Neoplasia Flashcards
what is pathology?
the science of disease using detailed knowledge of normal cell biology to determine how illness arises
what do pathologists do?
get specimens from clinicians, look macroscopically and interperate this in a clinical context to provide a likely diagnosis
what is neoplasia?
an excessive, irreversible uncontrolled growth which persists even after withdrawal of the stimuli which caused it
what is the difference between a tumour and neoplasia?
a tumour is swelling/lump
neoplasia is wider than this as not all neoplasms are guaranteed to cause swelling/lumps eg leukaemia
what are the types of neoplastic diseases?
normal tissue, benign disease, malignancy, dysplasia
what is hyperplasia
increase in the number of cells
what is hypertrophy?
increase in cell size
what is atrophy?
decrease in cell size
what is metaplasia?
change in cell type
what are some characteristics of benign neoplasms?
localised, well encapsulated, slow growing, resemble the origin, regular nucleus, few mitoses, damage at the local level
what is necrosis?
uncontrolled cell death
what is dysplasia?
abnorml/atypical cells due to failure in differentiation. in some areas in the body it can be called intraepithelial neoplasia. the degree of dysplasia helps the pathologist identify those tissues which are high risk for malignancy.tumour growing but it is confined to the epithelium (intraepithelial neoplasia)
how can dysplasia be detected?
there is a disordered architecture of the tissue, a loss of normal structure
what makes cells atypical?
pleomorphic nuclei and mitotic figures
what are pleomorphic nuclei?
the nuclei are larger and mis shapen
what are mitotic figures?
the cells are rapidly dividing, lots of cell division is noticeable
what are features of malignancy?
invasive, can metastasise, grows fast, may not resemble tissue of origin, shows features of dysplasia, damage at local or distinct sites
what is metastasis?
where invasive neoplasm spreads to the other areas of the body
what are the different ways of metastasis?
-through lymphatics
-through blood
-transcoelomic
what are complications of malignancy?
- the site of origin can be difficult to find which is called cancer of unknown primary
- this is important to know to help direct the treatment
generally how are benign neoplasms named?
oma eg adenoma, papilloma
generally how are malignant neoplasms named?
carcinoma for epithelial, sarcoma for connective tissue
why is understanding signalling important for all doctors?
it allows us both to identify the prognosis and use targeted treatment for the patient if we know the specific cell signalling pathways
what is metaplasia?
a change from one type of differentiated tissue into another. the resulting tissue is often better adapted to the environment.
what is immunohistochemistry?
shows us where certain proteins are expressed within the cell and in roughly what quantities they are expressed
how are the cell cycle and neoplasia linked?
we can look for specific changes in the cell cycle in neoplasms as part of diagnosis to help with creating management plans
the presence or absence of mutations in the cell cycle can help determine prognosis and treatment
what is grading?
how closely to not does the neoplasm correspond to the normal cells for that tissue. the more dysplastic the cells, the higher the grade. usually done by pathologist
what is staging?
how far the neoplasm has spread throughout the body. usually done by MDT
what is the classic staging tool?
TNM classification
tumour -measures local invasion
node - measure spread to lymph node
metastasis- measures spread to distant tissues
what are some examples of local effects
very tissue dependent
-generalised symptoms eg pain lump
-compression on surrounding structures
-ulceration
-bleeding/anemia
what are some examples of metazoic effects
very site dependent
-eg brain mets cause swelling, raised pressure, stroke and seizures
what are some examples of systemic effects?
-weight loss, loss of apetite
-fever or feeling non specifically not well
-infection
what are some examples of para neoplastic effects?
-secretion of excess substances eg hormones
-raised calcium leading to confusion
What are some examples of benign tumours in paediatrics?
Haemangioma
Naevus
Lymphangiomas
Sacroccoygeal teratomas
what is hyperplasia?
an increase in the size of an organ as a result of proliferation eg uterus in pregnancy
what is hypertrophy?
an increase in the size of an organ due to an increase in the size of constituent cells eg left ventricle in hypertension
what is a monoclonal tumour?
when one tumour derives from one cell only
what is a liable tumour?
has a very quick turnover and replacement of cells eg epidermal cells on the surface of skin are replaced every week. blood cells last 120 days and then they are replaced
what Is a stable tissue?
has a slow turnover eg cells in the bone
what is a permanent tissue?
cells have no turnover and have be used for the rest of our lives (eg neural cells)
what does hyperplasia lead to?
an increase in the size of an organ as a result of cell proliferation
what does hypertrophy lead to?
an increase in the size of an organ due to an increase in the size of constituent cells eg left ventricle of the heart in hypertension
what is necrosis?
death of cells in living tissue caused by external factors such as infection, trauma or toxins
what is histogenesis?
the differentiation of cells into specialised tissues and organs during growth
how are benign epithelial tumour named?
OMA
papilloma (covering epithelia)
adenoma (lining tubes or hollow organs or solid organs)
how are malignant epithelial tumours named?
CARCINOMA
eg adenocarcinoma (lining tubes of hollow organs)
how are benign tumours of connective tissue named?
OMA
how are malignant tumours of connective tissue named?
SARCOMA
generally where are no benign tumours recognised?
lymphoids
haematopoietic tissues
glial cells
mesothelium
what are malignant tumours of the lymphoid called?
lymphoma (hodgkin or non hodgkin)
how are malignant tumours of the haematopoeitc tissues named?
leukaemia
how are primitive nerve cell (sense or receptive cell)malignant tumours named?
neuroblastoma retinoblastoma ect
how are malignant tumours of glial cells named?
glioma eg astrocytoma
how are germ cell tumours named?
teratoma
what are moles called>
pigmented naevi
what is metaplasia?
change from one type of differentiated tissue to another. resulting tissue is often better suited fro the environment
what type of tumours generally spread via blood?
carcinomas (kidney colorectal and prostate) and sarcomas
what type of cancer is lymphatic spread rare in?
sarcomas
what is transcoelomic spread?
spread of tumours across peritoneum and peritoneal cavity eg. ovary and stomach
