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Year 3 Lecture Content > Neoplasia 1+2 > Flashcards

Neoplasia 1+2 Flashcards

1
Q

Define the following:

Tumour

Neoplasm

Benign

Malignant

Cancer

Metastasis

A
  • Tumour - Mass or swelling
  • Neoplasm Abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change
  • Benign Neoplasm which is localised and cannot spread
  • Malignant Neoplasm that can invade and destroy adjacent structures and spread to distant sites
  • Cancer Malignant neoplasm
  • Metastasis Spread of a cancer to a distant site
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2
Q

What are the different types of cell turnover before they become neoplasia?

A

1) Normal cell turnover - healing and repair - tissue has regained - proliferation ceases (no mutation)
2) Clinically irrelevant mutation - a cell mutates but no survival advantage - do not dominate over normal cell so get out competed
3) Benign neoplasia - In the pre-tumoural stage neoplastic mutations are present in the tissue, but have not yet given rise to a tumour. These are typically clinically silent. Neoplastic clone - dominate tisse but no malignant capability = benign

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3
Q

Benign neoplasms

what are they and when can they become clinically relevant?

A

Benign tumours remain limited to the site of origin, show expansive growth and do not metastasize. Often clinically irrelevant, but may cause

– Compression (e.g. meningeal neoplasm)

– Obstruction (e.g. bile duct neoplasm)

– Bleeding (e.g. colon neoplasm)

– Hormone secretion (e.g. thyroid neoplasm)

– Cosmetic effects (e.g. skin neoplasm)

– Progression to malignancy (e.g. colon neoplasm)

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4
Q

This is usually something that is asymptomatic but can become a space occopying lesion.

what is it?

A

Meningioma

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5
Q

it is a firm or rubbery, homogeneous, round or oval tumor that is surrounded by a thin fibrous capsule.

it is felt in the neck.

What is this?

A

Thyroid follicular adenoma

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6
Q

What is this showing?

It occurs due to being exposed to the sun a lot

Ranges in color from light tan to brown or black

Is round or oval shaped

Has a characteristic “pasted on” look

Is flat or slightly raised with a scaly surface

Ranges in size from very small to more than 1 inch (2.5 centimeters) across

May itch

What is this called?

A

Seborrhoeic keratosis

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7
Q

What does this person have?

What is the type of tumour

A

Tubular adenoma of the colon with low grade dysplasia

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8
Q

what is in situ neoplasia?

A
  • Some mutations (arising either de novo or in a benign neoplasm) give cells malignant capacity.
  • The malignant phenotype comes to dominate the tissue, but so far the cells have not actually invaded the basement membrane (in situ malignancy).
  • has malignant potential but not yet invaded
  • Precancerous
  • Complete excision is curative
  • Asymptomatic
  • Good for screening programmes
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9
Q

What is this showing?

This is found on routine pap smear

A

Carcinoma in situ

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10
Q

What is this?

There is a painless breast lump with slight bloody discharge

A

Ductal carcinoma in situ of breast

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11
Q

What is canceR?

A

Cells with malignant phenotype invade local structures and spread through tissues (invasive malignancy; “cancer”).

  • malignant neoplasm
  • invade and destroy adjacent tissue
  • metastasise distally which destroy tissue
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12
Q

What are the hallmarks of cancer?

A
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13
Q

What are the most common cancers for males?

What are the most cmmon cancers for females?

A

Males: Prostate, lung, bowel, head and neck, bladder

Females: Breast, lung, bwel, uterus, ovary

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14
Q

What are the routes of metastasis

A
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15
Q

Elderly man with long term smoking comes with this what doe they have?

A

Primary lung cancer with nodal metastases

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16
Q

Where has this lung cancer metastasised too?

A

Liver, bone and pleura

17
Q

Pathogenesis of cancer consists of genetic and environmental - give examples of both

A

Genetics

  • Inherited cancer syndromes (e.g. Li Fraumeni synd)

– ‘Familial cancers’: cancers occurring at higher frequency in some families without a clearly defined pattern of transmission

Environmental factors:

– UV rays – Ionising radiation – Viruses – Tissue inflammation – Occupational exposure (eg asbestos) – Carcinogens (eg vinyl chloride, cyclophosphamide)

18
Q

Clinical effects of cancer

A

Compression, obstruction, bleeding, cosmetic

  • Local destruction of tissues
  • Paraneoplastic syndromes – Hormone mediated (e.g. Cushing syndrome caused by ACTH/ACTH-like substance produced by lung cancer) – Immunologically mediated (e.g. Lambert-Eaton syndrome caused by antibodies against pre-synaptic voltage-gated calcium channels at the NMJ, causing severe muscle weakness)
  • Cachexia (TNF,IL1.INF gamma, leukemia inhib factor(LIF) produced by peritumoural macrophages and some tumour cells mobilises fat from tissues and suppresses appetite)
  • Pain • Death
19
Q

What does this person have

A

Post-auricular skin cancer

20
Q

What is the this person have?

persistent change in your bowel habits, including diarrhea or constipation or a change in the consistency of your stool. Rectal bleeding or blood in your stool. Persistent abdominal discomfort, such as cramps, gas or pain

A

Colorectal cancer causing obstruction

21
Q

What is the difference between

cytology, biopsy, excison

What type of examination can be performed?

A
  1. Cytology (a fluid sample of the tumour) 2. Biopsy (a solid sample of the tumour) 3. Excision (surgical removal of the whole tumour).

Types of examinations performed

  1. Macroscopic examination 2. Microscopic examination 3. Special tests (immunohistochemistry, FISH, PCR…)
22
Q

Role of the histopathologist in managing neoplasia

A
  • Provide a diagnosis – Benign / In situ / Malignant – Classification
  • Provide prognostic information – Tumour grade, vascular invasion, perineural invasion, extent of invasion, tumour stage
  • Provide predictive information – Testing the neoplasm for markers of responsiveness to specific therapies
  • Screening
23
Q

Which of these are benign and which are malignant?

A

sessile, pedunculated and papillary tumour - benign

fungating, ulcerated and annular - malignant

24
Q

what makes this a malignant neplasm

A

The colon is ulcerated

25
Q
A
26
Q

How are cancers classified

A
  • Behaviour and site – E.g. benign neoplasm of the colon – E.g. malignant neoplasm of the breast
  • Cell of origin – E.g. benign epithelial neoplasm of the colon – E.g. malignant mesenchymal neoplasm of the breast
27
Q

What can be seen here and is it malignant or benign?

A

Malignant

Nuclear hyperchromasia: Dark staining of the nucleus

Nuclear pleomorphism: Variability in size and shape of the nucleus

28
Q

Neoplasms and non neoplastic mass formin lesions have what suffix?

Malignant neoplasm of epithelial origin have what suffix

malignant neplasm of mesenchymal origin have what suffix

A

-oma

carcinoma - malignant neoplasm of epithelial origin

Sarcoma - mesenchymal origin

29
Q
A
30
Q

Pathological prognostic features of cancer

A
  • Tumour invasiveness – Depth of invasion, vascular invasion, perineural invasion - Depth of invasion of malignant melanoma (“Breslow depth”) is an important prognostic factor.
  • Grade – Degree of histological resemblance to the parent tissue
  • Stage – Extent of anatomical spread
31
Q

what is used for tumour grade?

A
32
Q

what gleason score do these prostatic adenocarcinoma have

A
33
Q

Gleason score -> how is this used to find the prognostic factor for prostatic adenocarcinoma

A

Gleason score (sum of the two commonest Gleason patterns in a tumour, e.g. 3+4) is an important prognostic factor in prostatic adenocarcinoma

34
Q

TNM stands fr

A

TNM is the globally recognised system used for most tumours

– T: Size of tumour and extent of local invasion

– N: Degree of spread to regional lymph nodes

– M: Presence or absence of distant metastases

35
Q

TNM Staging of colorectal carcinomas

what aother staging can be used

A

Duke staging (5 year prognosis)

Stage A - 90%

B - 40%

C- 10%

D metastatic disease

36
Q

Predictive testing: examples

A

Immunohistochemistry for hormone receptors in breast cancer

  • Fluorescence in situ hybridisation (FISH) for gene rearrangements in lung cancer (good for looking at amplification - looks for HER2 and look for gene rearrangement - look for chromosomal instability)
  • PCR-based methods for mutations in colorectal cancer - ras and b ras
37
Q

What type of cancers is screening good for?

A
38
Q

what does this person have

A

Cervical intraepithelial neoplasm

Year 3 Lecture Content (33 decks)

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