis
prognosis of cancer depends on
Tumor Type
Tumor Grade & Stage
Host reactions
In Iraq males the most common cancers are those of
larynx
lung
bladder
non Hodgkin lymphoma
leukemias
In Iraq females the most common cancers are those of
CNS tumors
lung cancers
breast cancer
non Hodgkin lymphoma
leukemias
can infections lead to cancer? if yes, give examples
1-Epstein-Barr infection (EBV)
»Burkitt lymphoma & nasopharyngeal carcinoma.
2-Viral hepatitis B&C
»Hepatocellular carcinoma
3-Humen papilloma virus
»Uterine cervix carcinoma
4-AIDS (HIV)
»Lymphoma & kaposi sarcoma
most common Adolescence age tumors:
Osteosarcoma
Ewing sarcoma
Medulloblastoma
tumor with Biphasic age incidence :
Hodgkin lymphoma ( 20 & 60 )
tumors common in children less than 5 years
Acute Leukemia
Lymphoma
CNS Tumors (retinoblastoma neuroblastoma)
soft tissue Sarcomas (rabdomyosarcoma).
