Lecture 9 - Neoplasia Flashcards
what does neoplasia stand for?
what does it mean
neo = new
plasia = formation
an abnormal growth of tissues
-loss of responsiveness to the normal things that stimulate growth
how can you differentiate between neoplastic cells and nonneoplastic proliferations, that are just reactions to inflammation?
neoplastic cells are monoclonal (derived from one cell)
reactions to inflammation are polyclonal
true or false
some neoplasms are benign and others are malignant
true
neoplasia behave as ______.
explain
as parasites bc they depend on the nutrients of the host.
but they do have autonomy in their growth
what 2 things does malignant neoplasm bind to in connective tissues?
what 2 things does it secrete and why?
binds to laminin and fibronectin
secretes collagenases or proteases to invade the surrounding tissues
true or false
neoplastic cells are not capable of attaining immortality
false - they are
immortality - the ability to keep dividing indefinitely
what can be the origin of neoplasia
either parenchymal or mesenchymal
neoplasia can be benign, malignant, or……
borderline
differentiate between parenchymal cells and mesenchymal cells
parenchymal cells are functioning cells like gland, epithelial, and hepatic cells
mesenchymal cells are SUPPORTING CELLS like stroma, fibrous, muscle and bone tissue (connective)
all malignant tumors are called…..
cancer
how do you differentiate between a benign and malignant tumor by looking at the name?
benign has “oma” at the end
malignant will have “carcinoma” (if derived from epithelial tissue) or “sarcoma” if arising from mesenchymal (connective) tissue
name for a benign tumor of fibrous tissues
fibroma
name for a malignant tumor of the glandular epithelium
adenocarcinoma
name for a malignant tumor of fibrous tissue
fibrosarcoma
name for a benign tumor in the cartilage
chondroma
name for a benign tumor in the glands
adenoma
name for a malignant tumor in squamous epithelium
squamous cell carcinoma
melanoma
MALIGNANT tumor of melanocyte (exception to the rule)
seminoma
MALIGNANT tumor of spermocyte (exception to rule)
lymphoma
MALIGNANT tumor of lymphoid tissue (exception to rule)
papilloma
benign epithelial neoplasm growing on any surface epithelium
leiomyoma
benign smooth muscle tumot
(usually in uterus or GI tract) AKA fibroid
pleomorphism
sign of malignancy
different shapes and sizes of the cell nucleus
hyperchromatism
coarse chromatin
both signs of malignancy
hyperchromatism = darkened nucleus in the stain
coarse chromatin - normally they are finely stained
abnormal mitotic figure
sign of malignancy
normally bipolar, when malignant it could be tri or quadripolar
a high ___ to ____ ration indiciates malignancy
high nuclear to cytoplasmic ratio
true or false
the presence of nuceloli indicates malignancy
true
-normally they’re not prominent
how can tumors be classified based on differentiation?
a well differentiated tumor has good prognosis. has high degree of resemblance to normal tissue
moderately differentiated - moderate prognosis
poorly differentiated - worse prognosis. means NO resemblence to the tissue of origin (SOMETIMES CALLED ANAPLASIA)
what does anaplasia mean and is it good or bad
lack of differentiation - very bad
pleomorphism, atypia, atypical mitosis, loss of polarity
has the worst prognosis
true or false
benign tumors are well differentiated
true
true or false
a malignant tumor can still be well differentiated
true
can be well, moderately, or poorly differentiated
for benign tumors - all are well differentiated
true or false
benign tumors cause remarkabel pressure on the neighboring tissues
false - malignant tumors
benign tumors cause slight pressure
hyperplasia vs metaplasia vs dysplasia vs neoplasia
hyperplasia - increase in cell number
metaplasia - change from one cell type to another (but reversible)
dysplasia - deranged cell growth. some nuclear atypia and the cells vary in size and shape
neoplasia - NEW, uncontrolled growth of cells that is out of physiologic control. hyperchromasia, loss of cell polarity
disordered growth
dysplasia
dysplasia is ___ and ___
irreversible and premalignant
true or false
in dysplasia, the cells do not invade the basement membrane
true
what is “carcinoma in situ”
preinvasive neoplasia
dysplasia represents a state between ___ and ____
hyperplasia and preinvasive neoplasia (carcinoma in situ)
true or false
dysplasia does not necessarily progress to cancer in all cases
true
metaplastic/dysplastic changes require…..
CONTINUOUS STIMULI - like smoking
mild dysplasia
mode rate dysplasia
severe dysplasia
mild - affects one tissue layer
mode rate - more than 1 layer is affected
severe - ALL layers are affected ** but basement membrane still isn’t breached*** AKA carcinoma in situe
____ dysplasia is also known as carcinoma in situ
severe
differentiate between invasion and metastasis
invasion - local spread when it invades the basement membrane and gets into neighboring tissue
metastasis is the secondary spread of cancer to a REMOTE AREA
happens when cells detach from the primary tumor and get into lymphatic vessels or bloodstream and get to distant organs
BREAST CARCINOMA metastizes to where
lung
liver
bone marrow
name the 4 steps of invasion of cancer, ending with metastasis
individual cells detach from each other
tumor cells attach to the ECM and bind laminin and fibronectin on basement membrane
ECM degrades through proteases that degrade ECM and type 4 collagen
cells that have detached from primary tumor enter lymphatic vessels or bloodstream where they get to distant organs
hematogenous spread is via….
arteries or veins
how does the direct invasion of nearby organs occur
when the tumor extends from its origin
differentiate between the staging and grading of cancer
staging describes the size of the tumor and how far it spread from where it originally originated
grading describes the appearance of the cancerous cells
what is TNM system
T=tumor size
N = node involvement (metastasis)
M = presence of distant metastasis
METHOD OF STAGING CANCER
explain the M stages in TNM system
M0 = no distant metastasis
M1 = distant metastasis present
the “T” of the TNM system ranges from….
Tis - T4
Tis being in situ and non invasive (confined to epithelium)
T4 being very large and invasive and has spread to adjacent organs
the “N” of the TNM system ranges from….
N0-N3
N0 = no lymph node involvement
N3 = more distant lymph node involvement
what is the grading of cancer based on?
the microscopic appearance of the neoplasm upon staining
a high cancer grade means what
worse prognosis
how many grades of malignant neoplasms are there?
explain them
grades 1- 4
grade 1 = best prognosis. well differentiated
grade 2 = moderately differentiated
grade 3 = poorly differentiated
grade 4 = nearly anaplastic – lost almost all features of original cells - worst prognosis
grade 1 is considereed ___ grade
grade 2, 3, 4….
grade 1 is low grade
2 is intermediate grade
3 is high grade
4 is anaplastic
true or false
anaplasia is a feature of malignant tumors
true
how is “history and physical examination” a diagnostic method for neoplasia
HC worker noticing weight loss, fatigue, pain, and possible mass
name 4 radiographic techniques that can help to detect masses
x-rays
CT scans
MRI
US (ultrasonography)
how can laboratory analyses be a diagnostic technique for neoplasia
specific antigen levels or genes may be detected
how is cytology an important diagnostic technique for neoplasia
pap smear can diagnose cervical dysplasias and neoplasms
FNA (fine needle aspiration) can exfoliate cells
how is tissue biopsy and surgery a diagnostic technique for neoplasm
biopsy - can get small tissues from colonoscopy, endoscopy, etc
surgery - portions of organ or tissue can be examined
true or false
there are multiple serological markers associated with malignant tumors
true
52 year ikd has increased serum cortisol and 2cm suprarenal mass
what is diagnosis
adenoma (tumor of epithelial glands)
name for malignant cells derived from skeletal muscle
Rhabdomyosarcoma
