Neoplasia

Question 1

What is meant by neoplasm?

Answer 1

Genetic disorder of cell growth, tumour

Question 2

What are characteristics of a benign tumours growth pattern?

Answer 2

-may be encapsulated
-expansion
-localised

Question 3

What are characteristics of a malignant tumours growth pattern?

Answer 3

-Invasion/infiltration
-no capsule
-metastasis (can travel to other organs)

Question 4

What are the histological features of a benign tumour?

Answer 4

-resembles tissue of origin
-uniform cell/nuclear shape and size
-few mitoses (dividing cells)

Question 5

What are the histological features of a malignant tumour?

Answer 5

-variable resemblance to tissue origin
-different shape sizes/nuclear sizes
-many mitoses

Question 6

What are clinical effects of benign tumours?

Answer 6

-Lump/pressure/obstruction depending on site and size
-+-hormone secretion
-treat by local excision

Question 7

What are clinical effects of malignant tumours?

Answer 7

-local pressure, infiltration and destruction
-+- hormone secretion
-local excision and chemotherapy or radiation if metastases present

Question 8

What is an example of a benign tumour which effects the salivary gland?

Answer 8

Pleomorphic adenoma

Question 9

What does the term adenoma mean?

Answer 9

A tumour arising from glandular tissue

Question 10

Where is a high risk area for cancer in the oral cavity?

Answer 10

Tongue

Question 11

What two components are all tumours composed of?

Answer 11

-Neoplastic cells that constitute the tumour parenchyma
-Reactive stroma made up of connective tissue, blood vessels, and cells of the adaptive and innate immune system.

Question 12

What does term ‘sarcoma’ mean?

Answer 12

Malignant CONNECTIVE TISSUE tumour

Question 13

What does term ‘carcinoma’ mean?

Answer 13

Malignant EPITHELIAL TISSUE tumour

Question 14

What is leukoplakia?

Answer 14

White patches in the mouth that cannot be rubbed off

Question 15

What epithelial tissues may dysplasia effect?

Answer 15

Squamous - oral, cervical
Glandular - Barret’s oesophagus
Transitional- Bladder

Question 16

What is meant by pleomorphism?

Answer 16

Different shapes and sizes

Question 17

How is dysplasia identified?

Answer 17

A change in the cells appearance and arrangement

Question 18

What HPV types are the most likely to be associated with malignancy?

Answer 18

HPV 16 and 18

Question 19

What are the stages of carcinogenesis?

Answer 19

Initiation- when carcinogen induces a genetic change in one cell
Promotion- another factor stimulates the initiated cell for division
Progression- Additional mutations resulting in malignancy.

Question 20

What are examples of chemical carcinogens?

Answer 20

-smoking polycyclic hydrocarbons including tars
-diet, drugs, alcohol
-asbestos

Question 21

What are examples of physical carcinogenesis?

Answer 21

-Ionising radiation
-UV light

Question 22

What are proto-oncogenes?

Answer 22

Normal genes which regulate cell division

Question 23

What are tumour suppressor genes?

Answer 23

Genes which act to inhibit cell division and suppress growth
Act as anti-oncogenes

Question 24

What is the function of TP53 gene?

Answer 24

Stop the cell cycle to allow DNA repair
Apoptosis

Question 25

What are examples of inherited cancer syndromes?

Answer 25

Retinoblastoma Colon cancers

Question 26

What are examples of familial cancer?

Answer 26

Breast, ovary, colon

Question 27

What are 6 hallmarks of cancer? !

Answer 27

-Evade apoptosis -Sustain angiogenesis -Tissue invasion and metastasis -limitless replicative potential -Self sufficiency in growth signals -insensitivity to anti-growth signals

Question 28

What are different ways malignant tumours can spread?

Answer 28

Local Lymphatic spread Blood spread Transcoelomic spread Intraepithelial spread

Question 29

What is metastasis?

Answer 29

Spread of the malignant cells to distant organs forming secondary tumours

Question 30

How are carcinomas usually spread?

Answer 30

Lymphatic Blood (later)

Question 31

How do sarcomas usually spread?

Answer 31

Blood

Question 32

How is tumour grading performed?

Answer 32

By looking at tissue with microscope and investigating tissue to notice any changes

Question 33

What is cancer staging?

Answer 33

Staging describes the extent or severity of a person’s cancer. Knowing the stage of disease helps planning treatment and estimating the person’s prognosis.

Question 34

How does the immune system recognise tumour cells?

Answer 34

-products of mutated genes -Viral proteins -Overexpressed proteins

Question 35

What cell drives the immune response to tumour associating antigens?

Answer 35

Cytotoxic T-lymphocytes (CD8+)

Question 36

How do tumour cells evade the immune response?

Answer 36

-Alter tumour antigen expression. Lack of T cell recognition -Activation of immunoregulatory pathways leading to T cell unresponsiveness and apoptosis -Immunosuppressive factors (cytokines). Inhibit t cell response

Question 37

What is immunotherapy?

Answer 37

Using the patients own immune response to control and destroy malignant cells