Neoplasia

Question 1

What is neoplasia?

Answer 1

A lesion resulting from autonomous or relatively autonomous abnormal growth of cells which persists after initialising stimulus removed

Question 2

What makes a neoplasm malignant?

Answer 2

The ability to invade and metastasise. Potentially lethal with abnormal characteristics

Question 3

What is a benign neoplasm?

Answer 3

A neoplasm that does not have the ability to invade and metastasise

Question 4

4 main distinguishing features of neoplasms

Answer 4

Differentiation, rate of growth, local invasion, metastasis

Question 5

What is differentiation in relation to neoplasms?

Answer 5

The extent to which neoplastic tissues resemble their tissue of origin.

Question 6

Features of well differentiated neoplasms?

Answer 6

Looks close to tissue of origin, little or no anaplasia, can be malignant but more frequently benign

Question 7

Features of poorly differentiated neoplasms?

Answer 7

Little resemblance to tissue of origin. Nuclear pleomorphism; abnormal nuclear features e.g. high nuclear:cytoplasm ratio, clumped chromatin, prominent nucleoli; increased mitotic activity; tumour giant cells; necrosis

Question 8

Features of undifferentiated/anaplastic neoplasms?

Answer 8

Cannot be identified by morphology alone, may need special stains/techniques to diagnose

Question 9

What is the difference between grade and stage of neoplasms?

Answer 9

Grade = how differentiated the tumour is (1= well differentiated, 3 = poor)
Stage = extent of spread of tumour (lower the better)

Question 10

What is dysplasia?

Answer 10

Confined neoplastic change - features of malignancy but confined within basement membrane

Question 11

What is carcinoma in situ?

Answer 11

Dysplastic changes that cover the full thickness of epithelium but without invasion - basement membrane not penetrated

Question 12

Why are mitosis and necrosis associated with tumour rate of growth?

Answer 12

Malignant neoplasms are fast growing, benign are slow growing. Mitosis is a sign that lots of cells are dividing rapidly while necrosis is a sign that the tumour is growing so fast the blood supply can’t keep up

Question 13

Local invasion - benign tumours

Answer 13

Cohesive and expansile masses, localised, don’t metastasise, usually slow growing and may be encapsulated

Question 14

Local invasion - malignant tumours

Answer 14

Invasive, penetrate organ walls, tissues, epithelial surfaces, most reliable way of distinguishing malignant tumour next to metastases

Question 15

Benign tumour of glandular/secretory epithelium

Answer 15

Adenoma (prefix with name of glandular tissue of origin e.g. colonic adenoma)

Question 15

Naming of benign tumours

Answer 15

Suffix -oma

Question 16

Benign tumour of non-glandular/surface epithelium

Answer 16

Papilloma (prefix with cell type of origin e.g. squamous cell papilloma)

Question 17

Naming of benign mesenchymal tumours

Answer 17

Suffix -oma (preceded by tissue or cell of origin e.g. osteoma for benign tumour of bone, leiomyoma for benign tumour of smooth muscle)

Question 18

Naming of malignant epithelial tumours

Answer 18

Carcinoma
If from glandular epithelium, called adenocarcinoma
If from non-glandular epithelium, carcinoma prefixed with cell of origin e.g. squamous cell carcinoma

Question 19

Malignant tumour of glandular epithelium

Answer 19

(Epithelium source) adenocarcinoma e.g. colonic adenocarcinoma, breast adenocarcinoma

Question 20

Malignant tumour of non-glandular surface epithelium

Answer 20

(Cell type) carcinoma e.g. Basal cell carcinoma, squamous cell carcinoma

Question 21

Naming of malignant mesenchymal tumours

Answer 21

Sarcoma prefixed with tissue or cell of origin e.g. rhabdomyosarcoma (malignant skeletal muscle tumour) or angiosarcoma (malignant blood vessel tumour)

Question 22

What is a teratoma?

Answer 22

Tumour of germ cell origin containing cells representing all three germ layers. Can be benign or malignant

Question 23

What is a precursor cell tumour?

Answer 23

Tumour with histological resemblance to embryological tissue in which they arise e.g. retinoblastoma, hepatoblastoma. Often occur in young patients

Question 24

What are neuroectodermal tumours?

Answer 24

Brain tumours e.g. glioblastoma multiforme, meningioma

Question 25

What is a hamartoma?

Answer 25

Non-neoplastic disordered overgrowth of normal tissue indigenous to site of occurrence. Developmental abnormality e.g. port wine stain

Question 26

What is a choristoma?

Answer 26

Benign normal tissue in abnormal location e.g. pancreas nodule in stomach. Also called heterotropic rest

Question 27

Name some haematolymphoid malignancies

Answer 27

Lymphoma - malignancy of B or T cell origin
Myeloma - malignancy of plasma cells
Leukaemia - malignancy of white blood cells

Question 28

Name some melanocytic neoplasms

Answer 28

Melanoma - malignancy of melanocytes
Melanocytic naevus - benign proliferation of melanocytes

Question 29

What are the hallmarks of cancer?

Answer 29

1. Avoiding immune destruction
2. Evading growth suppressors
3. Enabling replicative immortality
4. Tumour-promoting inflammation
5. Activating invasion and metastasis
6. Genomic instability
7. Inducing angiogenesis
8. Resisting cell death
9. Deregulating cellular energetics
10. Sustaining proliferative signalling