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Pathology > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

What is Neoplasia?

A

An abnormal new mass of tissue, with unregulated and uncoordinated cell growth

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2
Q

How does neoplasia occur?

A

proliferation of existing cells

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3
Q

What are the types of neoplasia?

A

Benign - doesn’t produce any problems unless its in a vital area e.g. brain

Malignant - immortalized clone, loss of cell regulation

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4
Q

Biology of tumour growth

A

Normal growth - polyclonal growth, well regulated

Hyperplasia - excessive polyclonal growth
Not cancerous but may progress to cancer in later years

Benign tumours - clonal proliferation, limited response to cell signal

Malignant tumours - immortalized clone, loss of cell regulation

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5
Q

Leiomyoma

A

benign tumour of smooth muscles

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6
Q

Lipoma

A

benign tumour of fat cells

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7
Q

Angioma

A

benign tumour of blood vessel

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8
Q

Adenoma

A

benign tumour of a gland

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9
Q

Fibroma

A

benign tumour of fibroblast

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10
Q

Characteristics of malignant tumours

A

Anaplasia or cellular atypia: Lack of differentiation
1) variation in shape and size of cells or nuclei
2) Enlarged + hyperchromatic nuclei, prominent nucleoli, increase nuclear to cytoplasmic ratio

Increased and abnormal mitotic activity (especially metaphase)

Dysplasia: disorganised and random growth

Invasion: direct extension and penetration by cancer cells into neighbouring tissues

Metastasis: spread of cancer cells through thecirculatory systemor thelymphatic systemto more distant locations.

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11
Q

Principal characteristics of carcinomas and sarcomas

A

printed table

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12
Q

What are the hallmarks of cancer?

A
  1. Self sufficiency in growth signals
  2. Insensitivity to anti-growth signals
  3. Tissue invasion & metastasis
  4. Limitless replicative potential
  5. Sustained angiogenesis
  6. Evading apoptosis
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13
Q

Initiators of cancer development

A

Initiation is the first step in the two-stage model of cancer development.
Initiators cause irreversible changes (mutations) to DNA (DNA damage) that increase cancer risk.
e.g. chemicals, viruses, radiation

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14
Q

Promoters of cancer development

A

Promotion is the second step in the two-stage model of cancer development.
Once a cell has been mutated by an initiator, it is susceptible to the effects of promoters. e.g. growth factors, hormones (estrogen plays an important role in progression of steroid hormone-dependent cancers)

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15
Q

What are the key three genetic events involved in the conversion of a normal cell into a neoplastic cell?

A
  1. Telomerase expression preventing telomeric shortening with each cell division and thwarts cell aging.
  2. Inactivation of tumour suppressor gene function in the immortalized cells removes inhibition of growth.
  3. Oncogenes activation sets up autocrine growth stimulation
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16
Q

Define Proto-oncogenes

A

Normal genes - positively regulate the cell cycle and help cells to grow.

17
Q

Define oncogenes

A

Mutations may cause proto-oncogenes to become oncogenes, disrupting normal cell division and causing cancers to form

18
Q

Neoplastic growth - promoting factors

A

Oncogenes
Anti-apoptotic genes
Telemorase expression
Epigenetic contributions

19
Q

Neoplastic growth - inhibiting factors

A

Tumour suppressor genes
Pro-apoptotic genes

20
Q

Role of oncogenes in cancer

A
21
Q

What is gain-of-function mutation?

A

When a proto-oncogenes causes cancer after mutation occurs in the gene that results in the gene being permanently turned on.
aka dominant mutations - only one copy of the gene needs to be mutated in order to encourage cancer

22
Q

Role of p53 in tumour development

A

Mutation causes P53 can lose its normal function.
Therefore does not arrest the cell cycle and damaged cell continues to divide - may result in cancer.

23
Q

What is the role normal p53?

A

When cellular damage occurs, P53 arrests the cell cycle (before S phase) until the damage is repaired.
If damage cannot be repaired, apoptosis occurs.

24
Q

What is the role of normal pRB?

A

Binding of Rb, converts E2F factors from transcriptional activators to transcriptional repressors.

25
Q

Role of pRB in tumour development

A

Mutation > loss of normal pRB function >

This leads to uncontrolled E2F induced expression of genes that are involved in cell proliferation.

26
Q

What is the role of anti-apoptotic proteins in cancer development?

A

Overexpression of pro-survival proteins such as BCL2 and BCL-XL help malignant transformation

27
Q

What is the role of telomerase in cancer development?

A

Increased telomerase expression produces vulnerability of cancer cells, distinguishing them from normal cells in the body.

28
Q

What is the role of epigenetic changes in cancer development?

A

Epigenetic modifications precede genetic changes and usually occur at an early stage in neoplastic development.

29
Q

What is cell transformation?

A

A process in which the addition of certain malignant characteristics in the cell due to alteration in genetic material.

30
Q

What are the phases of malignant tumour growth?

A

Transformation - DNA has to be damaged
Growth
Local invasion -
Distant metastasis

31
Q

What is metastasis?

A

The development of secondary malignant growths at a distance from the primary site of cancer

Carcinoma generally spread by lymphatics
Sarcoma generally spread by blood vessels

32
Q

What are the three common sites of metastasis?

A

Lung, liver, bones

33
Q

Metastasis

A
34
Q

What are the effects of tumours in hosts?

A

Local effects – structural
- Impair organ function
- Obstruction of vessels, airways, ureters, etc
- Haemorrhage or infarction

Paraneoplastic syndromes
Endocrine: hormone-secreting tumours
Neurological symptoms-immune mediated

Cancer cachexia (cancer wasting syndromes)
loss of appetite, severe weight loss, progressive weakness, anaemia
Doctors cannot reverse despite patient being able to eat

35
Q

How are tumours diagnosed?

A

History and clinical examination

Imaging – X-Ray, ultrasound, CT scan

Tumour markers – laboratory tests

Cytology – Pap-smear, fine needle aspiration (FNA)

Biopsy – histopathology

Molecular tests – gene mutation detection

36
Q

What is the TNM Classification?

A

A system used to classify malignancy
Primarily used in solid tumors & can be used to assist in prognostic cancer staging

37
Q

What are the objectives of TNM classifications?

A

Aid treatment planning,
Provide an indication of prognosis
Assist in the evaluation of treatment results
Facilitate the exchange of information between treatment centres

38
Q

What are the treatments of tumours?

A

Surgery: Removal of tumour along with the regional lymph nodes

Radiation: Ionisation radiation to kill the tumour cells

Chemotherapy: drugs that target rapid dividing cells
A combination of drugs is usually used

39
Q

What are the side effects of chemotherapy?

A

Anemia, loss of hair, and digestive problem due to damage of normal cells.

Pathology (11 decks)

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