Macro and Micro Morphology in Neoplasia

Question 1

Differentiation

Answer 1

• Refers to extent to which tumor resembles the tissue of origin
• Anaplasia: lack of differentiation
• Pleomorphism: variation in size and shape
• Numerous atypical nuclei, high n/c ratio
• Dysplasia: disorderly proliferation

Question 2

Tumor Growth Correlation

Answer 2

• Correlates in general w/ differentiation

Question 3

Characteristics of Benign vs. Malignant Cancer Chart

Answer 3

Question 4

Desmoplasia

Answer 4

• Paracrine stimulation of stellate stromal myofibroblasts (desmin and smooth muscle actin pos. cells) w/ type I collagen and c-fibronectin matrix production.

Question 5

Palpatory Differentiation of Breast Masses

Answer 5

Question 6

Grading of Tumors

Answer 6

• Based on the degree of differentiation and the number of mitotic figures in the tumor
• Classified as Grades I to IV w/ increasing anaplasia and aggressiveness
• Tumor grade may change as the tumor grows (w/ tumor progression)- *note* different parts of the same tumor may show different degrees of differentiation

Question 7

Staging of Cancer

Answer 7

• Staging is based on the size of the primary tumor and the extent of local and distant spread. Staging proves to be more of clinical value than grading
• TNM Staging system of the tumor:

*T: Tumore size

*N: L.N. metastasis

*M: Distant metastasis

Question 8

Methods of Metastasis

Answer 8

• Seeding of body cavities: ovary, colon and CNS masses
• Lymphatic spread: typical of carcinomas
• Hematogenous spread: typical of sarcomas, sites are often liver or lung

Question 9

Preneoplastic disorders

Answer 9

• Hyperplasia and dysplasia: endometrial carcinoma
• Chronic atrophic gastritis: gastric carcinoma
• Ulcerative colitis: colon carcinoma
• Leukoplaki: squamous cell carcinoma
• Colonic adenoma: colon carcinoma