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Pathology 2420 Part 1 > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

What is Sporadic Cancer?

A

a mutation in a single cell that divides and a tumour develops

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2
Q

What is Hereditary Cancer?

A

a cancer gene mutation that is present in every cell

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3
Q

What is Familial Cancer?

A

Increased risk of cancer in families compared to the general population
- shared genetic and environmental factors

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4
Q

What causes most cancers?

A

genetic abnormalities

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5
Q

What are mutations in genetic material caused by? (4)

A
  • radiation
  • exposure to carcinogens
  • infections
  • failure of cellular proof-reading mechanisms
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6
Q

What does genetic mutations result in?

A
  • loss of regulation over cell growth and proliferation
  • abnormal signaling by an oncogene and tumor suppressor gene
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7
Q

What do Tumour Suppressor genes do? (6)

A
  • inhibit proliferation
  • control cell growth
  • down regulate cell cycle
  • repair DNA
  • Act as a checkpoint for DNA damage
  • Mutations result in loss of function
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8
Q

What do Proto-oncogenes do? (8)

A
  • Code normal proteins that promote:
    • cell growth
    • cell survival
    • cause cellular proliferation
    • inhibit cell death
    • gain of function
  • becomes an oncogene when the proto-oncogene is mutated or deregulated
    • result is cancer
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9
Q

Explain the 2 Hit Hypothesis:

A

First hit: is when on the parent chromosomes has a mutation
Second hit: is when the combined chromosomes both have a mutation
In order for cancer to develop, both chromosomes need to have a mutation

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10
Q

What does the 2 Hit Hypothesis say about people who have a hereditary disposition to cancer?

A

They already have a chromosome with a mutation, so they only require a single hit on the other chromosome to develop cancer

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11
Q

Describe the Progression of Cancer:

A

Initiation: Healthy -> mutation -> Premalignant cell
Promotion: Proliferation of premalignant cells
Transformation: second alteration produces malignant cell from a premalignant cell
Progression: Malignant cells divide forming clinical cancer

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12
Q

What are the Hallmarks of Cancer? (6)

A
  • evading apoptosis
  • Self-sufficiency in growth signals
  • Insensitivity to anti-growth signals
  • Tissue invasion and metastasis
  • limitless replicative potential
  • Sustained angiogenesis
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13
Q

What are non-modifiable risk factors?

A

factors which patients cannot change

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14
Q

What are modifiable risk factors?

A

factors we can change within patients

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15
Q

What are the non-modifiable risk factors of cancer? (7)

A
  • age
  • sex
  • ethnicity
  • geography
  • genetic susceptibility
  • precursor lesions or preneoplastic conditions
  • reproductive history
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16
Q

What are the modifiable risk factors of cancer? (8)

A
  • smoking
  • obesity
  • physical activity
  • diet
  • Alcohol consumption
  • injection drug use
  • sexual history
  • uv radiation exposure
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17
Q

What are Carcinogens?

A

Diverse, natural, and synthetic products that can either be direct acting or indirectly acting, that affect the RNA, DNA and proteins within ourselves, resulting in cancer

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18
Q

What are the different types Carcinogens?

A

Chemical
- components of cigarette smoke
- asbestos
Radiation
- UV
- ionizing radiation
Viral and microbial

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19
Q

What is a Neoplasm?

A

Tumour = abnormal mass of tissue

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20
Q

What does a Neoplasm result from?

A
  • excessive cell division
  • evasion of apoptosis
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21
Q

What is Cancer a result of?

A

Cancer = Malignant
- deregulated growth
- ability to invade tissues

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22
Q

How are Tumours named?

A
  1. Cell type (tissue origin)
  2. Nature of tumour
    - benign
    - malignant
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23
Q

Describe a Benign tumour:

A
  • usually suffix “oma”
  • named based on architectural pattern
  • based on tissue type
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24
Q

What cancer types are exceptions to the “oma” rule?

A
  • melanoma
  • lymphoma
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25
Q

Describe a Malignant tumour:

A
  • classified based on tissue type
  • Sarcoma -> arises from connective tissue
  • Carcinoma -> arises from epithelial tissue
26
Q

What are the characteristics of Tumours? (4)

A
  • differentiation and anaplasia
  • rate of growth
  • local invasion
  • metastasis
27
Q

What is Differentiation?

A

extent to which cells resemble normal tissue counterpart
- well differentiated
- moderately differentiated
- poorly differentiated

28
Q

What is Anaplasia?

A

lack of differentiation
- do not resemble any tissue
- high degree of atypia and pleomorphism

29
Q

What is the rate of growth for Benign tumours?

A

slow growth

30
Q

What is the rate of growth for Malignant tumours?

A

rapid growth

31
Q

How does growth rate correlate blood supply?

A

Tumour cells promote angiogenesis by secreting growth factors

32
Q

What is Angiogenesis?

A

Formation of blood factors

33
Q

How does growth correlate with differentiation?

A

Poorly differentiated tumours grow faster

34
Q

What are the characteristics of Benign tumours when it comes to invasion?

A
  • well circumscribed
  • do not invade
  • expansile growth
35
Q

What are the characteristics of Malignant tumours when it comes to invasion?

A
  • irregular/ill-defined margins
  • invade and destroy tissue
  • infiltrative growth
36
Q

How do Carcinomas begin?

A
  • as localized growths originating from a single cell
  • start off confined to the epithelium
37
Q

What occurs if the basement membrane is intact on carcinomas?

A

Carcinoma in situ or High grade dysplasia

38
Q

What is Metastasis?

A

Tumour that is discontinuous from the primary lesion and involves other tissue
- unequivocal sign of malignancy

39
Q

What are the different pathways of Metastasis?

A
  • Seeding via body cavities -> peritoneal, pleural, pericardial cavities
  • Lymphatic spread
  • Hematogenous spread
40
Q

Describe Lymphatic spread:

A
  • most common, typically carcinomas
  • spread to lymph nodes through lymphatic drainage
41
Q

Describe Hematogenous spread:

A
  • Carcinomas and preferred route of spread for sarcomas
  • liver and lungs frequent sites
42
Q

What are Paraneoplastic Syndromes?

A

a group of rare disorders that are triggered by an abnormal immune system response to a cancerous tumour or neoplasm

43
Q

What can occur with Local Effects of a Tumour?

A
  • depends on tumour location
  • symptoms can occur with both benign and malignancy tumours
44
Q

What can occur with Hormonal Effects of a Tumour?

A
  • Hormone producing tumours
    ex. B cell adenoma in pancreas -> insulin production -> hypoglycemia
    Adrenal cortex adenoma -> steroid production -> secondary effects
45
Q

What is Cancer Cachexia?

A
  • progressive loss of fats & lean body mass with weakness, anorexia & anemia
  • not due to nutritional demand by tumour
    several factors may be responsible:
  • reduced food intake
  • reduced synthesis & storage of fat or increased mobilization of fatty acids
46
Q

Why is Paraneoplastic Syndrome important?

A

May be earliest manifestation of an occult neoplasm, mimic metastatic disease, and cause significant, even lethal, clinical problem

47
Q

What symptoms can Paraneoplastic Syndrome cause?

A
  • endocrine (lung carcinoma may cause Cushing’s disease)
  • neurological (seizures, changes in speech and muscle tone)
  • blood cell abnormalities (increased clotting)
48
Q

What is the process of Grading Cancer?

A

Estimates aggressiveness of the neoplasm and is based on the degree of differentiation
- assess pathologically

49
Q

What are some of the criteria used to grade cancer? (3)

A
  • differentiation
  • mitoses
  • necrosis
50
Q

What is the graded scale?

A
  • well differentiated
  • moderately differentiated
  • poorly differentiated
51
Q

What is the process of Staging Cancer?

A

determined using a combination of clinical and pathological parameters

52
Q

What is Clinical Staging of Cancer?

A

Based on information obtained prior to definitive treatment

53
Q

What is Pathological Staging of Cancer?

A

Information obtained at surgery and from examination of the tissues by a pathologist

54
Q

What is Pathological Staging of Cancer based on? (3)

A
  • tumour size
  • extent of spread to regional lymph nodes
  • presence or absence of metastasis to other organs
55
Q

What are the 5 reasons to stage Cancer?

A
  • use of common language across health care providers and patients
  • helps guide treatment
  • estimation of prognosis
  • comparison of results over time
  • clinical trials standardization
56
Q

What is Screening?

A

the process of identifying asymptomatic individuals with an elevated risk of cancer

57
Q

What does earlier identification allow?

A
  • earlier diagnosis
  • early treatment
  • opportunity to decrease morbidity and mortality from the disease
58
Q

What are the most routinely screened cancers?

A
  • cervical cancer -> pap test/smear
  • Breast cancer -> mammography
  • Colon cancer -> fecal immunohistochemical test (FIT), Colonoscopy
59
Q

What are the most routinely screened cancers?

A
  • cervical cancer -> pap test/smear
  • Breast cancer -> mammography
  • Colon cancer -> fecal immunohistochemical test (FIT), Colonoscopy
60
Q

By screening, what are you able to detect?

A

Precursor lesion

61
Q

How is cancer diagnosed?

A
  • tissue sample
  • examination under the microscope by a pathologist
62
Q

What are the limitations to regular cancer screenings?

A
  • Sometimes test results suggest you have cancer even though you don’t (called a false positive).
  • The test may not detect cancer even though it is present (called a false negative).
  • Some cancers would not necessarily lead to death or decreased quality of life (overdiagnosis).
  • Having screening tests may lead to more tests and procedures that may be harmful.

Pathology 2420 Part 1 (6 decks)

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