Neoplasia 1+2 Flashcards
Define the following:
Tumour
Neoplasm
Benign
Malignant
Cancer
Metastasis
- 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
What are the different types of cell turnover before they become neoplasia?
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
Benign neoplasms
what are they and when can they become clinically relevant?
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)
This is usually something that is asymptomatic but can become a space occopying lesion.
what is it?
Meningioma
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?
Thyroid follicular adenoma
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?
Seborrhoeic keratosis
What does this person have?
What is the type of tumour
Tubular adenoma of the colon with low grade dysplasia
what is in situ neoplasia?
- 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
What is this showing?
This is found on routine pap smear
Carcinoma in situ
What is this?
There is a painless breast lump with slight bloody discharge
Ductal carcinoma in situ of breast
What is canceR?
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
What are the hallmarks of cancer?
What are the most common cancers for males?
What are the most cmmon cancers for females?
Males: Prostate, lung, bowel, head and neck, bladder
Females: Breast, lung, bwel, uterus, ovary
What are the routes of metastasis
Elderly man with long term smoking comes with this what doe they have?
Primary lung cancer with nodal metastases
Where has this lung cancer metastasised too?
Liver, bone and pleura
Pathogenesis of cancer consists of genetic and environmental - give examples of both
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)
Clinical effects of cancer
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
What does this person have
Post-auricular skin cancer
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
Colorectal cancer causing obstruction
What is the difference between
cytology, biopsy, excison
What type of examination can be performed?
- 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
- Macroscopic examination 2. Microscopic examination 3. Special tests (immunohistochemistry, FISH, PCR…)
Role of the histopathologist in managing neoplasia
- 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
Which of these are benign and which are malignant?
sessile, pedunculated and papillary tumour - benign
fungating, ulcerated and annular - malignant
what makes this a malignant neplasm
The colon is ulcerated
