Neoplasia 1

Question 1

a tumour

Answer 1

a swelling (any clinical detectable lump or swelling)

Question 2

neoplasm

Answer 2

‘ a neoplasm is an abnormal growth of cells that persists after the initial stimulus is removed’ - new growth - just one type of tumour

Question 3

oncology

Answer 3

study of tumours and neoplasm

Question 4

hyperplasia

Answer 4

increase in cell number

Question 5

hypertrophy

Answer 5

increase in cell size

Question 6

regeneration

Answer 6

return to normal mechanisms e.g. the liver

• stimulated by GF

Question 7

benign neoplasia

Answer 7

gross and microscopic appearances are considered to be innocent, implying that it will remain localised and not spread to other sites

• less well differentiated

Question 8

cancer

Answer 8

a malignant neoplasm

Question 9

neoplasm

Answer 9

an abnormal growth of cells that persists after the initial stimulus and invades surrounding tissues with the potential to spread to distant sites

Question 10

metastasis

Answer 10

where a malignant neoplasm has spread from its original site to a new non-contiguous site

Question 11

dysplasia

Answer 11

A pre-neoplastic alteration in which the cells how disordered tissue organisation.

Question 12

characteristics of dysplasia

Answer 12

Reversible

Can exhibit considerable pleomorphism, with large hyperchromatic nuclei and high nuclear to cytoplasmic ratio

If detected early it can be prevented from progressing to cancer

Question 13

summary of how a tumour can be defined

Answer 13

Question 14

primary site

Answer 14

original location of malignant neoplasm

Question 15

secondary site

Answer 15

place to which it has spread

Question 16

how do we tell the difference between benign and malignant tumours

Answer 16

1. Behaviour of the tumour
   
   • E.g. if its metastases = probably malignant
2. Appears different to the naked eye
3. Differentiation

Question 17

behaviour of benign neoplasms

Answer 17

• remain confined to their site of origin and do not produce metastases
• Grow in a confined area- capsule
• Pushing outer margin
• Rarely dangerous (depends on location)

Question 18

where could a benign tumour be dangerous

Answer 18

in the brain- confined space

Question 19

behaviour of malignant neoplasms

Answer 19

• invade and have the potential to metastasise
• Irregular outer margin and shape
• May have ulcerations and necrosis
• Infiltrative
• Grow very rapidly

Question 21

definititon of differentitation

Answer 21

process of becoming different by growth or differentiation

Question 22

differentitation and benign tumours

Answer 22

closely resemble the parent tissue- well differentiated

Question 23

differentiation and malignant neoplasms

Answer 23

range from well to poorly differentiated dependent on how closely they resemble the cell origin

Question 24

cells with no resemblance to any tissue are called

Answer 24

anaplastic

Question 25

characteristics of poorly differentiated cells (6)

Answer 25

1. Increased nuclear size 2. Increases nuclear to cytoplasmic size 3. Increased nuclear staining (hyperchromasia) 4. Increased mitotic figures 5. Abnormal mitotic figures 6. Variation in size and shape of cells and nuclei (pleomorphism)

Question 26

what term do clinicians use to indicate differentition

Answer 26

grade - a high grade tumour is usually poorly differentiated

Question 27

melanoma

Answer 27

- poorly differneited - pigment= melanin

Question 28

summary of behaviour of benign tumour

Answer 28

- grows locally - retained functions of their cells of origin

Question 29

histology of benign tumour

Answer 29

- resembles cells/tissue of origin - few mitoses - normal or mild increase in nuclear to cytoplasmic ration - cells are unifrom throughout the tumour

Question 30

summary of behaviour of malignant tumour

Answer 30

- expansive and invasive - potential to metastasise - less likely to retain functions of cells of origin and may soemtimes acquired unexpected functions

Question 31

histology of malignant tumour

Answer 31

- failure ot fully differentiate - many mitoses - high nuclear to cytoplasmic ration - cells/ nuceli vary in size and shape (pleomorphism)

Question 32

pleomorphism

Answer 32

cells/ nuceli vary in size and shape

Question 33

example of grade

Answer 33

grade 1- well differentiated grade 3- poorly differnetiated

Question 34

gradding pattern for the breast

Answer 34

Gleasons pattern

Question 35

the higher the grade

Answer 35

the less liekly to survive

Question 36

dysplasia and differentiation

Answer 36

## Footnote Altered differentiation Not yet invasive Mild, moderate and severe- worsening differentiation

Question 37

Dysplasia in the cervice

Answer 37

**CIN1-** mild dysplasia Malignant changes just affecting lower third of epithelium **CIN2-** moderate dysplasia Lower 2/3rd **CIN3-** severe dysplasia Full thickness of the epithelium

Question 38

why do we get neoplasia (2)

Answer 38

1. Cacrinogenesis 2. Non-lethal genetic damage (can be genetic, can be spontaneous, can be environmental)

Question 39

mutations and neoplasia

Answer 39

* Accumulated mutations in somatic cells * Mutations are caused by initiators- mutagenic agents * Promoters then cause cell proliferation * A tumour is formed by the clonal expansion of a single precursor cell that has incurred genetic damage

Question 40

give 4 intiators

Answer 40

* Chemicals * smoking * alcohol * diet and obesity * Infectious agents * HOV * Radiation * Inherited mutation

Question 41

progression of a normal cell to neoplastic cells due to mutation

Answer 41

1) normal cell population 2) Intiator causes mutation in one cell 3) Mitosis of cell and vertical transmsision of mutation 4) most cells start to have mutation

Question 42

germline mutations

Answer 42

e.g. BRCA1 skips out this progressing stage\*

Question 43

a selection of cell is monoclonal if

Answer 43

they all originated from a single founding cell

Question 44

neoplasms emerges from

Answer 44

this group of cells by a process called progression - characterised by an accumulation of more mutations - mutations may give the cell advanatges such as faster growth

Question 45

4 classes of normal regulatory genes

Answer 45

* Growth promoting **proto-oncogenes** * Growth inhibiting **tumour suppressor genes** * Genes that regulated programmed cell death – **apoptosis** * Genes involved in **DNA repair**

Question 46

proto-oncogenes

Answer 46

- participate in signalling pathwyas which drive proliferation - '**increase in function' mutation** - when mutated become **Oncogenes**

Question 47

oncoge

Question 48

oncogenes

Answer 48

* are created by mutations in proto-oncogenes and encode proteins called oncoproteins that have the ability to promote cell growth in the absence of normal growth promoting signals * They can transform cells despite a normal copy of the same gene * **Oncogenes are dominant over their normal counterparts (allele)**

Question 49

oncogene mutations can be targeted by

Answer 49

inhibitors eg.g. BRAF inhibitor - therefoe eimportnant to identify oncogene causing cancer

Question 50

tumour suppressor genes

Answer 50

* Normal function is to stop cell proliferation * Generally cause a **loss of function** * In most instances **both alleles** must be damaged for transformation to occur * Abnormalities in these genes leads to failure of growth inhibition (e.g. TP53)

Question 51

apoptosis regulating genes

Answer 51

* May acquire abnormalities that result in less cell death and enhanced survival of mutated cells * E.g. follicular B cell lymphoma

Question 52

DNA repair genes

Answer 52

* Loss of function mutations * Contribute indirectly to carcinogenesis * Impair the ability of cell to recognise and repair non-lethal genetic damage in other genes * As a result affected cells acquire mutations at an accelerated rate, a state referred to as a mutator phenotype and is marked by genomic instability