Neoplasia Flashcards

1
Q

Whata are th features of cancer cells

A
  • Increased nuclear to cytoplasmic ratio
  • nuclear pleomorphism
  • nuclear hyperchromasia
  • prominent nucleoli
  • increased mitotic activity
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2
Q

What is an increased nuclear to cytoplasmic ratio

A

Large nuclei with little cytoplasm

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3
Q

What is a nuclear pleomorphism

A

Variation in nuclear size and shape

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4
Q

What is a nuclear hyperchromasia

A

Dark staining nuclei

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5
Q

What is a prominent nuceoli

A

Large nuceoli

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6
Q

What is a increased mitotic activtiy

A

Increased cell proliferation

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7
Q

How many cells does cancer arise from

A

One cell

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8
Q

When a normal cell recieves the initiating mutation what happens to it

A

It becomes a precursor cell with stem cell like properities

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9
Q

What happens to a precursor cell

A

Accumulates mutations and becomes a cancer cell

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10
Q

What will happen to the cancer cell

A

Accumulate mutatios and grow to form a tumour with different subclones

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11
Q

What is a tumour

A

A mass of swelling

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12
Q

What is a neoplasm

A

Abnormal mass of tissue which the growth exceeds and persits even when the stimuli is removed

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13
Q

What does benign mean

A

Has no harm.

Localised and does not spread

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14
Q

What does malignant mean

A

Can spread to distant sites and invade adjacent structures

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15
Q

What does cancer mean

A

Malignant neoplasm

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16
Q

What is metastasis

A

Spread of cancer to distant sites

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17
Q

What is the gross appearance of a benign neoplasm

A

Well circumscribed

Small

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18
Q

What is the gross apperance of a malignant neoplasm

A
Irregular
Generally large
Haemmorhage 
Ulceration
Necrosis
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19
Q

What is the microscopic feature of a benign neoplasm

A
Normal nuclear size
Small/inconspicuous nucleoli 
Absenrt pleomorphism
Infrequent mitoses
Good differentiation
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20
Q

What is the microscopic feature of malignant neoplasm

A
Enlarged nuclear size
Prominent nucleoli
Marked pleomorphism 
Frequent mitoses
Varirable differentiation
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21
Q

What is the growth speed of a benign neoplasm

A

Slow

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22
Q

What is the growth speed of a malignant neoplasm

A

Fast

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23
Q

What are the main steps a tumour has to undergo to become a tumour

A
  1. Loosening of cell junctions
  2. Degradation of the extracellular matrix
  3. Migration of tumour cells
  4. Invade the wall of the blood vessel to enter the blood
  5. Form a tumour plug (thrombus around it)
  6. Extravasation to form a metastatic tumour deposit
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24
Q

Hwo are cell juntions loosened

A
  • e cadherin mutations occurs to loosen the cell junction of cells so its easier for the cell to become detaches off from the epithelium
  • epithelial mesenchymal transition occurs
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25
Q

What is the epithelial mesenchymal transition

A

Epithelial cells become mesenchymal cells to gain motiliy

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26
Q

Why is the extracellular matrix degraded

A

Once the cell detaches it needs to invade the stroma and extracellular matrix

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27
Q

How is the extracellular matrix degraded

A

Matrix metalloproteinases (MMPs)
Cathepsin d
Urokinase plasminogen activator

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28
Q

How do cells migrate

A

By contraction of the actin cytoskeleton

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29
Q

What is a perineural invasion

A

When tumour cells not only invade the stroma but nerves too

30
Q

What does perineural invasion show clinically

A
  • cancer associated pain
  • disability if the surgeon has to cut the nerve during surgery
  • regrowth of the tumour if the surgeon fails to remove it
31
Q

What are the 3 main metastasis route

A
  1. Lymphatic spread
  2. Haematogenous spread
  3. Seeding of body cavity
32
Q

How does lymphatic spread occur

A
  1. When the tumour enters a lymphatic space
  2. This allows spread to lymph nodes
  3. Lymph nodes act as a trap to trap the tumour
  4. Tumour grows in the lymph node
33
Q

If the lymphatic sprea if prominent what can it give rise to

A

Lymphangitis carcinomatosa (lymphatic are full of tumour cells)

34
Q

In haematogenous spread what type of vessel is most affected and why

A

Veins- they have thinner walls

35
Q

What is seeding of body cavities in metasises

A

Tumours metasise by seeding the body cavity

36
Q

Which organs frequently recieve metastasis

A

Liver
Lungs
Brain
Bone marrow

37
Q

Which tumours can metastase to bone

A
Lung 
Breast 
Prostate
Thyroid 
Kidney
38
Q

What can bone metasises by

A

Lytic

Sclerotic

39
Q

What is lytic bone metasise

A

bone is destroyed

40
Q

What is sclerotic bone metasises

A

New bone is formed in repsonce to the tumout

41
Q

What does staging a tumour relate to

A

The spread, extent of invasion

42
Q

What is the most common staging system used

A

TNM

43
Q

What does staging give a indication of

A

Prognosis of the cancer

44
Q

What are the risk factors for neoplasia

A
Inherited genetic predisposition 
Age
Enviromental 
Chronic inflammation 
Dysplasia and carcinoma in situ
45
Q

What are some enviromental factors

A
Smoking 
Alcohol
Diet and obesity
Infection 
Reproduction 
Occupation e.g asbestos
46
Q

What is dysplasia

A

Disordered cell growth due to accumulation of non lethal mutation (resembled malignant cells but are not invasive)

47
Q

What role does the immune response play in fighting off cancer

A
  1. Tumour cells produce abnormal proteins
  2. These are recognsied as foregin by the immune system
  3. Tumour antigens are phagocytosed by dendritic cells and presented to the t cell in the lymph nodes
  4. T cells are acitvated and migrate to the tumour to attack it.
48
Q

What does differentiation mean

A

How well cancer resembles its origin of cell

49
Q

What is grading

A

A numericla value to differentiation

50
Q

What is grade 1

A

Well differentiated

51
Q

What is grade 2

A

Moderately differentiated

52
Q

What si grade 3

A

Poorly differenitiated

53
Q

What are undifferentiated tumours

A

Tumours that are poorly differentiated that it is impossible to tell what their origin is

54
Q

What can we use to identify undifferentiated tumours

A

Immunohistochemistry

55
Q

What is immunohistochemistry

A

Using antibodies that are coloured and if they bind to the antigen it stains

56
Q

How are neoplasms classified

A

They are classed into the tissue origin i.e epithelium or mesenchymal. They are then subdivided into benign or malignant

57
Q

What pre-fix do benign neoplasms end in

A

-oma

58
Q

What pre-fix do malignant neoplasms end in if they have a epithelium origin

A

Carcinoma

59
Q

What pre-fix do malignant mesenchymal neoplasms end in

A
  • Sarcoma
60
Q

What are the other ways of classifying neoplasms

A
  • histological apperance

- molecular classification

61
Q

Name an example of a cancer that is classed accordingly to its histological apperance

A

Thyroid carcnoma

62
Q

What are the 3 classification of thyroid carcinoma

A

Papillary thyroid carcinoma
Follicular thyroid carcinoma
Anaplastic thyroid carcinoma

63
Q

Which histological subtype of thyroid carcinoma has a good prognosis

A

Papillary thyroid carcinoma

64
Q

Which histological subtype of thyroid carcinoma has a poor prognosis

A

Anaplastic thyroid carcinoma

65
Q

What is the route of spread of papillary thyroid carcinoma

A

Lymphatic

66
Q

What is the route of spread of follicular thyroid carcinoma

A

Haematogenous

67
Q

What is the route of spread of anaplastic thyroid carcinoma

A

Local invasion

68
Q

What are teratomas

A

Neoplasms derived from embryonic germ cells (can occur in the testis and ovaries)

69
Q

What are embryonic tumours

A

These arise during development

70
Q

What are hamatomas

A

Tumour like malformation, they present at birth but stop growing when the person stops growing