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FCP > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Neoplasia

A

abnormal proliferation of cells. These cells are unresponsive to typical mechanisms to regulate cell division.

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2
Q

Oncogenesis

A

The development of a tumour

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3
Q

Outline the 3 steps in the development of a malignant tumour

A
  1. Initiation (mutagenesis) - may be inherited/spontaneous/caused by ROS/pathogen
  2. Promotion - promoters themselves are not mutagenic but create a promotive environment where initiated cells have an advantage
  3. Progression - genetic instability increase tumour cell heterogeneity
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4
Q

Mutagenesis

A

the production of genetic mutations

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5
Q

Anaplasia

A

poor cellular differentiation; cells lose their morphological characteristics and their orientation with respect to each other and endothelial cells

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6
Q

What are the most important factors for classification of a tumour as benign vs malignant?

A
  • Differentiation
  • Growth rate
  • Local invasion
  • Metastasis
  • Host consequences
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7
Q

Describe the differentiation shown by benign tumours

A
  • Well-differentiated
  • Similar to tissue of origin
  • Little to no anaplasia
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8
Q

Describe the differentiation shown by malignant tumours

A
  • Lack of differentiation
  • Atypical structure
  • Variable anaplasia
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9
Q

Describe the growth rate of benign tumours

A
  • Slow, progressive growth
  • Rare mitotic figures
  • Normal mitotic figures
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10
Q

Describe the growth rate of malignant tumours

A
  • Slow to rapid growth
  • Many mitotic figures
  • Abnormal mitotic figures
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11
Q

Describe the local invasion of benign tumours

A
  • No invasion
  • Cohesive growth
  • Capsule often present
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12
Q

Describe the local invasion of malignant tumours

A
  • Local infiltration
  • Infiltrative growth
  • Usually no capsule
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13
Q

Describe the metastasis shown by benign tumours

A

No metastasis

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14
Q

Describe the metastasis shown by malignant tumours

A

Frequent metastasis

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15
Q

Describe the host consequences of benign tumours

A

Space occupying lesion- effect depends on location

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16
Q

Describe the host consequences of malignant tumours

A

Life-threatening

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17
Q

Describe the nuclear morphology of benign tumours

A
  • Minimal to mild anisokaryosis
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18
Q

Describe the nuclear morphology of malignant tumours

A
  • Marked anisokaryosis with frequent binucleation/multinucleation
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19
Q

Anisokaryosis

A

Variation in the size of nuclei in the cell

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20
Q

Describe the cellular morphology of benign tumours

A
  • Minimal to mild anisocytosis
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21
Q

Describe the cellular morphology of malignant tumours

A
  • Marked anisocytosis
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22
Q

Anisocytosis

A

Cells that differ from one another in size

23
Q

Describe the nuclear:cytoplasmic ratio of benign tumour cells

A

Normal to reduced

24
Q

Describe the nuclear:cytoplasmic ratio of malignant tumour cells

A

Increased

25
Q

Describe the mitotic count of benign tumour cells

A

Low

26
Q

Describe the mitotic count of metastatic tumour cells

A

High

27
Q

Describe the presence of necrosis in benign tumours

A

Minimal or absent

28
Q

Describe the presence of necrosis in malignant tumours

A

Frequently present

29
Q

Where do malignant tumours invade in their surroundings?

A

Blood and lymphatic vessels

30
Q

What are the common neoplastic lesions seen in practice?

A
  • Mesenchymal
    • connective tissue - fibrosarcoma, fibroma, lipoma
    • endothelium - haemangioma, haemangiosarcoma
    • haematopoietic - lymphoma, leukaemia, histocytoma, MCT
    • muscle - rhabdomyosarcoma
  • Epithelial
    • lining epithelial - SCC, melanoma
    • glandular epithelium - adenocarcinoma
  • Nervous
    • glial cell - astrocytoma, olidodendroglioma, PNST
    • neural cell - ganglioneuroma
31
Q
A

Benign - sebaceous adenoma

32
Q
A

Pre-malignant - Bowenoid carcinoma

Once there has been invasion of the basement membrane, this is considered malignant

33
Q
A

Malignant - squamous cell carcinoma

34
Q

Describe the process of metastasis

A
  • Metastasis: spread of a tumour
  • Cancer cells leave the primary tumour and travel through blood and lymphatic vessels
  • 90% of deaths from cancer are due to cancerous growths at body locations distant from the primary tumour
  • Invasion and metastasis are the major causes of cancer-related morbidity and mortality
35
Q

Pathways of metastasis

A
  • Transcoelomic: cancers that arise on the surface of abdominal and thoracic structures
  • Lymphatic: lymph node closest to the tumour is colonised earliest, and develop the largest tumour masses
  • Haematogenous: tumours generally invade veins rather than arteries as thinner walls. Ultimately enter lungs and liver.
36
Q

The lung is a common site for metastasis of which tumour types

A
  • Osteosarcoma
  • Haemangiosarcoma
  • Melanoma
  • Mammary tumours
  • Others: thyroid, tonsillar, pancreatic
37
Q

The liver, spleen and kidney are common metastatic site for which tumour types?

A
  • Mast cell tumours
  • Haemangiosarcomas
38
Q

Bone is a common metastatic site for which types of tumours?

A
  • Mammary gland tumours
  • Prostatic carcinomas
  • Urinary bladder turnouts
39
Q

Describe the range of effects that may arise from a neoplasia

A
  • Direct effects - space-occupying lesion
  • Indirect effects - paraneoplastic syndrome; these complications might be the main sign
40
Q

Paraneoplastic syndromes

A

Collection of haematological, endocrinological and metabolic complications caused by cancer

41
Q

Describe cancer cachexia

A
  • Wasting syndrome resulting from altered carbohydrate, protein and lipid metabolism
  • Complex pathogenesis due to IL-1, Il-6, TNF-alpha and prostaglandins
42
Q

Describe endocrinopathies as a result of neoplasia

A
  • Endocrine neoplasm: functioning endocrine tumour e.g. insulinoma (beta islet cell carcinoma or adenoma)
  • Non-endocrine neoplasm: hormonally active substance not normally found in the tissue of tumour origin e.g. many tumour cells produce PTH-related protein → causes bone resorption and renal calcium resorption
43
Q

Describe skeletal syndrome associated with cancer

A
  • Hypertrophic pulmonary osteopathy: rapid periostea new bone growth affecting distal limbs; common with lung tumours (primary or metastatic)
  • Myelofibrosis: overgrowth of non-neoplastic fibroblasts in bone marrow, impairing normal haematopoiesis and resulting in cytopenia
44
Q

Describe some common paraneoplastic syndromes

A
  • Cancer cachexia - most common
  • Endocrinopathies
  • Skeletal syndromes
  • Vascular and haematological disorders
  • Epidermal necrosis (Seen with pancreatic and hepatic tumours)
  • Nodular dermatofibrosis (renal adenocarcinoma)
  • Alopecia (pancreatic carcinoma)
  • Exfoliative dermatitis (thymoma)
  • Myasthenia gravis (thymoma, hepatic carcinoma, osteogenic sarcoma)
45
Q

Complete carcinogen

A

an agent that causes both initiation and promotion.

e.g. ionising radiation → direct DNA damage and ROS generation

46
Q

Differentiate between direct-acting and indirect-acting chemical carcinogens

A
  • Direct - effective in the form in which they enter the body
  • Indirect - pro carcinogens that require metabolic activation by enzymes in order to be effective
47
Q

Briefly describe the main mechanisms by which viruses may cause neoplastic transformation

A
  • Direct mechanism
    • dominant oncogene mechanisms - virus contains a mutated gene that drives tumour development
    • Insertional mechanism - virus does not possess its own oncogene, but inserts viral DNA that in turn activates the target cell’s oncogene
    • Hit and run mechanism - viral genome causes neoplasm by transient residence in the target cells (virus causes tumour but isn’t detectable in the tumour afterwards)
  • Indirect mechanism
    • Suppression of immune system
    • Stimulation of target cell proliferation
48
Q

Viral example of hit and run mechanism

A

Bovine papillomavirus

49
Q

Viral example of insertional mechanism

A

Avian leukosis virus

50
Q

Viral example of dominant oncogene mechanism

A

Feline leukaemia retrovirus

Canine papillomavirus

51
Q

How can you diagnose a neoplasm?

A
  • Physical exam and diagnostic imaging → starting point but not enough on its own
  • Cytological exam - examination of cells
  • Histopathological exam - examination of tissue
52
Q

True/false: cytology alone (i.e. from an FNA) is adequate to assess a neoplasm.

A

False

Histopathology is needed - important for diagnosis, but also informs prognosis and treatment plan

53
Q

Describe the information histopathology of a neoplasm can provide

A
  • Tissue architecture
    • Invasion of adjacent issue/vasculature
    • Necrosis
    • Mitotic count
  • Tumour grade
    • Predicts biological behaviour
    • Based on published grading criteria

FCP (34 decks)

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