Neoplasia 2

Question 1

In histopathology what are the types of specimen submitted?

Answer 1

1) cytology - fluid sample of tumour
2) biopsy - solid sample of tumour
3) excision - surgical removal of the whole tumour

Question 2

In histopathology what are the types of examinations are performed?

Answer 2

1) macroscopic examination
2) microscopic examination
3) special tests - immunohistochemistry, FISH, PCR

Question 3

Wha is the role of a histopathologist in managing neoplasia’s?

Answer 3

1) provide diagnosis - benign, in situ, malignant, classification
2) provide prognostic information - tumour grade, vascular invasion, perineural invasion, extent of invasion, tumour stage
3) provide predictive information - testing the neoplasm for markers of responsivness to specific therapies
4) Screening

Question 4

What tumour shapes tend to be more benign or malignant?

Answer 4

Benign - sessile, pedunculated and papillary tumours

Malignant - fungating, ulcerated and annular tumours

Question 5

What are the architectural and nuclear features of benign neoplasms?

Answer 5

Architectural

• resemblance to normal tissue = goof
• tumour border = circumscribed
• invasion = absent

Nuclear

• hyperchromasia = often absent
• irregular nuclear border = absent
• pleomorphism = absent
• prominent nucleoli = often absent
• mitotic activity = low

Question 6

What are the architectural and nuclear features of malignant neoplasms?

Answer 6

Architectural

• resemblance to normal tissue = variable, often poor
• tumour border = often poorly defined
• invasion =present

Nuclear

• hyperchromasia = present
• irregular nuclear border = present
• pleomorphism = present
• prominent nucleoli = present
• mitotic activity = high

Question 7

What is the suffix for malignant neoplasms of epithelial origin?

Answer 7

carcinoma

Question 8

What is the suffix for malignant neoplasms of mesenchymal origin?

Answer 8

sarcoma

Question 9

What are the main pathological prognostic features?

Answer 9

1) tumour invasiveness - depth of invasion, vascular invasion, perineural invasion
2) grade- degree of histological resemblance to the parent tissue
3) stage - extent of anatomical spread - depth through tissue (mucosa, serosa)

Question 10

What is the breslow depth?

Answer 10

depth of invasion of malignant melanoma - important prognostic factor
Depth of invasion is the main way to stage a tumour

Question 11

What is gleason’s patterns?

Answer 11

1) small, uniform glands
2) more stroma between glands
3) distinctly infiltrative margins
4) irregular masses of neoplastic glands
5) only occasional gland formation
from 1 to 5 it become more and more poorly differentiated
This pattern is important prognostic factor in prostatic adenocarcinoma

Question 12

How are tumours staged?

Answer 12

TNM staging
T- tumour size and local invasion
N- degree of spread to regional lymph nodes
M - presence or absence of distant metastases
A “p” in front of staging e.g. pT2, pN1, pM0 = Means the staging has been done by a pathologist
Not applicable in all cases e.g. CNS, lymphomas

Question 13

What is % of 5 year survival cases in terms of Duke staging for colorectal cancer?

Answer 13

A- 90%
B- 40%
C- 10%

Question 14

What predictive testing methods are used for hormone receptor sensitive breast cancers?

Answer 14

Immunohistochemistry

Question 15

What predictive testing methods are used to determine gene rearrangements in lung cancer?

Answer 15

fluorescent in situ hybridisation

Question 16

What predictive testing methods are used to determine mutations in colorectal cancer?

Answer 16

PCR

Question 17

What is the aim for screening?

Answer 17

based on the concept of detecting carcinoma in situ, before it has become invasive