Neoplasia 2

Question 1

What is invasion?

Answer 1

Breach of the basement membrane with progressive infiltration and destruction of surrounding tissues

Question 2

How does invasion occour?

Answer 2

• Altered adheasion
• Stromal Proteolysis
• Motility

Cell now has an alterted pheonotype more simular to that of surrounding cells

Question 3

What happens in altered adheasion?

Answer 3

Reduction in E-Cadherin expression
Changes in integrin expression

Normal epethilial cells not held together as tightly

Question 4

What happens in stromal proteolysis?

Answer 4

Altered expression of proteases (MMPs)
This degrades the basement membrane

The maligant cells can take advantage of the non-neoplastic cells and form a niche.

Question 5

What is a niche?

Answer 5

Correct conditions for a malignant cell to grow

Involves stroma, fibroblasts, endothelial cells and imflammatory cells

Non noeplastic cells provide proteases and GFs

Question 6

What does motility involve?

Answer 6

Changes in actin cytoskeleton allowing it to contract and ‘ratchet’ epithelial cells along

Question 7

What is Metastasis?

Answer 7

Spread of tumour to sites that are discontinuous from the primary tumour

Question 8

What are the steps involed in metatasis?

Answer 8

Growth and invasion at primary site
Enterance into transport system and lodging at secondary site
Growth at secondary site

Question 9

What are the metastasis transport routes?

Answer 9

Blood vessels- normally veins

Lymphatic vessles- follows drainage route

Fluid in body cavities- pleural/ peritoneal/ pericardial

Question 10

What determines the site of a metastasis?

Answer 10

Regional drainage

Seed and soil phenomenon

Question 11

What is regional drainage?

Answer 11

Lymphatic metastasis- predictable due to drainage

Transcoelemic- other areas in space or adjacent organs

Blood borne- normally next capillary bed

Question 12

What is the seed and soil phenomenon?

Answer 12

Could explain unpredictable distribution of blood borne

Just because a cell can get the doesn’t mean it can grow (may not have the correct niche)

Question 13

What neoplasms commmonly spread to bones?

Answer 13

Breast 
Bronchus 
Kidney 
Thyroid 
Prostate

Question 14

What is a lytic lesion?

Answer 14

Spots of softened bone damage that appear as holes where the bone has been destroyed

Question 15

What is a sclerotic leasion?

Answer 15

Unusual hardening or thickenings of the bone

Can be benign or malignant

Question 16

What are the local effects of neoplams?

Answer 16

• Direct invasion/ destruction of normal tissue
• Ulceration -bleeding
• Compression of adjacent structures
• Blocking tubes and orifices (obstructions)
• Raised pressure due to growth/ swelling (brain)

Question 17

What are systemic effects of neoplasms?

Answer 17

Increased turmor burden- parasitic effect on host
Secreated factor such as cytokines combine to produce response

Production of hormones (normally by benign tumours)

Question 18

What can the parasitic effect look like?

Answer 18

Cachexia (loss of fat/ lean muscle, increased BMR, loss taste/ smell)
Malaise
Immunosuppression
Thromboosis (blood viscous, more clots forming)