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ESA2 Emily > MOD Neoplasia 1 > Flashcards

MOD Neoplasia 1 Flashcards

0
Q

Describe a tumour

A

Heritably altered, relatively autonomous growth of tissue which presents as a clinically detectable lump or swelling.

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1
Q

Define neoplastic tumour

A

Focal, purposeless overgrowth of one cellular component.

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2
Q

Describe how a tumour is often DRIVEN

A

by normal genes that are expressed inappropriately as oncogenes (from pronto oncogenes)

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3
Q

How many different tumours can be distinguished under the microscope?

A

600 different types!

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4
Q

Why may a malignant tumour show areas of necrosis and ulceration if on a surface?

A

Tumour is growing faster than can initiate new blood supply and so breaks the surface

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5
Q

Give the four features of malignant tumours

A

Purposeless
Atypical (structurally and functionally abnormal in varying degrees)
Autonomous (escape controls of regular growth)
Aggressive (invade host)

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6
Q

Define transformation

A

Change of a normal cell to a malignant cell

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7
Q

Define neoplasm

A

Abnormal new growth of cells that persists after initial stimulus is removed

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8
Q

Define malignant neoplasm

A

Abnormal growth of new cells that persists after initial stimulus is removed and invades surrounding tissue with potential to spread to distant sites

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9
Q

Define carcinoma

A

Malignant epithelial tumour

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10
Q

What is a malignant epithelial tumour also known as?

A

Carcinoma

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11
Q

What is carcinogensis is

A

Production of cancer

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12
Q

What is a blastoma?

A

Poorly differentiated cell of embryonic type which is often found in children from immature precursor cells

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13
Q

What are the characteristics of benign tumours?

A

Slow growing
Non infiltrating
Non fatal

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14
Q

What is metastasis?

A

Move to of a malignant neoplasm from its original site to a new non-contiguous site (called the secondary site)

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15
Q

What are the 4 basic types of tissue?

A

Epithelial
Connective
Muscular
Neurones

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16
Q

What proportion of tumours do epithelial tumours make up?

A

80%

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17
Q

What can be said about the differentiation of benign tumours?

A

Always well differentiated. Closely resemble the parent tissue

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18
Q

Define adenoma and adenocarcinoma

A

Benign tumour arsing from gland

Malignant tumour arising from gland

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19
Q

What is an adenoma with a cavity called?

A

A cavity is called a cyst
Therefore….
Cystadenoma

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20
Q

Define polyp

A

Club-shaped tumour dangling from surface by a stalk.

They are soft and fleshy which grow out of skin or mucosa

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21
Q

Define sessile polyp

A

Polyp without a stalk (means a sitting polyp)

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22
Q

What is a polyp containing glandular growth called?

A

Adenomatous polyp

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23
Q

What is a papilloma?

A

Outgrowth from an epithelial surface but with thin branches (papillae)
Resemble a cauliflower in cross-section

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24
Q

What is a haemangioma?

A

Benign tumour of blood vessels

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25
Q

What is a lymphangioma?

A

Benign tumour of lymphatic vessels

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26
Q

What is the differentiation like of a malignant tumour?

A

Anything from well to poorly differentiated. It is not mean a tumour is necessarily benign if well differentiated.

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27
Q

Describe pleomorphism

A

As differentiation gets worse cells have increasing nuclear to cytoplasmic ratio, nuclear hyperchromasia, more Mitotic figures and increasing variation in size and shape of cells and nuclei.

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28
Q

Describe the link between dysplasia and differentiation

A

Worsening dysplasia indicates worsening differentiation.

29
Q

Define dysplasia

A

Enlargement of an organ or tissue by proliferation of cells of an abnormal type, as a developmental disorder or an early stage in the development of cancer.

30
Q

Is dysplasia reversible?

A

Yes

31
Q

Is neoplasia reversible?

A

No!

32
Q

Name some tumours of the testis

Are they malignant or benign?

A

Malignant teratoma
Semioma

Usually malignant in the Testis

33
Q

Name some tumours of the ovaries

Are they malignant or benign?

A

Benign teratoma- dermoid cyst

Often benign

34
Q

What type of tumour is a myeloma?

A

MALIGNANT bone marrow tumour

35
Q

Generally what suffix is used for malignant tumours?

A

Sarcoma

36
Q

Which type of tissues can only be malignant?

A

Lymphoid

Haematopoietic (blood forming which first occurring in bone marrow and then enter blood to cause leukaemia)

37
Q

What is hodgkins and non-hodgkins lymphoma?

A

Hodgkins lymphpomana is a rare kind of cancer which normally presents as painless swelling of an armpit or groin ((where the lymph nodes are) as b-lymphocytes multiple in an abnormal way and collect here. You are more at risk if you already have a weakened immune system or have previously been exposed to the Epstein-Barr virus (causes glandular fever)

Presence of a Reed-Sternberg cell under a microscope when looking at the biopsy means it is hodgkins. If the cell is not present then it is non-hodgkins. Symptoms and outcomes of both diseases are very similar. But non-hodgkins is much more common.

38
Q

Are lymphomas malignant or benign?

A

Malignant! Despite name

Used to be called lymphosarcomas

39
Q

What is a Leiomyoma?

A

Benign tumour of smooth muscle

40
Q

Rhabdomyoma?

A

Benign tumour of striated muscle. Strirations present as either rods or wands.

41
Q

What makes a ganglioneuroma strange?

A

It should not exist because it is a benign tumour of neurones. But neurones are an example of permanent cell type and therefore should NOT divide!

42
Q

Glioblastoma

A

Malignant glial tumour

43
Q

Give some examples of neuroendocrine tumours

A

Phaeochromocytoma (adrenal glands)
Carcinoid tumour (various organs)
Small cell carcinoma (bronchus)

44
Q

Describe pleomorphic adenoma of salivary glands

A

Contains a mixture of epithelium, connective tissue and cartilage.

In this case, pleomorphic means polymorphic

45
Q

Describe fibroadenoma of breast

A

Contains glands and connective tissue.

46
Q

What is a teratoma?

A

Monster-Oma
Derived from cells so primitive that they can produce all 3 embryonic derivatives (ectoderm, mesoderm, endoderm)
They can be benign or malignant and tend to arise along the midline (base of skull, anterior mediastinum, aorta, gonads)

47
Q

What is a hemartoma?

A

Lump of tissue belonging to an organ in which the lump is found but has been wrongly assembled in development. They present at birth (appearing as a lump of buried leftovers) and grow with the person.

48
Q

Choristoma

A

Lump of normal tissue in an abnormal place. (Ectopic)

49
Q

Why is predicting the life span of a patient with a tumour difficult?

A

Tumours of one morphological type can have very different effects in different organs e.g. Adenocarcinoma of prostate is much better than pancreatic!

Also different body responses in different people affect the tumours ability to grow and metastasis

50
Q

What are the features of a malignant cell?

A

Less differentiated
Features of rapid growth
Additional bizarre features (atypia)

51
Q

What is tumour progression?

A

Tumours cells getting more poorly differentiated throughout their life

52
Q

Why do tumour cells have more cytoplasmic basophillia?

A

This is the ability of the cytoplasm to stain more readily and it does this because there is increased RNA and more active protein synthesis as the cell is making more of itself.

53
Q

What is relevant about the number of mitoses and cancer?

A

Proportional to the rate of growth and therefore aggressiveness of the tumour. Pathology reports sometimes refer to number of mitoses as a measure of malignancy.

54
Q

What are the behavioural changes in malignant cells?

A

Immortality (HeLa)
Loss of anchorage dependence (they don’t need to grow on a surface)
Loss of contact inhibition (do not stop growing when they touch each other and instead pile up on each other)
Decreased requirement for growth factors (supply to self by autocrine secretion)

55
Q

What are the functional changes of malignant cells?

A

Decreased adhesion between cells (between cells and stroma)
Tendency to shed surface molecules. If an enzyme is shed, then it can help invade tissue e.g. Collagenase can help invade through extracellular matrix
Shedding of tissue factor may lead to exaggerated clotting

If these molecules are found in the blood they can help diagnosis and are called TUMOUR MARKERS.

56
Q

All tumours contain 2 components. What are they?

A

Population of neoplastic cells which is nourished and supported by…
Connective tissue and vessels (non-neoplastic stroma) which actually is provided by the host.

57
Q

What would be the result of a tumour growing from a bacterially contaminated surface?

A

Ulceration

Often skin or gut

58
Q

How is an ulcer created?

A

Surface of tumour is eroded by friction and then colonised by bacteria. Resulting in a non-healing ulcer.

59
Q

How long must an ulcer be present on the skin to suggest malignancy?

A

3-4 weeks

60
Q

If a tumour contains lots of connective tissue stroma it is very hard. What is this called?

A

Scirrhous carcinoma

Greek for hard

61
Q

What is a kind of soft tumour?

Most are hard

A

Epithelial tumours with little stroma

62
Q

If you cut into different types of tumours what colour are they?

A

Most white
Melanomas are black
Angiomas are red with blood
Hepatomas are green with bile

63
Q

What kind of tumour is associated with foci of necrosis?

A

Malignant tumours

Poor prognosis

64
Q

What kind of tumour is suggested in large spaces filled with cysts?

A

Epithelial.
Can be benign or malignant.
Secretion has no way out and so expands lumen of glands

65
Q

How do mutations occur and cause a neoplasm?

A
  1. Mutations caused by initiators (mutagenic agents) and promotors (which cause cell proliferation).
  2. There is a combination of the above causing an expanded, monoclonal population of malignant cells. Chemicals, radiation are main initiators. But can also be promotors.
  3. Neoplasm arises from monoclonal population by progression and accumulation of more mutation.
66
Q

What is progression?

A

A neoplasm arising from monoclonal population. Characterised by more mutation.

67
Q

What are the signs to illustrate how aggressive a tumour is?

A

Look at cellular abnormalities- lack of differentiation, cytologic atypia, pleomorphism

Look at architecture- abnormal cellular pattern (glandular), infiltration (local invasion of neighbouring tissues).

68
Q

What are the secondary changes associated with tumours?

A

Ulceration
Necrosis (secondary to ischaemia and often seen at centre of a tumour. Often malignant, but can be benign tumours. Could be caused by high pressure of tissue in centre of tumour)
Calcification (dead or necrotic cells. Used in breast screening by mammograms)
Torsion (of pedunculated tumours (on a stalk))

69
Q

What is lyonisation?

A

Random activation of one isoenzyme in a group of tissue.

In neoplasia, cell proliferation will occur from one of these cells to create a monoclonal population.

ESA2 Emily (8 decks)

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