Neoplasia 1

Question 1

What is a tumour?

Answer 1

Swelling (any clinically detectable lump or swelling)

Question 2

Define neoplasm

Answer 2

An abnormal growth of cells that persists after initial stimulus is removed; ‘new growth’

Question 3

Define oncology

Answer 3

The study of tumours and neoplasms

Question 4

Define benign neoplasm

Answer 4

Abnormal growth of cells that is grossly and microscopically innocent, will remain localised and won’t spread to other sites

Question 5

Define cancer

Answer 5

A malignant neoplasm (colloquial term)

Question 6

Define malignant neoplasm

Answer 6

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

Question 7

Define metastasis

Answer 7

A malignant neoplasm that has spread from original site to a new non-contiguous site

Question 8

Define dysplasia

Answer 8

Pre-neoplastic alteration in which cells show disordered tissue organisation; reversible

Question 9

What are the two types of malignant neoplasm?

Answer 9

1) Primary = original location

2) Secondary = metastasis

Question 10

What are key characteristics of benign metaplasia?

Answer 10

• Grows in a confined area
• Pushing outer margin
• Rarely dangerous location
• Closely resemble parent tissue (well differentiated)

Question 11

What are key characteristics of malignant metaplasia?

Answer 11

• Invade and have potential to metastasise
• irregular outer margin and shape
• May have ulcerations and necrosis
• Infiltrative
• Ranges from well to poorly differentiated

Question 12

Define what an anaplastic cell mean

Answer 12

Cells with no resemblance to any tissue (poorly differentiated)

Question 13

What are features of worsening differentiation?

Answer 13

• Increasing nuclear size
• Increasing nuclear to cytoplasmic ratio
• Increasing nuclear staining (hyperchromia)
• Increasing mitotic figures
• Abnormal mitotic figures (Mercedes Benz)
• Variation in size and shape of cells and nuclei (polymorphism)

Question 14

What does a high grade metaplasia mean in terms of differentiation?

Answer 14

Poorly differentiated

-based on Gleason’s pattern (breast cancer)

Question 15

What type of differentiation would you see in dysplasia?

Answer 15

Ranges from mild, moderate and severe differentiation

-has not breached basement membrane; not yet invasive

Question 16

What tiggers metaplasia development?

Answer 16

Carcinogens and non-lethal genetic damage

Question 17

Briefly describe the development of a neoplasm

Answer 17

1) Accumulation of mutations in somatic cells
- mutations from initiators (mutagenic agents)
2) Promoters cause proliferation
3) Tumour formed by clonal expansion of a single cell that has incurred genetic damage

Question 18

List examples of initiators

Answer 18

• Chemicals e.g. smoking, alcohol, diet and obesity
• Infectious agents e.g. HPV
• Radiation
• Inherited mutations

Question 19

Define the term monoclonal

Answer 19

A collection of cells that originated from a single founding cell

Question 20

Define progression in terms of neoplastic development

Answer 20

Accumulation of mutations

Question 21

What are the genes affected in neoplastic development?

Answer 21

1) Proto-oncogenes = drive proliferation and can activate a new function
2) Tumour suppressor genes = usually stop cell proliferation but mutation leads to failure of growth inhibition
3) Apoptosis regulating gene = mutations result in less cell death and enhanced survival
4) DNA repair genes = impaired ability to recognise and repair non-lethal genetic damage

Question 22

What are the general rules of naming a neoplasm?

Answer 22

Benign = end in -oma
Malignant = end in carcinoma (epithelial) or sarcoma (stromal)