Neoplasia Flashcards
1
Q
Neoplasia
A
- an excessive, irreversible and uncontrolled growth which persists even after withdrawal of the stimuli which caused it
- tumour: swelling/lump
2
Q
Normal tissue adapting
A
- when normal cells are under stress, they undergo changes to help respond to this stress
- hyperplasia: increase in cell number
- hypertrophy: increase in cell size
-atrophy: decrease in cell size and number
-metaplasia: cell changes to another type of
3
Q
Hyperplasia
A
- can be physiological/pathological
- production of new cells from stem cells
- can only occur in tissues which are not permanent (not in heart)
- pathological hyperplasia: another method of leading to malignancy in select tissue
4
Q
Hypertrophy
A
- can be physiological or pathological
- gene activation -> protein synthesis-> production of cellular organelles
- PI3K/AKT pathway import net in physiological hypertrophy
- multiple G protein linked signalling pathways are importantly in pathologic hypertrophy
5
Q
Atrophy
A
- decrease in stress-> decrease in cell number and size
- decrease cell number-> apoptosis
- ubiquitin- protea some degradation of cytoskeleton by tagging intermediate filaments with ubiquitin and degradation by proteasomes
- autophagy of cellular components by autophagosomes fused to lysosomes-> hydro lyric enzyme breakdown
6
Q
Metaplasia
A
- reprogrammed of stem cells
- can occur across any of the cell categories but most frequently epithelium
- can be a step on the malignancy pathway
7
Q
Aplasia and hypoplasia
A
- aplasia: failure of cell production in embryogenesis, on a spectrum between complete agenesis and hypoplasia eg. Pulmonary agenesis
- hypoplasia: decrease in cell production during embryogenesis which leads to a smaller overall organ seize
8
Q
Severe changes if stress lasts a long time
A
- causes more severe changes
• apoptosis: programmed cell death
•necrosis: uncontrolled cell death
•inflammation: a reaction to cell death, inflammatory cell “clean-up”
•neoplasia: long term
9
Q
Benign disease
A
- localised, well encapsulated, slow growing, resemble the tissue of origin, regular nuclei, few mitosis, damage at the local level
10
Q
Dysplasia
A
- abnormal/atypical cells due to a failure of differentiation
- in some areas of the body, it is called intraepithelial neoplasia
- ## the degree of dysplasia helps the pathologist identify those tissues which are high risk of malignancy in the future
11
Q
Malignancy
A
- invasive, can metastasise, grows fast, may not resemble tissue of origin, shows features of dysplasia, damage at local or distant sites
12
Q
Metastasis
A
- where the invasive neoplasm spreads to other areas of the body through:
-lymphatics , blood or transcoelomic
13
Q
Cancer of unknown primary
A
- sometime have metastasis but cannot easily identify the site the cancer originated in
- this requires a pathologist to try and identify, where possible, the origin of the cancer to help direct treatment
14
Q
Naming epithelial neoplasms
A
- tissue
• covering epithelia - example of benign (-oma)
• papilloma - example of malignant (-carcinoma)
• carcinoma
15
Q
Signalling in neoplasia
A
- in various neoplasms, alternation in cell signalling pathways can change the available treatment and prognosis of the patient
16
Q
HER2 and breast cancer
A
- HER2 works via a receptor tyrosine kinase pathway
- if there is an overexpression of HER2 in breast cancer, this suggest a more aggressive cancer
- there are also good treatment specifically targeting HER2 positive breast cancer
- knowing the signalling pathway allows us to both identify prognosis and use targeted treatment for patient
17
Q
Immunohistochemistry
A
- shows us where certain proteins are expressed within the cel and in roughly what quantities they are expressed
- HERS2 can be measured on the membrane of cells, using this technique
18
Q
Cell cycle in neoplasia
A
- look for specific changes in the cell cycle in neoplasms, as part of diagnosis and to help with creating management plans
- presence/absences of mutations in the cycle can help determine prognosis and treatment
-eg. Looking for micro satellite instability MSI in various cancers
19
Q
MSI
A
- occurs when there is failure of the mechanisms to repair damaged DNA in the cell cycle
- repair system is known as as the mismatch repair system MMR
- if there is damage to MMR system, damaged DNA can be passed down to new cells, making them prone to the mutations causing cancer
- higher chance of mutation caused by failure of MMR system is MSI
20
Q
Multidisciplinary team and neoplasm
A
- neoplasms are often discussed at MDT to decided on best management for patient
- management depends on the grade and stage of neoplasm
21
Q
What is grading
A
- grading: how closely (or not) does the neoplasm correspond with normal cells for that tissue
- the more dysplastic the cells are the higher the grade
- grade can be correlated with likelihood to respond to treatment and with prognosis
22
Q
What is staging
A
- staging: how far the neoplasm spread through the body
- classical staging tool is TNM classification:
• tumour: measures local invasion
• node: measures spread to lymph nodes
• metastasis: measures spread to distant tissue - however, several neoplasms have their own special classification
23
Q
Effects of neoplasms: local
A
- generalised sunrooms (pain, lump)
- compression of surround structures
- ulceration
- bleeding/anaemia
- obstruction
24
Q
Different effect of neoplasms: metastatic
A
- depends on the site of metastasis
25
Different effect of neoplasm: systemic
-weight loss, loss of appetite, cachexia
- fever or feeling non-specifically unwell
- infection
26
Different effect of neoplasm: para- neoplastic
- secretion if excess substances
- raised calcium ( leads to confusion)
27
Different effects of neoplasms: mental health
- depression, anxiety, frustration- worsening quality of life
