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Principles of Medicine (POM) - Block 2 > Lecture 13: Cancer > Flashcards

Lecture 13: Cancer Flashcards

1
Q

What is a tumour?

A

Any kind of mass forming a lesion

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2
Q

What is neoplasm?

A

autonomous (free) growth of tissue which have escaped normal constraints on cell proliferation

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3
Q

How can neoplasms be further categorised?

A

May be either:

  • Benign: remain localised
  • Malignant: invade locally and/or spread to distant sites
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4
Q

What are cancers?

A

malignant neoplasms

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5
Q

True or false: malignant tumours rarely cause death

A

True - e.g. skin cancers and such don’t cause death even if it has spread

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6
Q

True or false: benign tumours can’t spread so they can’t kill

A

False - they can kill if in a dangerous location e.g. the brain

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7
Q

What are hamartomas?

A

localised benign overgrowths of 1 or more mature cell types e.g. lung hamartomas composed of cartilage and bronchial tissue.
they represent architectural not cytological abnormalities i.e. Normal tissues organised abnormally

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8
Q

What are heterotopias?

A

normal tissues being found in parts of body where they’re normally not present e.g. pancreas in intestine
i.e. Normal tissues in wrong place

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9
Q

How are neoplasms classified?

A

Primary description = based on cell origin

Secondary description = benign or malignant

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10
Q

How are connective tissue neoplasms classified?

A
  • OMAS = benign

- SARCOMAS = malignant

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11
Q

How are epithelial neoplasms defined?

A
  • OMA = benign

- CARCINOMA = malignant

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12
Q

How are haematological neoplasms defined?

A

malignant in lymphocytes = lymphoma

malignant in bone marrow = leukaemia

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13
Q

What are teratomas?

A

tumours derived from germ cells, can contain tissue from all 3 germ cell layers, may contain mature tissue and even cancers

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14
Q

What are some malignant tumours that end with -oma?

A

Lymphoma
Melanoma
Hepatoma (liver cell cancer)
Teratoma

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15
Q

What are the 4 areas of difference between benign and malignant tumours?

A
  • Invasion
  • metastasis
  • differentiation
  • growth pattern
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16
Q

What is meant by the term invasion (when comparing tumours)?

A

Means the direct extension into adjacent connective tissue and/or other structures e.g. blood vessels. This is what distinguishes dysplasia/carcinoma in situ from cancer

17
Q

What is meant by metastasis (when comparing tumours)?

A

Means spread via blood vessels etc. to other parts of body (all malignant tumours have capacity to metastasise)

18
Q

What is meant by differentiation (when comparing tumours)?

A

Means how much do tumour cells resemble derivative tissue

19
Q

How can tumour cells differ from normal cells?

A
  • larger nuclei (larger nuclear-cytoplasmic ratio)
  • more mitoses than normal derivative tissue
  • abnormal mitoses e.g. tripolar
  • marked nuclear pleomorphism (nuclear size + shape)
20
Q

What is meant by growth pattern (when comparing tumours)?

A

Means how much does architecture of tumour resemble derivative tissue architecture.

21
Q

Do tumours have less or more well defined architecture than the tissue they’re derived from?

A

Less well defined architecture

22
Q

What may happen to benign tumours?

A

They may become malignant

23
Q

How do tumours spread?

A
  • direct extension
  • haematogenous
  • lymphatic
  • transcoelomic
  • perineural
24
Q

What is meant by direct extension in terms of tumour spread?

A

Associated w/stromal response to tumour including fibroblastic proliferation (‘desmoplastic response’), vascular proliferation (angiogenesis) and an immune response

25
Q

What is meant by haematogenous in terms of tumour spread?

A

Spread via blood vessels, venules + capillaries because thinner walls (note: most sarcomas metastatise first via blood vessels)

26
Q

What is meant by lymphatic in terms of tumour spread?

A

Spread via lymphatics to lymph nodes + beyond, pattern dictated by normal lymphatic drainage of organ in question (note: most epithelial cancers metastasis first via lymphatics)

27
Q

What is meant by transcoelomic in terms of tumour spread?

A

Spread via seeding of body cavities, commonest examples = pleural cavities and peritoneal cavities

28
Q

What is meant by perineural in terms of tumour spread?

A

Spread via nerves

29
Q

How is tumour spread assessed?

A
  1. clinically
  2. radiologically
  3. pathologically
    Known as triple assessment
30
Q

How do we describe tumour spread (stage)?

A

Using TNM system tho details diff for each kind of cancer:
T - tumour - size or extent of local invasion
N - nodes - no. lymph nodes involved
M - metastases - presence of distant metastases

31
Q

What do we mean by tumour grade?

A

How differentiated is the tumour (cytology)

32
Q

What is more important in terms of tumour prognosis: Grade or Stage?

A

Stage more important than grade

Principles of Medicine (POM) - Block 2 (12 decks)

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