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Cancer Biology (BIO-6009A) > Lecture 2: The Neoplastic Phenotype > Flashcards

Lecture 2: The Neoplastic Phenotype Flashcards

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1
Q

What is neoplasm?

A

Neoplasm - abnormal and excessive growth of tissue

Neoplastic - adjectival form

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2
Q

What are the constituents of neoplasms?

A
  1. Neoplastic cells - tumour cells (genetically altered cells)
  2. Stromal cells
    a. connective tissue (incl
    blood vessels support
    tumour cell growth)
    b. Lymphoid and other
    leucocytes (react to
    presence of tumour)
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3
Q

What are the different types of neoplasm?

A
  1. Benign
  2. Malignant
  3. Indeterminate (uncertain malignant potential)
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4
Q

How are neoplasms classified based on tumour type and origin site?

A
  1. Solid neoplasm
    a. Leiomyoma of the
    myometrium (benign)
    b. Adenocarcinoma of the
    colon (malignant)
    c. Pheochromocytoma of
    the adrenal gland
    (indeterminate)
  2. Liquid phase neoplasm
    (bone marrow -> blood)
    a. Chronic lymphocytic
    leukaemia

E.G., Leiomyoma = smooth muscle.

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5
Q

What are benign neoplasms?

A
  1. Circumscribed growth
  2. Smooth boundary with normal tissues (capsule)
  3. Well-differentiated (resemble normal)
  4. Slow growth
  5. May be multiple
  6. Never invade normal tissue
  7. never metastasise
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6
Q

What are malignant neoplasms?

A
  1. Ill-defined growth
  2. Irregular boundary with normal tissues
  3. Differentiation varies
  4. Rate of growth varies
  5. Local invasion and tissue destruction
  6. May metastasise (BCC & gliomas exceptions)
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7
Q

What are indeterminate neoplasms?

A
  1. Pathology not conclusive
  2. Awaiting of events to be sure
  3. E.g., some endocrine tumours such as adrenal pheochromocytoma and stromal tumours of gastro-intestinal tract
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8
Q

What are the harmful affect of neoplasms on patients?

A
  1. Local; Mass - effect
    depends on location
    b. May be complicated
    by: ulceration,
    haemorrhage,
    obstruction, rupture,
    infraction, torsion
    b. Invasion + destruction
  2. Distant
    a. metastasis
    b. metabolic/hormonal
    effects (both) -
    Paraneoplastic
    syndromes
    c. Immunological effects
    (both)
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9
Q

What are the phases of oncogenesis?

A
  1. Initiation (transformation)
  2. Progression
  3. Development of subclones - tumour heterogeneity
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10
Q

What are the origins of neoplasms?

A
  1. Normal tissue
  2. Hyperplastic state (hyperplasia = potentially reversible cellular proliferation)
  3. From pre-existing benign neoplasm
  4. Addition of +ve & -ve environmental factors
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11
Q

What is Dysplasia/intraepithelial neoplasia?

A
  1. precursor of neoplastic changes of epithelia (prior to invasion)
  2. Abnormalities in epithelial architecture & cytology
  3. Graded spectrum of abnormalities
    a. Dysplasia -mild, moderate, severe
    b. Intraepithelial neoplasia - Grade 1, 2, 3
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12
Q

What is the architecture of intraepithelial neoplasia?

A
  1. Disorder
  2. loss of polarity
  3. disordered/absent maturation
  4. Abnormally placed mitoses
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13
Q

What is the cytology of intraepithelial neoplasia?

A
  1. WHOLE CELL:
    a. increased nucleo-cytoplasmic ratio & variation
  2. NUCLEUS:
    a. abnormal outline and structure
    b. Increased staining
    c. increased variation of size
    d. increased mitosis
  3. CYTOPLASM
    a. abnormal maturation
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14
Q

What is the cytology of intraepithelial neoplasia?

A
  1. WHOLE CELL:
    a. increased nucleo-cytoplasmic ratio & variation
  2. NUCLEUS:
    a. abnormal outline and structure
    b. Increased staining
    c. increased variation of size
    d. increased mitosis
  3. CYTOPLASM
    a. abnormal maturation
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15
Q

What is meant by invasion?

A
  1. loss of normal cellular adhesion
  2. Active process
    a. lysis of matrix and cells
    b. Tumour cell mobility
    c. Production of tumour stroma by host
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16
Q

What is a tumour stroma?

A
  1. “Connective tissue produced locally in response to the presence of neoplasm”
  2. Components
    a. fibroblasts/myofibroblasts
    b. fibres
    c. matrix components
    d. blood vessels
    e. leucocytes
17
Q

What does a stroma do?

A
  1. supports neoplastic cell growth (blood supply)
  2. interacts with neoplastic cells (dynamic reciprocity)
  3. can have +ve or -ve effects
18
Q

What are the pathways of metastasis?

A
  1. Lymphatic vessels
  2. Blood vessels
  3. body cavities and surfaces
  4. direct impantation
19
Q

What are the 7 steps of the metastatic cascade?

A
  1. Neoplastic cells invasde ECM
  2. cellular separation
  3. invasion of blood and/or lymphatic vessels
  4. circulatory phase
  5. neoplastic cells arrest at distant site
  6. extravasation of neoplastic cells
  7. survival and growth at 2ndary site
20
Q

How are carcinomas distributed via metastases?

A
  1. carcinoma = epithelial origin
  2. Lymphatic spread to lymph nodes
  3. blood borne spread to distant organs
21
Q

How are sarcomas distributed via metastases?

A
  1. connective tissue origin
  2. blood-borne spread
22
Q

How are leukaemias/lymphomas distributed via metastases?

A
  1. blood etc
  2. usually begin with blood stream
23
Q

What is the effect of neoplasms on the immune system?

A
  1. Incompetence of immune system may = neoplasms
  2. Mechanisms of immune incompetence
    a. constitutional immunodeficiency
    b. age-related loss of function
    c. acquired immunodeficiency (therapeutic and disease related)
24
Q

What is the effect of neoplasms on the immune system? (continued)

A
  1. neoplasm may be recognised by immune system - new antigens on cell surface
    a. humoral response
    b. cellular response
  2. Neoplasm may inhibit function of immune system
    a. increased vulnerability to opportunistic infection
25
Q

What is a leiomyoma

A

benign neoplasm of smooth muscle

26
Q

What is a adenocarcinoma

A

malignant glandular neoplasm

27
Q

What is a pheochromocytoma?

A

hormone-secreting neoplasm

28
Q

How are benign tumours harmful?

A

Their cellular mass - level of effect depends on their location
Can be complicated by: ulceration, haemorrhage, obstruction, rupture, infraction, torsion

Metabolic, hormonal, and immunological effects

Cancer Biology (BIO-6009A) (24 decks)

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