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Principles > Neoplasia 4 > Flashcards

Neoplasia 4 Flashcards

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1
Q

What is the hope when the cancer has been fully removed?

A

If it has been fully removed, the hope it that it will not come back.

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2
Q

What does the progression of the cancer depend on?

A

Depends on type of tumour.

Depends on anatomical site.

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3
Q

what does the severity of the cancer depend on?

A

How malignant is it behaving?
Subtly different to how far it has spread@
How

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4
Q

What does macro mean?

A

Round

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5
Q

Why is it important to see if the tumour is Symmetrical?

A

Symmetrical things are almost always benign.

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6
Q

How can you tell if a cancer is homogenous?

A

If the genetic material is Homogenous.
Cut surface is uniform
One area looks the same as another.

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7
Q

why does the fact that a tumour is Encapsulated matter in deciding if a tumour is malignant or benign?

A

Most growing lesions stimulate a response by the surrounding tissue.
Often we try and fence it off with a capsule.
To form a capsule takes time - infers that the lesion is slow growing.
Slow growing lesions are usually benign.

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8
Q

What do Malignant tumours look like?

A 
Malignant lesions look nasty.
Malignant lesions don't look natural.
Irregular.
Infiltrative.
Destructive.
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9
Q

How can you tell that a tumour is Heterogenous?

A 
Different areas
May denote
Haemorrhage
Necrosis
(these are also signs it is malignant)
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10
Q

What is Histopathology?

A

the study of changes in tissues caused by disease.

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11
Q

What is Differentiation and how can it affect a person’s ability to determine what the cell of origin is?

A

All cells originate from a stem cell.
Recessive various signals to mature into a specific cell type with a specific function.
The cells “differentiate”.
Well differentiated - look more like what they should look like.
Poorly differentiated - difficult to tell what the cell of origin is.

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12
Q

Malignant

A

N:C ratio.

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13
Q

How can Mitosis indicate whether a cell is malignant or benign?

A

If you are seeing increases mitotic activity that is a signal that something is wrong, and the cell is malignant.

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14
Q

What is Taxonomy?

A 
Big groups
Epithelial
Mesenchymal - connective tissue
Haematopoietic - white cell etc.
Others - melanocytic, brain (glial).
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15
Q

What different types of tumours occur on each type of epithelium?

A

Epithelium - carcinomas
Glandular - adenoma vs. aadenocarcinoma
Squamous - papilloma vs. SCC
Bladder - transitional cell carcinoma (TCC)
Sometimes called urothelial cell carcinoma.

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16
Q

what are Mesenchymes?

A

Tumours of connective tissues.
Bone, cartilage, peripheral nerves, fat, fibrous tissue, smooth muscle, skeletal muscle, miscellaneous others.
Malignant lesions are known as sarcomas.

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17
Q

What is karyotype?

A

this is where we can culture cells and can see full chromosome complement.

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18
Q

What do they look for in molecular genetics to suggest the properties of a tumour?

A

Small changes
Look at oncogenes etc.
Diagnosis, prognonsis and therapy.

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19
Q

What do you need to consider when thinking about how far the tumour has gone.

A 
Stage.
May relate to size.
Or how far through tissue planes.
Possible involvement of other structures.
TNM.
Tumour.
Node.
Metastasis.
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20
Q

What does how big is it, mean for certain structures?

A

For certain structures it is how far through e.g. the bowel wall is it?

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21
Q

what does the stage of the cancer depend on?

A

How far.
Can have a well differentiated tumour that has grown slowly byut been there for ages.
It will have a high stage.
Could have an aggressive rapidly growing cancer that is caught early.
It will have a low stage.
Often depends on site.

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22
Q

What do you need to consider when deciding how bad a tumour is?

A 
Grade.
Give some indication of what the actual cells are like.
Concept of differentiation.
Well differentiated - low grade.
Poorly differentiated - high grade.
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23
Q

What is Mass Effect and how can it affect the body?

A 
Local problems because of the size.
Compression of adjacent structures.
Anatomically dependent.
Brain - any mass effect is bad.
Blocking of blood vessels.
Blocking of airways.
Blocking of bile ducts. (If it pops your bile ducts you will get jaundice)
24
Q

How does Anatomy affect how quickly a tumour is noticed?

A

Some tumours aren’t near other structures and can get big without anyone noticing. They present late and do badly.

25
Q

What are examples of tumours that would allow for early presentation?

A

Vocal cord - change in voice occurs early.
Skin cancers - you can see them.
Breast cancer - if you self-examine you can find them early.
Testicular cancer - self-examine

26
Q

What is a Loss of function and how can this act as a warning sign?

A

The organ can no longer perform its normal function.
Different tumours will have different effects depending on where and what they are.
Loss of function can be a useful warning sign - hoarseness, jaundice (blocked bile ducts).

27
Q

What are some characteristics of lung cancer?

A

Decreased are of healthy lung.
Decreased oxygen consumption.
Often a late occurrence.
Often large and multiple tumours.
However, patients with lung cancer often have pre-existing lung disease. Might not take much to further reduce lung function.
Infection.
Secondary to obstruction.
Like a pond without flowing water - stagnates.
Same thing occurs throughout the body - bladder.

28
Q

What can be the effects of having a tumour in the brain?

A 
No such thing as benign....
Lots of important things in the brain.
Breathing centres.
Control over heart rate.
Pressure increases.
Seizures - don't breathe.
29
Q

Do tumours require energy?

A

Tumours divide frequently compared to normal tissues.
Very metabolically active.
Require energy.

30
Q

Why does cancer cause weight loss?

A

The weight loss associated caused by cancer is called cachexia.
Not just energy use of tumour. Tumours can produce all sorts of molecules that result in increased metabolism throughout the body. Mainly tissue necrosis factor (TNF).

31
Q

Where can tumours infiltrate and what can this cause?

A

Direct invasion of other structures.
Other organs.
Fistulas and sinuses.
Poo in the wrong places.
Into the brain
Lung cancers through chest wall.
Nerves.
Loss of function.
Motor - swallowing, diaphragm.
Sensory - pain (late sign) or loss of sensation.
Others - autonomic functions.
Blood vessels.
Already commented on haemorrhage within tumours as a sign of malignancy (heterogeneus appearance).
Larger vessels are the problem - can be catastrophic.
Often cause of sudden death in patients with known cancer. Autopsy.
Bone arrow.
Produces white cells (neutrophils), platelets and red blood cells.
Folate etc. require by all dividing cells - tumours use up a lot. Less for other cells.

32
Q

What is Paraneoplastic?

A

Not directly related to the tumour. Often unusual.
Tumours can produce hormones.
Can result in electrolyte disturbances - high calcium, low sodium.
Osteoarthropathy - big fingers.
Unusual neurological symptoms.
Autopsy.

33
Q

What are Paraneoplastic Syndromes and what are some examples of these?

A

A paraneoplastic syndrome is a syndrome (a set of signs and symptoms) that is the consequence of cancer in the body, but unlike a mass effect, is not due to the local presence of cancer cells.
Skin rash - very common. Often unknown causes.
Fever - most common symptom associated with tumours. Related to abnormal production of endogenous “pyrogens”.
Pyrexia of unknown origin - PUO. Lots of causes but the important one not to miss are cancers.

34
Q

Why is it important for the body to avoid Immunosuppression when it comes to cancer?

A

Tumours express proteins that are not normally expressed. Can stimulate an immune response.
Often tumours that stimulate a strong response have a good prognosis.
Tumours want to survive and so want to avoid attack by the immune system.
Many have developed complex mechanisms to evade the immune system.
Cancer patients are at risk of infection (cancer and drugs).
Infection is not an uncommon cause of death in cancer patients.
Often get unusual infections - reactivation of chicken pox (shingles) etc.

35
Q

Are Metastases a problem and what do they cause?

A 
Often cause more trouble than the primary.
Liver mets - loss of function.
Lung - loss of function.
Bone.
Pathological fracture.
Calcium metabolism.
High levels of calcium - arrhythmia.
Kidney problems.
36
Q

Palliative Care

A

Many palliative care strategies are aimed at reducing symptoms from what we described earlier.
Palliative care - make death as comfortable and dignified as possible.
Unpleasant and emotional.

37
Q

What are the 4 things a team wants from the pathologist?

A

Is it out?
What is it?
How far has it gone?
How bad is it?

38
Q

How does the N:C (Nucleus to Cytoplasm) ratio predict whether a cell is malignant or benign?

A

High NC ratio is a strong predictor of malignancy. Like every rule, there are exceptions.

39
Q

How does regularity predict whether a cell is malignant or benign?

A

The more regular the tumour, the more likely that it is benign?

40
Q

What is Pleomorphism?

A

the occurrence of more than one distinct form of a natural object, such as the cells in a tumour.

41
Q

What is Hyperchromasia?

A

A hyperchromatic (increased colour) state of the nucleus, suggesting malignancy.

42
Q

What tumours are common in fat and what are the different types called?

A 
Benign tumours are common.
Lipoma. Usually subcutaneous.
Malignant - liposarcoma.
Rare. Deep soft tissue.
Retroperitoneum, testicular.
43
Q

What are Benign and malignant tumours that occur in bone called?

A

Benign - osteoma.

Malignant - osteosarcoma. Rare. Children and long bones.

44
Q

Cartilage

A

Chondro = cartilage.
Benign - lots of. Enchondroma
Malignant - chondrosarcoma.

45
Q

What are the different types of tumour you can get in skeletal muscle?

A

Rhabdo - derived from “striated”
Rhabdomyoma - rare, children
Rhabdomyosarcoma - are, eye, bile duct, gynae tract - others.

46
Q

What are examples of different tumours you get in smooth muscle?

A

Leio - greek for smooth

Benign - Leiomyoma. One of the most common tumours in the body.

47
Q

what is leiomyosarcoma?

A

Leiomyosarcoma (LMS) is a type of soft tissue sarcoma. Very uncommon.

48
Q

What are some of the different types of tumours that can develop in the nerves?

A

Benign - neurofibroma, schwannoma

Malignant - malignant peripheral nerve sheath tumour.

49
Q

What are he different types of tumours that can occur in the blood vessels?

A

Benign - haemangioma etc.

Malignant - angiosarcoma, Kaposi’s sarcoma.

50
Q

What are some examples of other types of sarcoma’s

A

Ewing’s sarcoma
Synovial sarcoma
Lots of fibrosarcoma variants.

51
Q

What types of tumours arise in the CNS?

A

Gliomas.
Different group.
Range from benign version of a tumour to malignant version.

52
Q

What are different types of melanocytic tumours?

A

Freckle - ephelis
Mole - naevus
Malignant - melanoma
Exception to rule ‘oma

53
Q

What are different types of cancers of the blood?

A

All “malignant”
Different rules as already “systemic”
Leukaemias
Lymphomas

54
Q

Sometimes morphology is not enough. What is morphology?

A

The form and structure of a particular organism, organ, tissue, or cell.

55
Q

What is cytogenetics?

A

Cytogenetics is a branch of genetics that is concerned with how the chromosomes relate to cell behaviour, particularly to their behaviour during mitosis and meiosis.

56
Q

What is the result of having a tumour in the bladder or kidney?

A 
Obstruction.
Can't drain urine.
Backwards pressure.
Kidney stops function.
Build up of toxins and abnormal electrolyte balance.

Principles (57 decks)

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