Neoplasia 2

Question 1

What is the difference between a benign and malignant tumour?

Answer 1

Malignant tumours have the ability to invade and metastasise.

Question 2

What is the systemic consequence of metastasis?

Answer 2

There is a greatly increased tumour burden, and vast numbers of malignant cells.

Question 3

What are the three steps involved in metastasis?

Answer 3

Cells must grow and invade at a primary site, they then must enter a transport system and become lodged somewhere followed by growth at this new, secondary site.

Question 4

What must metastasising cells evade in order to be successful?

Answer 4

The immune response from the body.

Question 5

What three properties of an cancerous epithelial cell change when it invades?

Answer 5

Motility, stromal proteolysis and altered adhesion

Question 6

What is EMT?

Answer 6

Epithelial to mesenchymal transition. This occurs because cells undergo change when they invade tissue.

Question 7

What is responsible for altered adhesion between 2 malignant cells?

Answer 7

E-Cadherin

Question 8

What is responsible for altered adhesion between malignant cells and other stromal proteins?

Answer 8

Altered integrin expression.

Question 9

What is a Matrix metalloproteinase?

Answer 9

These degrade the basement membrane and stroma and allow invasion of cells.

Question 10

What is a cancer niche?

Answer 10

This is the name for the cells surrounding the tumour which are taken advantage of, and secrete some growth factors as well as proteases.

Question 11

What is the major change in a cell which leads to altered motility?

Answer 11

Changes in the actin cytoskeleton.

Question 12

Through what structures can cancerous cells travel to distant sites?

Answer 12

Blood vessels, lymphatic system and coelomic spaces.

Question 13

What is extravasation?

Answer 13

When cells travel to a distant site in a vessel, this is the process in which they leave the vessel.

Question 14

What is the name for growth of tumour cells once they reach a distant site?

Answer 14

Colonisation.

Question 15

What is tumour dormancy?

Answer 15

This is where tumour free individuals harbour micrometastisis

Question 16

What is the most common cause of malignant tumour relapses?

Answer 16

Growth of micrometastasis.

Question 17

What determines the second neoplasm site?

Answer 17

This depends on where the fluid drains to. For lymph it is lymph nodes, for blood vessels next capillary bed (lung or liver) and for coelomic fluid it is generally adjacent organs.

Question 18

What can be said about the niche at a second cancer site?

Answer 18

This must be a similar environment which means that requirements for tumour growth are met.

Question 19

Name some neoplasms which commonly metastasis to bone.

Answer 19

Prostate, thyroid, breast, bronchus, kidney.

Question 20

What is seen on an X-ray of bone which is affected by secondary neoplasm?

Answer 20

Areas of osteolysis are present. When the primary is prostate, then instead areas of dense bone are seen.

Question 21

Name a carcinoma which rarely metastasises

Answer 21

Basal cell carcinoma

Question 22

In what cases is a tumour still malignant if it does not metastasis?

Answer 22

If it has invaded local tissue.

Question 23

What are paraneoplastic syndromes?

Answer 23

These are systemic effects of the neoplasm, for example tumour burden, hormones and other effects.

Question 24

Name some local complications of neoplasms.

Answer 24

Ulceration leading to bleeding, blocking of tubes, damage to local tissue and compression of adjacent structures.

Question 25

What are common systemic effects of cancer?

Answer 25

This is caused by the parasitic effect of increased tumour burden. It includes weightloss, cachexia, reduced appetite, immunosuppression and thrombosis.

Question 26

Why do benign tumours of endocrine glands usually secrete hormones?

Answer 26

They are usually well differentiated.

Question 27

Name a malignant neoplasm which secretes ADH and ACTH.

Answer 27

Bronchial small cell carcinoma.

Question 28

What hormone does bronchial squamous cell carcinoma secrete?

Answer 28

PTH-like hormone.

Question 29

There are some miscellaneous systemic effects associated with cancer. Name a few:

Answer 29

Neuropathy of brain and peripheral nerves, myositis, fever, skin abnormalities (in pigmentation and itching)