MBC - Cancer

Question 1

What are cancer cell?

Answer 1

Cells that no longer respond ti growth and death signals

Question 2

What can mutations cause?

Answer 2

Proliferations of cancer cells and make them irresponsive to death

Question 3

What is a tumour?

Answer 3

Any kind of mass forming lesion

Question 4

How does a secondary tumour form?

Answer 4

Once a primary tumour is large enough, it may break away and travel to other tissues to metastasise, forming a secondary tumour

Question 5

What are the 3 types of tumour?

Answer 5

Neoplastic
Haramtomatous
Inflammatory

Question 6

What does hamartomatous mean?

Answer 6

Benign lesion caused by tissues being organised in an abnormal way

Question 7

What is a neoplasm?

Answer 7

Tumour that is either benign or malignant. Cancer is a malignant neoplasm

Question 8

What is one of the main differences between a benign and a malignant neoplasm?

Answer 8

Benign neoplasm is clearly demarcated and sometimes is mobile. Malignant neoplasms however are integrated into the tissue and have invaded underlying tissue

Question 9

What is a hamartoma?

Answer 9

Localised benign overgrowth of one or more mature cell types.

Question 10

What is an example of a hamartoma?

Answer 10

E.g. in the lung, hamartomas are composed of cartilage and bronchial tissue which cytologically is fine, however architecturally abnormal.

Question 11

What is a heterotopia?

Answer 11

Where tissue is found where it shouldn’t be found

Question 12

What is an example of a heterotopia?

Answer 12

We sometimes find pancreatic tissue in the wall of the intestine - the tissue will be completely normal, just in the wrong location

Question 13

How do we classify neoplasms?

Answer 13

Done first by cell origin and then divided into benign and malignant

Question 14

What does chondro- mean?

Answer 14

Derived from the cartilage

Question 15

What does -oma mean?

Answer 15

Benign tumour

Question 16

What does -sarcoma mean?

Answer 16

Malignant tumour

Question 17

What is a carcinoma?

Answer 17

Tumour of the epithelial cells (malignant)

Question 18

What are myomas?

Answer 18

Benign tumour of skeletal muscle

Question 19

What is a leiomyoma?

Answer 19

Benign tumour of smooth muscle

Question 20

What is an osteosarcoma?

Answer 20

Malignant bone tumour

Question 21

What is a lymphoma?

Answer 21

Malignant tumour of lymphocytes (benign is very rare)

Question 22

What is leukaemia?

Answer 22

Malignant tumour of bone marrow (benign is very rare)

Question 23

What is a papilloma?

Answer 23

Benign tumour of epithelial lining

Question 24

What is a squamous cell carcinoma?

Answer 24

Malignant tumour of squamous cell epihelia

Question 25

What is an adenoma?

Answer 25

Gland lining benign tumour

Question 26

What is an adenocarcinoma?

Answer 26

Gland lining malignant tumour

Question 27

What is a teratoma?

Answer 27

Tumours derived from the germ cells.

Question 28

What can teratomas give rise to?

Answer 28

Any kind of tissue from the germinal tissues: ectoderm, mesoderm, endoderm

Question 29

What do teratomas contain?

Answer 29

Mature tissue, immature tissue and even cancers.

Question 30

What is the difference between benign and malignant neoplasms with respect to invasion?

Answer 30

Benign: No direct extension into adjacent connective tissue or other structures Malignant: May be direct extension into adjacent connective tissue or other structures

Question 31

What is the difference between benign and malignant neoplasms with respect to metastasis?

Answer 31

Benign: don't invade locally so cannot metastasise Malignant: have the capacity to metastasise although they don't have to - they can be found early and localised therefore excised with curative surgery.

Question 32

What is the difference between benign and malignant neoplasms with respect to differentiation?

Answer 32

Benign: well differentiated - resembles the tissue it is found within/on. Malignant: poorly differentiated - doesn't resemble surrounding tissue. Tumour cells often have larger nuclei and more mitoses therefore marked nuclear pleomorphism.

Question 33

What is the difference between benign and malignant neoplasms with respect to growth pattern?

Answer 33

Benign: often retain cytological appearances of derived tissue but also the growth pattern - more ordinary architecture. Malignant: abnormal growth pattern and bizarre architecture.

Question 34

What are the routes by which neoplasms spread?

Answer 34

1. Direct extension 2. Haematogenous 3. Lymphatic 4. Transcoelomic 5. Perineural 6. Iatrogenic (e.g. doctor)

Question 35

What is direct extension?

Answer 35

- Associated with stromal response to the tumour | - Includes fibroblastic and vascular proliferation with an immune response

Question 36

What is haematogenous spread?

Answer 36

Via the blood stream, venues and capillaries are usually invaded due to their thin walls. This is a common method for most sarcomas.

Question 37

What is lymphatic spread?

Answer 37

Lymphatics drain to lymph nodes which drain to thoracic duct and then to vena cava. Most epithelial cancers first metastasise via lymphatics

Question 38

What is transcoelomic spread?

Answer 38

Via the seeding of body cavities, e.g. the pleural cavities and peritoneal cavities for intra-thoracic and intra-abdominal cancers respectively.

Question 39

What is perineural spread?

Answer 39

Via the nerves - in or around them due to their low resistance. This is common for cancers in the liver.

Question 40

How can we assess tumour spread?

Answer 40

Clinically - palpation Radiologically - Scans Pathologically - Definitive way of staging

Question 41

What is the TNM system?

Answer 41

Tumour Nodes Metastasis Helps us define and describe the spread of tumours

Question 42

What do we ask for T?

Answer 42

How big is the tumour? | What tissues has it invaded locally?

Question 43

What do we ask for N?

Answer 43

Has it spread to the lymph nodes? How many lymph nodes? Which lymph nodes?

Question 44

What do we ask for M?

Answer 44

Has it metastasised - via blood or lymphatics? | To where has it travelled - how far?

Question 45

What does a high TNM mean?

Answer 45

This means the worse a tumour has gotten and means that is has advanced.

Question 46

What is the stage of tumour?

Answer 46

How far the tumour has spread - described through the TNM system

Question 47

What is the grade of a tumour?

Answer 47

How differentiated is the tumour?

Question 48

What is more important, stage or grade of tumour?

Answer 48

Stage, however they both correlate with each other typically.