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HB 2 > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

What is the definition of neoplasia? Is it similar to hyperplasia?

A

New growth
An abnormal mass of tissue
Loss of responsiveness to normal growth control (uncontrolled)
Continues even when stimulus stops

Different from hyperplasia

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2
Q

What kinds of mutation contribute to neoplasia?

A

Acquired mutations triggers cell growth

Mutation of single cell, when cell proliferated clinal progeny are affected by mutation and also new mutations that add on

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3
Q

What is a neoplasm?

A

Tumor

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4
Q

What 2 classifications can be used to describe tumors?

A

Benign or malignant based on potential clinical behavior

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5
Q

What 2 basic components do all tumors have?

A

Parenchyma: made up of neoplastic cells, determines its biologic behavior

Reactive stroma: made up of connective tissue, blood vessels and inflammatory cells, contributes to growth and spread, determines whether or not it will invade other tissues

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6
Q

Describe the nomenclature of benign tumors containing mesenchymal cells.

A

Type of cell + (-oma)

fibrous tissue: Fibro + oma = Fibroma
fatty tissue: Lipo + oma = Lipoma
cartilage: Chondro + oma = Chondroma
smooth muscle: Leiomyo + oma = Leiomyoma
skeletal muscle: Rhabdomyo + oma = Rhabdomyoma

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7
Q

How are epithelial benign tumors classified?

A

The cell of origin or
Microscopic pattern or
Macroscopic architecture

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8
Q

Define adenoma. Examples.

A

Benign epithelial neoplasms derived from glands..may
or may not form glandular structures (may or may not appear as gland)

Parathyroid adenoma
Pituitary adenoma

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9
Q

Define papilloma. Examples.

A

Benign epithelial neoplasms growing on any surface that produce microscopic or macroscopic finger-like pattern

Squamous cell papilloma
Lid margin papilloma

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10
Q

Define polyp. Is it benign or malignant? What if it has glandular tissue? Examples.

A

A mass that projects above a mucosal surface
to form a macroscopically visible structure, could be benign or malignant.

If has glandular tissue→adenomatous polyp

Nasal polyp
Colonic polyp

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11
Q

Are malignant tumors associated with cancer?

A

Yes

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12
Q

What is a sarcoma? Examples.

A

Malignant tumor arising in solid mesenchymal tissue

From fibrous tissue: Fibrosarcoma
From bone : Osteosarcoma
From cartilage: Chondrosarcoma
From fat: Liposarcoma

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13
Q

What is a carcinoma? Examples (glandular).

A

Malignant tumors arising from epithelial origin

From stratified squamous cells: squamous cell carcinomas.
Carcinomas that grow in a glandular pattern are called
adenocarcinomas (ex Renal cell adenocarcinoma)

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14
Q

What are some examples of malignant tumors arising mesenchymal cells of the blood and related cells?

A

Hematopoietic cells: LEUKEMIAS
Lymphoid tissues: LYMPHOMAS (mainly lymph nodes)

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15
Q

What are some nomenclature exceptions for malignant tumors?

A

Melanoma (skin) (always malignant)
Mesothelioma (mesothelium)
Seminoma (testis)
Lymphoma (lymphoid tissue)

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16
Q

Define mixed tumors. How do they arise? What do they consist of? Example.

A

Arises from a divergent differentiation of a single neoplastic clone (one cell gives rise to 2 different cell types, cell can divide and differentiate)

Usually consists of cells from a single germ layer

Ex. Salivary gland tumors: contain epithelial components scattered within a myxoid stroma that may contain islands of cartilage or bone

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17
Q

Define teratoma. From where do they originate?

A

Contains recognizable mature or immature cells or tissues representative of more than one germ-cell
ayer and some times all three

Originate from totipotential cells (can give rise to any cell type) such as those normally present in the ovary and testis.

Have the capacity to differentiate into any of the cell types found in the adult body. So they may give rise to neoplasms that mimic bone, epithelium, muscle, fat, nerve and other tissues.

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18
Q

What kinds of tumors are mature vs immature teratomas?

A

Mature: generally benign

Immature (anaplastic):may be malignant

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19
Q

Define hamartoma. Example.

A

a benign mass of disorganized cells indigenous to the particular site (disorganized but they belong there in tissue or organ)

e.g. pulmonary hamartoma in the lungs
Combined hamartoma of the retina and RPE (CHRRPE)
Retinal astrocytic hamartoma (astrocytes)
Congenital simple hamartoma of the RPE

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20
Q

Define choristoma. Example.

A

a mass composed of normal cells in a wrong location (normal cells not where they are supposed to be)

e.g. pancreatic choristoma in liver or stomach

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21
Q

Are limbal dermoid-choristoma concerning? What kind of cells can they include?

A

Generally not something to worry about

Can include epidermal appendages, connective tissue, skin, fat, sweat gland, lacrimal gland, muscle, teeth, cartilage, bone, vascular structures, and neurologic tissue, including the brain

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22
Q

Define dysplasia. Are they malignant? Where do they occur? Example?

A

a loss in the uniformity of the individual cells and a loss in their architectural orientation (architectural anarchy!)

Cells look abnormal but are not malignant
Non-neoplastic (can be precursors but not neoplastic, appear abnormal)

Occurs mainly in epithelia

Ex: uterine cervix (severe and mild)

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23
Q

What three characteristics do dysplastic cells show?

A

Pleomorphism- different sizes and shapes

Hyperchromasia- stains darker because nucleus is larger

Increased mitosis- rapid but controlled

24
Q

Is dysplasia cancerous? Is it reversible?

A

Does not mean cancer
Does not necessarily progress to cancer (but it can)
May be reversible

25
Q

What are carcinoma in-situ? Is it benign or malignant?

A

When dysplastic changes involve the entire thickness of the epithelium
Benign (appears malignant and is a carcinoma but NOT malignant)

Displays the cytological features of malignancy without invasion of the basement membrane (large nuclei).
Applicable only to epithelial neoplasms.

26
Q

Describe the clinical significance of dysplasia. What contributes to the risk of invasive cancer?

A

It is a premalignant condition (not guaranteed to become malignant)

The risk of invasive cancer varies with:
grade of dysplasia (mild, moderate, severe)
duration of dysplasia (over long period if no change has occurred it most likely won’t happen)
site of dysplasia

27
Q

What are the differences between dysplasia and cancer?

A

Lack of invasiveness
Reversibility

28
Q

How can benign and malignant tumors be distinguished from one another?

A

Degree of differentiation
Rate of growth
Local invasiveness
Distant spread

29
Q

Define differentiation.

A

the extent to which the parenchymal cells of the tumor resemble their normal counterparts morphologically and functionally

30
Q

What are the 4 levels of differentiation associated with tumors? Which is anaplasia?

A

well differentiated = closely resemble their normal counterparts
moderately differentiated
poorly differentiated
undifferentiated (Anaplasia) (when you cannot determine where a cell came from based on appearance)

31
Q

How are benign and malignant tumors each classified under differentiation?

A

Benign tumors = often well differentiated

Malignant tumors = often poorly differentiated, can be anaplastic

32
Q

Describe the rate of growth of benign tumors?

A

Usually progressive and slow; may come to a standstill or
regress

33
Q

Describe the rate of growth of malignant tumors?

A

Erratic, may be slow to rapid

Correlates inversely with the level of differentiation
(Rapid growth= less differentiated (anaplastic))

34
Q

Describe the local invasion of benign tumors.

A

Remain localized
Cannot invade
Usually encapsulated

35
Q

Describe the local invasion of malignant tumors.

A

Progressive infiltration
Destruction
Usually not encapsulated
Can invade

36
Q

Define distant spread (metastasis)? What tumor type is it associated with?

A

The development of secondary implants discontinuous with the primary tumor, possibly in remote tissues (tumor develops in one place, goes to remote site, discontinuous with primary tumor)

Malignant

37
Q

What is the probability of correlation between cancer and metastasis? Do all cancers have the same ability to metastasize?

A

30% of patients with newly diagnosed solid tumors
(excluding skin cancers other than melanomas)
present with clinically evident metastases

Cancers have different ability to metastasize

38
Q

How does anaplastic and size contribute to likeliness to metastasize?

A

Generally, the more anaplastic and the larger the primary tumor, the more likely it is to metastasize

39
Q

What are the three pathways of metastasis?

A

Seeding of the body cavities
Lymphatic spread
Hematogenous spread

40
Q

Describe location of the seeding of body cavities pathway of metastasis?

A

Invade cavities

Pleural, peritoneal cavities and cerebral ventricles

41
Q

Describe lymphatic spread pathway of metastasis? Examples.

A

Favored by carcinomas

Breast carcinoma → axillary lymph nodes (armpit)
Lung carcinomas → bronchial lymph nodes

42
Q

Describe hematogenous spread pathway of metastasis? What organs are most frequently involved?

A

Spreads through blood

Favored by sarcomas
Also used by carcinomas (mesenchymal)
Veins are more commonly invaded
The liver and lungs are the most frequently involved secondary sites (lands here after traveling through blood)

43
Q

List the characteristics of benign tumors.

A

Will remain localized
Cannot spread to distant sites
Generally can be locally excised (encapsulated)
Patient generally survive

44
Q

List the characteristics of malignant tumors.

A

Can invade and destroy adjacent structure
Can spread to distant sites
Cause death (if not treated )

45
Q

Are benign tumors fatal?

A

May not be fatal but can cause many issues

(Ex: pituitary adenoma can get large and compress on ON causing loss of vision)

46
Q

Describe the characteristic of a benign leiomyoma.

A

Small
Well demarcated
Slow growing
Noninvasive
Nonmetastatic
Well differentiated

47
Q

Describe the characteristic of a malignant leiomyosarcoma.

A

Large
Poorly demarcated
rapidly growing with hemorrhage and necrosis
Locally invasive
METASTATIC
poorly differentiated

48
Q

What environmental factors have risk of cancer?

A

1.Infectious agents
2.Smoking
3.Alcohol consumption
4.Diet
5.Obesity
6.Reproductive history
7.Environmental carcinogens

49
Q

How can occupation/exposure increase risk of cancer?

A

Asbestos – mesothelioma
Radiation – thyroid cancer

50
Q

How can nonhereditary predisposing conditions increases risk of cancer?

A

Chronic inflammation: Ulcerative colitis – colon cancer

Precancerous lesions: Adenoma – colon cancer

Immunodeficiency state

51
Q

What cancers are associated with young ages and older ages?

A

Young (neuroblastoma, retinoblastoma, Wilms tumor)

Older (prostate cancer, thyroid cancer, colon cancer)

52
Q

What kind of risk factor is associated with breast cancer (BRCA1 and BRCA 2 genes)?

A

Genetic predisposition

53
Q

Describe preferred vs exclusive cancers associated with gender.

A

Preferred – breast cancer in women

Exclusive – prostate cancer in men, ovarian cancer in women

54
Q

Describe preneoplastic disorders.

A

Acquired diseases
Known to be associated with increased risk for development of cancer

Ex: chronic inflammation where cells are made at rapid rate, metaplasia

55
Q

Are cancers sporadic or familial? How do they arise?

A

Most cancers are sporadic

Familial tend to arise earlier in life

56
Q

What cancer is the leading cause of death for men and women?

A

Lung cancer

HB 2 (17 decks)

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