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Pathology > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Define neoplasia

A

An abnormal mass of tissue, the growth of which exceeds that of the normal tissue and persists in the same excessive manner after cessation of the stimuli which evoked the change

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2
Q

Define differentiation

A

The extent to which neoplastic cells resemble comparable normal cells, both morphological and functionally

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3
Q

Define anaplasia

A

Lack of differentiation characterised by:
Pleonorphism
Abnormal nuclear morphology
Mitoses
Loss of polarity
Other changes

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4
Q

Define pleomorphism

A

Variation in size and shape of cells and nuclei

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5
Q

Define dysplasia

A

A loss in the uniformity of the individual cells as well as a loss in their architectural organisation
Mild-moderate dysplasia is reversible if the stimulus is removed

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6
Q

Define grading

A

An estimate of the clinical gravity of a tumour based on the degree of differentiation and number of mitoses within the tumour

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7
Q

Define staging

A

An estimate of the clinical gravity of a tumour based on the anatomical extent of the tumour
2 systems:
TNM - tumour nodes metastases
AJC - American joint committee

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8
Q

In tumours what is parenchyma

A

Proliferating neoplastic cells

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9
Q

In tumours what is stroma

A

Non- neoplastic supportive tissue eg connective tissue, blood vessels

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10
Q

Local invasion in benign tumours

A

Most benign tumours grow as cohesive expansile masses that develop a capsule
Do not penetrate the capsule
Provides a plane for surgical cleavage

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11
Q

Invasion of malignant neoplasms

A

Infiltrate and destroy normal tissue around them
Surgical treatment requires removal of a considerable margin of

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12
Q

What are the four steps of the process of invasion of the cellular matrix

A
  1. Detachment of tumour cells from each other
  2. Attachment to matrix proteins binding to laminin, fibronectin via cell surface receptors
  3. Degradation of the extracellular matrix
  4. Migration of tumour cells
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13
Q

What is the single most important feature distinguishing benign from malignant tumours

A

Metastasis

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14
Q

What are the 3 routes of metastasis

A
  1. Spread into body cavities
  2. Invasion of lymphatics
  3. Haematogenous spread
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15
Q

Mechanisms dictating the distribution of metastases

A
  1. Tumour cell adhesion molecules
    Ligands that are normally expressed in target organ cells
  2. Chemokines
    For target organs present in the tumour cells
  3. Chemoattractants
    From target cells
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16
Q

What is carcinogénesis

A

The clonal growth of cells that have incurred mutations in four classes of genes
- those that regulate cell growth (proto-oncogenes and tumour supperessorngenes)
Those that regulate apoptosis and dna repair

17
Q

Carcinogenic chemical agents

A
  1. Alkylation agents - cyclophosphamide busulfan
  2. Aromatic hydrocarbons - cigarette smoke
  3. Azo dyes - beta-naphthylamine
  4. Naturally occurring carcinogens - aflatoxin B produced by fungus aspergillus flavus, hepatocellular cancer
  5. Nitrosamines and amides - can’t be synthesised in GI tract
  6. Miscellaneous - asbestos, nickel
18
Q

Radiation carcinogenic agents

A

UVB = skin cancer
Ionising radiation = myeloid leukaemias, thyroid cancer

19
Q

Viral carcinogenic tumours

A

HPV - cervical
EBV - Burkitt lymphoma, nasopharyngeal ca, B cell lymphoma
HepB - liver
HTLV -1 = leukaemia
H.pylori

20
Q

Define paraneoplastic syndrome

A

Symptom complexes that occur in patients with cancer that cannot be readily explained by local or distant spread of the tumor or by the release of hormones normally released by the tissue of origin

21
Q

Define endocrinopathies

A

Some nonendocrine cancers produce hormones or hormone like factors

22
Q

4 examples of endocrinopathies

A
  1. Small cell lung cancer produce adrenocorticotropic hormones = Cushing syndrome
  2. Small cell lung cancer produce ADH = SIADH
  3. Carcinoid tumours produce serotonin and bradykinin = vasoactive affects
  4. Hypercalacaemia - elaboration of PTH- like peptides or TNF alpha = resorption of bone
23
Q

The oral contraceptive pill is protective against..

A

Endometrial and ovarian carcinomas

24
Q

Most common type of thyroid cancer is ..

A

Papillary (75-85%)

25
Q

What malignancies are associated with acanthosis nigricans

A

Gastric carcinoma
Lung
Uterine

26
Q

What six disease processes is asbestosis linked with

A

Parenchymal interstitial fibrosis
Localised fibrous plaques
Pleural effusions
Lung cancer
Malignant pleural and peritoneal mesothelioma
Laryngeal cancer

27
Q

Chronic inflammatory states that can lead to malignancy

A

Cystitis
Sialadinitis
IBD
Reflux
Lichen planus
Hepatitis
AIDS
PID
Osteomyelitis
Mononucleosis
Hashimotos thyroiditis
Chronic pancreatitis

28
Q

What is present on the blood film for myelofibrosis

A

Leukoerythroblastic anaemia

29
Q

Clinical feature of meylofibrosis

A

Fullness in the splenic region because of anaemia and splenomegaly

30
Q

Median survival of myelofibrosis

A

3-5 years

31
Q

What is the bilirubin in uncomplicated haemolytic anaemia

A

Unconjugated

32
Q

What cancer marker is ca 125 for

A

Ovarian cancer

33
Q

What cancer marker is ca 19-9 for

A

Colon cancer and pancreatic cancer

34
Q

What cancer marker is ca 15-3 for

A

Breast cancer

35
Q

What cancer marker is AFP for

A

Liver cancer, nonseminomatous germ cell tumour of testis

36
Q

What cancer marker is HCG for

A

Trophoblastic tumours and nonseminomatous testicular tumours

37
Q

What is cancer marker neuron specific enolase for

A

Neuroblastoma

38
Q

What is the most common pathway for initial dissemination of carcinomas and sarcomas

A

Lymphatic spread

39
Q

What metastases commonly involve liver and lung

A

Haematogenous metastases

Pathology (6 decks)

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