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Mechanisms Of Disease > Neoplasia 2 > Flashcards

Neoplasia 2 Flashcards

1
Q

Describe the 3 steps of invasion and metastasis

A

Grow and invade at primary site
Enter a transport system and lodge at a secondary site
Grow at the secondary site to form a new tumour (colonisation)

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2
Q

When is metastasis most likely to fail?

A

Entering a vessel and lodging at a distant site
OR
Growing at the secondary site

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3
Q

Invasion involves which 3 important alterations?

A

Altered adhesion
Stromal proteolysis
Motility

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4
Q

In carcinomas, what change happens upon invasion?

A

Epithelia-to-mesenchymal transition

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5
Q

How is adhesion altered between malignant cells for invasion?

A

Reduction in E-Cadherin expression

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6
Q

How is adhesion altered between malignant cells and stromal proteins in invasion?

A

Changes in integrin expression

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7
Q

Which enzymes are used to degrade the basement membrane and stroma?

A

Matrix metalloproteinases

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8
Q

What do we call the surrounding cells in the microenvironment that help with cancer invasion?

A

Niche

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9
Q

How do we change motility?

A

Changes in actin cytoskeleton

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10
Q

How does signalling through integrins occur?

A

Via small G proteins such as members of Rho family

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11
Q

What are the 3 routes of transport for metastasis?

A

Blood vessels (capillaries and venules)
Lymphatic vessels
Body cavities - transcoelomic spread

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12
Q

What are the 2 stages that malignant cells must achieve at the secondary site?

A

Extravasation (get out of the vessel)

Colonisation

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13
Q

Define micrometastases

A

Surviving microscopic deposits of malignant cells that fail to grow

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14
Q

Why might someone who has just has an organ transplant develop cancer?

A

They are taking immunosuppressant drugs

Any micrometastases in their/the donor organ(s) may begin to develop with the compromised immune system

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15
Q

Tumour dormancy is usually due to which 3 things?

A

Immune attack
Reduced angiogenesis
Hostile secondary site

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16
Q

What are the 2 most common sites of blood-borne metastases?

A

Lung
Liver
(Next capillary bed encountered)

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17
Q

Describe the seed and soil phenomenon

A

Interactions between malignant cells and local tumour environment at the secondary site
There are patterns to where many cancers spread
Different cancers ‘prefer’ different areas

18
Q

How do carcinomas typically spread?

A

Lymphatics

19
Q

How do sarcomas typically spread?

A

Blood stream

20
Q

What are the 4 most common sites of blood-borne metastases?

A

Lung
Bone
Liver
Brain

21
Q

Cancers of which origins most commonly metastasise to bone?

A 
Breast 
Bronchus
Kidney 
Thyroid 
Prostate
22
Q

What effect does prostate cancer have on bone?

A

Increases bone production

23
Q

Give an examples of an aggressive tumour that often metastasises early

A

Small cell bronchial carcinoma

24
Q

Give an example of a tumour that almost never metastasises

A

Basal cell carcinoma of skin

25
Q

What is the likelihood of metastasis related to?

A

Size of the primary neoplasm

26
Q

Describe some local effects of tumours

A

Direct invasion and destruction of normal tissue
Ulceration at a surface, leading to bleeding
Compression of adjacent structures
Blocking tubes or orifices

27
Q

Give examples of some of the systemic effects that an increased tumour burden can have

A

Reduced appetite and weight loss
Malaise
Immunosuppression
Thrombosis

28
Q

What do we call extreme weight loss and loss of appetite?

A

Cachexia

29
Q

Which hormones are most commonly secreted by tumours?

A

ACTH
ADH
PTH like hormone

30
Q

Name some of the miscellaneous systemic effects of tumours

A 
Neuropathies
Skin problems
Fever
Myositis 
Clubbing
31
Q

Describe some features of astrocytomas

A

More common in children
Most common glioma
Unlikely to metastasise
Locally aggressive

32
Q

Are malignant melanomas likely to metastasise?

A

Yes

Early

33
Q

What are the most common sites for malignant melanoma to metastasise to?

A

Skin
Brain
GI tract

34
Q

What is another name for a carcinoid tumour?

A

Neuron doctrine/endocrine tumour

35
Q

What is the most common and 2nd most common sites of carcinoid tumours?

A

Most common = appendix

2nd = small bowel

36
Q

What is carcinoid syndrome?

A 
Effects of extensive metastasis of neuroendocrine tumours 
Tachycardia 
Sweating
Skin flushing 
Anxiety 
Diarrhoea
37
Q

Which chemical mediators are responsible for carcinoid syndrome?

A

Serotonin

Prostaglandins

38
Q

What is a very important risk factor for carcinoma of the pancreas?

A

Cigarette smoking

39
Q

Why does carcinoma of the pancreas usually have a poor prognosis?

A

Symptoms occur at a late stage therefore not detected until late on
(Weight loss and obstructive jaundice)

40
Q

What is Trousseau’s sign?

A

With carcinoma of the pancreas, often patients develop venous thromboses

41
Q

Name 3 symptoms of lung cancer

A

Breathlessness
Pain on breathing
Hoarseness

42
Q

Which 3 sites are most likely to lead to secondary lung tumours?

A

Breast
Kidney
GI tract

Mechanisms Of Disease (11 decks)

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