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Pathology-Alaa > Neoplasia 1 &2 > Flashcards

Neoplasia 1 &2 Flashcards

1
Q

what is neoplasm? what is a malignant neoplasm? give example

A

-abnormal growth of cells that persist even when the stimulus is removed! -

abnormal growth of cells that persist even when a stimulus is removed AND it INVADES surrounding tissues & can spread to.

ex: CANCER

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2
Q

what is a tumour?

A

any clinically detectable lump or swelling

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3
Q

what is a metastasis? what is meant by the primary site? secondary site?

A

a malignant neoplasm has spread from its origin site to another site.

-primary site: the original location

-secondary site: place to which it has spread

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4
Q

what is Dysplasia?

A

pre-neoplastic alteration in which cells show disordered tissue organisation.

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5
Q

It is NOT neoplastic because the change is reversible. name the correct term.

A

Dysplasia

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6
Q

Benign vs malignant neoplasm describe how they would appear to the naked eye

A

Benign: remain put at their original site.closely resembles parent tissue, well differentiated!

EXOphytic growth= grow in a restricts area>> have a pushing outer margin.

Malignant: can metastasise, range from well to poorly differentiated!

ENDOphytic=irregular outer margin shape>>shows area of necrosis & ulcerations

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7
Q

give an example of a non-neoplastic tumour

A

abscess , hematomas

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8
Q

A ______ neoplasm has cells that closely resemble the parent tissue. therefore they r well DIFFERENTIATED.

A

Benign

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9
Q

cells with no resemblance to any tissue are called

A

Anaplastic cells

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10
Q

term used to describe increased nuclear staining

A

hyperchromasia

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11
Q

Occurring in various distinct forms. In terms of cells, having variation in the size and shape of cells or their nuclei. name term

A

Pleomorphism

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12
Q

what causes neoplasia?

A

accumulated MUTATIONS that r caused by

-initiators >> which are mutagenic agents ex: chemicals, infections, radiation

-promoters >> which cause cell proliferation

**MUTATIONS CAN ALSO BE INHERITED

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13
Q

With worsening differentiation individual cells have ________ nuclear size and nuclear to cytoplasmic ratio, __________ hyperchromasia

A

increased

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14
Q

what is meant by monocolonal cells?

A

cells are defined as a group of cells produced from a single ancestral cell by repeated cellular replication.

Thus they can be said to form a single “clone”.

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15
Q

A neoplasm emerges from this monoclonal population through a process called _________characterised by the accumulation of yet more mutations.

A

progression

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16
Q

how do we know neoplasms r monoclonal?

A

A collection of cells is monoclonal if they all originated from a SINGLE FOUNDING CELL.

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17
Q

what is lyonization

A

“X-inactivation “

is a process by which one of the copies of the X chromosome present in female mammals is inactivated.

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18
Q

protooncogene vs ocongene

A

Proto-oncogene: A normal gene which, when altered by mutation, becomes an oncogene that can contribute to cancer.

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19
Q

what 3 things do u take into account when naming neoplasm?

A

neoplasm’s ….

1) site of origin
2) benign or malignant
3) type of tissue the tumour forms

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20
Q

Difference in naming benign and maligannt tumors.

A

Benign–oma.

Malignant

–carcinoma if it is an epithelial malignant neoplasm, ( which constitute 90% malignant tumours)

or

–sarcoma if it is a stromal malignant

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21
Q

Malignant ones end in _________if it is an epithelial malignant neoplasm, which constitute 90% malignant tumours,

A

–carcinoma

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22
Q

what is it meant when we say the carcinoma is “in-situ” or “invasive”

A

in-situ >>> no invasion of epithelial basement membrane invasive >>> penetrated through basement membrane

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23
Q

what is Leukaemia?

A

malignant neoplasm of blood-forming cells arising in the bone marrow

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24
Q

what is a lymphoma? myeloma?

A

lymphomas are malignant neoplasms of lymphocytes, mainly affecting lymph nodes.

Myeloma is malignant neoplasm of plasma cells

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25
Q

_____________neoplasm arise from pluripotent cells, mainly in the testis or ovary.

A

germ cell neoplasms

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26
Q

A _________ is a type of cancer, more common in children, that is caused by malignancies in precursor cells, often called blasts. give 3 examples

A

“-blastomas”

nephroblastoma, medulloblastoma and retinoblastoma.

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27
Q

which types of genes r involved in neoplasm? 2

A

Proto- Oncogenes become abnormally activated (where they’re called oncogenes. tumor supressor genes become in activated!

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28
Q

what is the difference btw Osteoma and osteosarcoma

A

Osteoma>>benign bone tumour

osteosarcoma >>malignant bone tumour.

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29
Q

examples of germ cell neoplasms (2)

A

GERM CELL NEOPLASMS

1) Testis Malignant teratoma Seminoma (a malignant neoplasm)
2) Ovary Benign teratoma = dermoid cyst

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30
Q

how do cells invade and metastisise? 3

A

For malignant cells to get from a primary site to a secondary site they must:

(1) grow and invade at the primary site
(2) enter a transport system and lodge at a secondary site;
(3) grow at the secondary site to form a new tumour (colonisation)
* ***at every point the cells must AVOID being destroyed by the immune system.*

31
Q

The ability of malignant cells to invade and spread to distant sites leads to a greatly increased ________

A

tumour burden.

32
Q

INVASION INVOLVES 3 IMPORTANT ALTERATIONS: describe each

A

for carcinoma cells:

  • altered adhesion:
  • stromal proteolysis
  • motility actin cytoskeleton changes
33
Q

what is transcoelomic spread.

A

when malignant cells reach their sites via:

fluid in body cavities (pleura, peritoneal, pericardial and brain ventricles)

34
Q

what is meant by tumour dormancy

A

Dormancy is a stage in cancer progression where the cells cease dividing but survive in a quiescent state while waiting for appropriate environmental conditions to begin proliferation again

ga3deen imba96een

35
Q

what is meant by tumour dormancy? what may cause it

A

when a disease free person can have many micro metastases.

  • immune attack
  • could be due to the niche at the primary site is different than the niche at the secondary site and the cancer cells can’t undergo ANGIOGENESIS &; become HOSTILE
36
Q

what determines the site of a secondary tumour?

A

(1) regional drainage of blood, lymph or coelomic fluid
(2) The “seed and soil” phenomenon, which may explain the seemingly unpredictable distribution of blood- borne metastases, is due to interactions between malignant cells and the local tumour environment at the secondary site.

37
Q

what is the “seed and soil” phenomenon,

A

The “seed and soil” phenomenon, which may explain the seemingly unpredictable distribution of blood- borne metastases, is due to interactions between malignant cells and the local tumour environment at the secondary site.

SEED>> tumours

SOIL>> the niche at the secondary site (whether the seed will grow or not depends on the soil!)

38
Q

_________typically spread first to draining lymph nodes & then to blood-borne distant sites.

A

Carcinomas (an epithelial malignant neoplasm)

39
Q

what r common sites of blood-borne metastasis?

A

LBLB

lungs, bone, liver, brain

40
Q

the neoplasms that r located in the (5 organs) r most frequently spread to BONE. which one commonly cause lytic and which sclerotic lesions?

A

breast, bronchus, kidney, thyroid, prostate

41
Q

what r the effects of neoplasms? (2 categories)

A

1) Local effects (direct) -primary neoplasm -secondary neoplasm
2) systemic effects (indirect) -effects of increasing tumour burden -secreted hormones -miscellaneous effects

42
Q

what r paraneoplastic syndromes

A

A paraneoplastic syndrome is a syndrome (a set of signs and symptoms) that is the consequence of cancer in the body

BUUTT,

unlike mass effect, its NOT due to the local PRESENCE of cancer cells. In contrast, they r mediated by humoral factors (ex hormones or cytokines) excreted by tumor cells or by an immune response against the tumor.

43
Q

the local effects of primary and secondary neoplasms are due to:

A

(1) direct invasion and destruction of normal tissue; (2) ulceration at a surface leading to bleeding; (3) compression of adjacent structures (4) blocking tubes and orifices

44
Q

what r the systemic effects of neoplasms?

A

u get increased tumour burden leading to a parasitic effect on the host.

it also secretes factors such as cytokines>>cause weight loss and reduced appetite (cachexia), malaise (unwell), immunosuppression, thrombosis.

45
Q

examples of Miscellaneous systemic effects?

A

neuropathies affecting the brain and peripheral nerves, skin problems such as pruritis and abnormal pigmentation, fever, and myositis (inflammation of muscle tissue)

46
Q

what r the systemic effects of neoplasms?

A
  • Endocrine – hormone production by an endocrine tumour, ectopic hormone production
  • Haematological, e.g., anaemia, thrombosis, DIC
  • Neurological
  • Dermatological
  • General effects – cachexia, malaise, immunosuppression, fever, finger clubbing, hypercalcaemia
47
Q

what is the EMT? “epithelial-to- mesenchymal transition”

A

during invasion, the carcinoma undergoes alterations (altered adhesion, proteolysis. motility)>> when then have these alterations,

they undergo a phenotypic change which makes the carcinoma (epithelial cell) look like a mesenchymal cell!

48
Q

what causes EMT?

A

altered adhesion, proteolysis. motility

49
Q

In altered adhesion, adhesion btw malignant cells involves_______ & btw malignant cell & ; stromal proteins______. -signalling through_____ is crucial and occurs via small g proteins such as changes in the _____family

A

E-cadherin integrin integrin rho

50
Q

how do the malignant cells undergo proteolysis? why must this occur

A

they undergo alteration in their expressions of proteases. MMP> matrix metalloproteases they need to destroy the basement membrane in order to invade!

51
Q

describe what a Niche is? why is it important to the carcinoma?

A

malignant cells release various factors that co-opt neighbouring cells such as: -stroma -fibroblasts -endothelial cells -inflammatory cells forming a NICHE! its these cells that release proteases that enable the cancer cells to actually MIGRATE.

52
Q

what is a micro metastases?

A

During colonisation, tiny clusters of cells fail to grow & r lodged at its place > NOT YET died & r just sitting there by the “DOOR” waiting for some opportunity so they can leave! they r about 10-20 cells, so little! thats why we can detect them! & patient doesn’t know they’ve got em! this is why we never tell a patient that has been cured from cancer that they have been 100% cured!! cuz they might have risk of micro metastases. ***we can think of a micrometasteses as a ticking bomb waiting to go off! Micrometasteses represent a form of TUMOR DORMANCY..get it? door? lol they’re just sitting there dormant

53
Q

tumour cells have their own personalities and each type differs, some may be aggressive, some may not. give examples for each

A

-small cell BRONCHIOL carcinoma is so aggressive! -basal cell carcinoma not that much.

54
Q

give an example of a carcinoma that rarely metastasises!

A

basal cell carcinoma!

55
Q

what is Rhabdomyosarcoma (RMS)

A

is a cancer made up of cells that normally develop into skeletal muscles.

56
Q

what is Choriocarcinoma?

A

a malignant tumour of the uterus which originated in the fetus CHORION the outermost membrane surrounding an embryo. it contributes to the formation of the placenta

57
Q

which ones r malignant? a) multiple myeloma b) neurofibroma c) meningioma d) osteosarcoma e) lymphoma

A

a d e

58
Q

which of following are typical characteristics of benign neoplasms

a) contain abnormal mitotic figures
b) have diploid DNA
c) maintain structural differentiation
d) show diffuse invasion through surrounding tissues
e) give rise to metastases

A

b) have diploid DNA
c) maintain structural differentiation

59
Q

what is an adenocarcinoma? Adenocarcinomas..

a) may produce mucin
b) can occur in the thyroid gland
c) contain neurosecretory granules
d) form glandular acini
e) contain intracytoplasmic cytokeratin

A

a malignant tumour formed from glandular structures of epithelial cells

everything except C.

60
Q

Tumours of soft tissue……

a) are more often malignant than benign
b) often arise at sites of injury
c) are classified by the tissue of origin
d) present with symptoms specific to their histological type
e) if malignant are referred to as sarcomas

A

c) are classified by the tissue of origin
e) if malignant are referred to as sarcomas

61
Q

Features of dysplasia include which ones?

a) loss of normal maturation
b) uniformity of cell shape and size
c) increased mitotic activity
d) penetration through basement membrane
e) high nuclear/cytoplasmic ratio

A

a) loss of normal maturation
c) increased mitotic activity
e) high nuclear/cytoplasmic ratio

dysplasia: pre-neoplastic alteration in which cells show disordered tissue organisation.

62
Q

sarcomas frequently metastasise via the______

A

blood stream

63
Q

the ovaries are a recognised site of metastasis from _______cancer

A

gastric

64
Q

Features of the transformed phenotype include:

a) loss of contact inhibition
b) reduced mitotic activity
c) complex nutritional requirements
d) short life span
e) loss of density dependent growth inhibition

A

a) loss of contact inhibition
e) loss of density dependent growth inhibition

65
Q

Describe the” microscope appearance” of benign and malignant neoplasms. and there differences in differentiation ***Clinicians use the term _____ to indicate differentiation. high/low? ___ being poorly differentiated.

A

A benign neoplasm cells closely resemble the parent tissue, i.e. they are WELL differentiated. Malignant neoplasms range from well to poorly differentiated

***With worsening differentiation individual cells have ICREASED: nuclear size, nuclear to cytoplasmic ratio, nuclear staining (hyperchromasia),mitotic figures and variation in size and shape of cells and nuclei, which is called pleomorphism.

GRADE. High grade

66
Q

How do we know neoplasms are monoclonal?

A

A benign neoplasm cells closely resemble the parent tissue, i.e. they are WELL differentiated. Malignant neoplasms range from well to poorly differentiated

67
Q

give some examples of malignant tumors related to endocrine function

A

Bronchial small cell carcinoma>> produce ACTH or ADH

Bronchial Squamous cell carcinoma>> Produce PTH-like hormone.

68
Q

What is an anaplastic tumour?

A

Anaplastic means very POORLY DIFFERENTIATED

69
Q

Which cancer occurs mostly in men in the UK?

A

Prostate! Order>> prostate-lungs-colon-bladder-lymphoma

70
Q

Which cancer occurs mostly in wommen in the UK?

A

Breast

71
Q

what is a sarcoma?

A

A sarcoma is a cancer that originates from cells which occur in and make supporting tissues (connective tissues) of the body.

72
Q

what r tumor supressor genes? what happens to them in neoplasia? give an example of one?

A

which normally suppress neoplasm formation, become inactivated.

P53! gardian of the genome!

73
Q

yas

A

Pathology-Alaa (16 decks)

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