Neoplasia 1: introduction

Question 1

Division of tumors

Answer 1

• Benign
• Malignant
• Local (intermediate) tumor

Question 2

comapre between Neoplasia & Hyperplasia

Answer 2

• hyperplasia is purposeful & useful, neoplasia is purposless & harmful
• Hyperlasia is caused by stimulus (irritation), neoplasia may not be caused by stimulus
• Hyperplasia is reversible when stimulus is removed, neoplasia is irreversible & doesnt stop (unlimited)
• Neoplasia has abdnormal cytology
• Hyperplasia is multi-focal (many cell sources), neoplasia is unifocal (one cell source)

Question 3

general difference in benign tumors from malignant tumors

Answer 3

more gentically stable, with little to no changes in phenotype

Question 4

Most benign tumors are capsulated except ____

Answer 4

• Leiomyoma (in uterus)
• papilloma
• ivory osteoma

Question 5

describe gross pathology of benign tumors

Answer 5

• Well circumscribed (defined) globular masses
• Mostly capsulated
• cut section shows no (rare) hemorrhage or necrosis

Question 6

define cell differentiation

Answer 6

extend by which a tumor cell resembles comparable normal cell

Question 7

define tissue (histological) differentiation

Answer 7

degree of resemblance of structural pattern between tumor mass and normal tissue

Question 8

describe cell differentiation & histological differnetiation of benign tumors

Answer 8

• perfect cell differentiation (mimics normal cell)
• similar to normal tissue in histological differentiation

Question 9

rate of growth of benign tumors

Answer 9

slow

Question 10

local invation & metastis of benign tumors

Answer 10

doesn’t have the capacity to invade, infiltrate or metatstasize

Question 11

prognosis of benign tumors

Answer 11

• good prognosis overall
• most benign tumors don’t recur if well excised

Question 12

when does benign tumor prognosis becomes not good/ where does it have serious effects

Answer 12

• Brain: pressure on vital centers
• B cells of islets of langerhans of pancreas: secrete excess hormones (insulin) which leads to hyperinsulinism
• Pituitary gland: pressure on trophic cells
• Larynx or intestine (hollow organ): obstruction
• transform into Malignant tumor

Question 13

gross pathology of Malignant tumors

Answer 13

• Ill defined infiltrating margins
• with hemorrhage & necrosis
• irregular
• non-capsulated

Question 14

Microscopic morphology of malignant tumors

Answer 14

Anaplasia/cellular Atypia:
* cellular & nuclear Pleomorphism
* hyperchromatism of nucleus
* enlargement of nucleus (N/C=1:1)
* Nucleoli may be prominent
* Abdundant mitosis
* Abnormal mitotic figures
* Tumor giant cell containing polypoid nucleus or multiple nuclei

Question 15

Histological differentiation of malignent tumor

Answer 15

loss of polarity:
* total loss of common structure with no recognisable pattern of orientation

Question 16

Rate of growth of malignant tumors

Answer 16

rapid

Question 17

spread of maligant tumors

Answer 17

• infiltration, invasion destruction & metastis

Question 18

what should the surgeon take into account when removing a maligenant tumor

Answer 18

• remove the tumor with a wide safety margin
• Examine the edge of the margin for any cancer cells

Question 19

Define Metastis

Answer 19

Secondary implantation of the tumor that is discontinuous with the primary (source of) tumor, located in remote tissues

Question 20

most common form of malignancy

Answer 20

Carcinoma

Question 21

site of Carcinomas

Answer 21

epithelium

Question 22

prognosis of Carcinoma

Answer 22

better than sarcoma

Question 23

most common age group for Carcinoma

Answer 23

above 40 (old)

Question 24

gross morphology of Carcinomas

Answer 24

• hard consistency
• greyish color
• smaller than sarcoma
• with irregular infiltrating growth
• less necrosis & hemorrhage than sarcoma

Question 25

Microscopy morphology of Carcinomas

Answer 25

• Cellular anaplasia atypia, however less than Sarcoma
• CT surrounds group of cells= Cell Cohesion
• Less blood vessels & better formed vessles than in Sarcoma (less hemorrhage)

Question 26

site of Sarcoma

Answer 26

Mesenchyme

Question 27

most common age group of sarcoma patients

Answer 27

young (below 20)

Question 28

mode of growth of Carcinoma

Answer 28

mainly infiltrative, but also expansile

Question 29

Mode of growth of Sarcoma

Answer 29

Expansile

Question 30

Gross morphology of Sarcoma

Answer 30

• tinged Pink color (due to richer vascularity)
• soft & fleshy consistency
• Large bulky mass (expansile)

Question 31

Microscopic Morphology of Sarcoma

Answer 31

• worse Cellular anaplasia atypia than carcinoma
• No cell cohesion= CT surrounds indivisual cells
• more & thin walled blood vessels than Carcinoma
• Hemorrhage
• Necrosis
• secondary Hylaine myxomatous degeneration

Question 32

Compare between distant spread of Sarcoma & Carcinoma

Answer 32

Carcinoma:
* Lymphatics first then blood
* slower than sarcoma

Sarcoma:
* Blood first then lymphatics
* Faster than carcinoma

Question 33

which malignancy has the worst prognosis

Answer 33

Sarcoma

Question 34

which malignancy grows fastest

Answer 34

Sarcoma

Question 35

which malignancy can grow by infilration

Answer 35

Carcinoma

Question 36

which malignancy has cell cohesion (CT surrounds group of cells)

Answer 36

Carcinoma

Question 37

which malignancy is hard

Answer 37

Carcinoma

Question 38

which malignancy spreads early by blood

Answer 38

Sarcoma

Question 39

Charactaristics of Intermediate (locally malignant) tumors

Answer 39

3 good:
* better prognosis than malignant tumors
* Locally invasive
* rarely metastasizes

1 bad:
* recurrance after surgical removal

Question 40

Enumerate examples of intermediate tumors

Answer 40

BAGCCC
1. Basal cells carcinoma of skin
2. Ameloblastoma/Adamantinoma
3. Giant cell tumor of bone (osteoclastoma)
4. Carcinoid tumor (neuroendocrine)
5. Craniopharyngioma (CNS)
6. Chordoma