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Phase 1 - S2 Pathology > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Define neoplasm

A

An abnormal growth of cells that persists after the initial stimulus is removed

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2
Q

Define malignant neoplasms

A

An abnormal growth of cells that persists after the initial stimulus is removed and invades surrounding tissue with potential to spread to distant sites

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3
Q

What is a tumour

A

Clinically detectable lump or swelling

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4
Q

What is a metastasis

A

Malignant neoplasms that has spread from its original site to a new site

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5
Q

True or false a cancer is any neoplasm

A

False - it’s any malignant neoplasms

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6
Q

What is the primary site of a tumour

A

The original location to where a tumour grows

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7
Q

What is the secondary site of a tumour

A

The place where a tumour spreads too

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8
Q

why is dyplasia not neoplastic

A

because It is reversible so is pre-neoplastic instead

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9
Q

true or false - neoplasia is irreversible

A

true

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10
Q

what are benign neoplasms

A

neoplasms which remain to their site of origin and don’t produce metastases

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11
Q

which neoplasms have the potential to metastasise

A

malignant neoplasms

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12
Q

how do benign tumours cause damage

A

they stay in a confined area and so push on the margin, damaging structures and causing inflammation - this is why they are rarely dangerous

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13
Q

what do malignant tumours look like

A
  • irregular outer margin

- areas of necrosis and ulceration

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14
Q

why do malignant tumours often have areas of necrosis

A

as angiogenesis must to survive but this often doesn’t supply enough blood and so parts of the tumour die

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15
Q

what do benign tissues look like under a microscope

A

they are well differentiated and so looks like the normal parent tissue

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16
Q

what do malignant tumours look like under a microscope

A

ranges from well to poorly differentiated

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17
Q

what are anaplastic cells

A

cells with no resemblance to any tissue

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18
Q

what do cells with worsening differentiation look like

A

increasing nuclear size, increasing nuclear to cytoplasmic ratio, increasing nuclear staining (hyperchromasia), more mitotic figures, size and shape variations

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19
Q

what is pleomorphism

A

variations in cell size and shape

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20
Q

true or false - cells with a higher grade are well differentiated

A

false - cells with a higher grade are poorly differentiated

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21
Q

what causes neoplasms

A

accumulated mutations in somatic cells

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22
Q

what causes the mutations leading to a neoplasm

A

initiators which are mutagenic agents

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23
Q

what cause cell proliferation in the making of neoplasms

A

promoters

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24
Q

name some main initiators

A

chemicals, infections, radiation

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25
Q

what is progression

A

the accumulation of more mutations to form a neoplasm from a monoclonal population

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26
Q

how do we know that neoplasms are monoclonal

A

neoplastic tissues only express 1 isoenzyme of the glucose-6-phosphate

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27
Q

what are proto-oncogenes

A

cells which positively affect growth

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28
Q

what happens with proto-oncogenes are abnormally activated

A

they become oncogenes which favour neoplasm formation

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29
Q

what happens to tumour suppressing genes to favour neoplasm formation

A

they become suppressed

30
Q

what do benign neoplasms end in

A

oma

31
Q

what do malignant neoplasms in the epitheial end in

A

carcinoma

32
Q

what do stromal malignant neoplasms end in

A

sarcoma

33
Q

what are in-situ carinomas

A

neoplasms which have not invaded through the basement membrane

34
Q

what is leukaemia

A

malignant neoplasm of blood forming cells arising in the bone marrow

35
Q

what are lymphomas

A

malignant neoplasms of lymphocytes

36
Q

what is a myeloma

A

malignant neoplasm of plasma cells

37
Q

what are blastomas

A

neoplasms which arise from immature precursor cells

38
Q

what are papilloma shaped neoplasms

A

tumour with finger like projections

39
Q

name 3 types of benign epithelial neoplasms

A
  • squamous papilloma
  • transitional papilloma
  • adenoma (glandular)
40
Q

what is tumour burden

A

Refers to the number of cancer cells, the size of a tumor, or the amount of cancer in the body. Also called tumor load.

41
Q

how do malignant cells get from a primary site to a secondary site

A

after growing and invading a primary site they travel through a transport system and lodge at a secondary site where a new tumour grows

42
Q

what is colonisation

A

the growth of a new tumour at a secondary site

43
Q

what must malignant cells avoid when spreading

A

destruction by immune cells such as natural killer cells

44
Q

what 3 changes are required for invasion producing epithelial to mesenchymal transition

A
  • altered adhesion
  • stromal proteolysis
  • motility
45
Q

what must be altered in cells to allow adhesion between malignant cells

A

E-cadherin expression

46
Q

what must be altered in cells to allow adhesion between malignant and stromal proteins

A

integrin expression

47
Q

why do malignant cells require altered stromal proteases

A

in order to degrade the basement membrane and stroma in order to invade

48
Q

which proteases are commonly altered for invasion by malignant cells

A

matrix metalloproteinases

49
Q

what is a niche

A

collection of malignant and non-malignant cells (which provides growth factors and proteases)

50
Q

how is altered mobility achieved in malignant cells

A

changes to the actin cytoskeleton

51
Q

how do malignant cells reach distant sites

A
  • through blood vessels
  • though lymphatics
  • through fluid in body cavities (transcoelmic spread)
52
Q

What are microscopic deposits of malignant cells which fail to grow called

A

micrometasteses

53
Q

what is tumour dormancy

A

how apparently disease free people may harbour many micrometasteses

54
Q

what factors determine the site of a secondary tumour

A
  • drainage of blood, lymph and fluid

- or there can be an unpredictable distribution of blood-borne metastases

55
Q

through what do carcinomas usually spread

A

through the lymphatics to the draining lymph node

56
Q

through what do sarcomas usually spread

A

blood vessels to the lungs, bone, liver and brain

57
Q

what are the effects of a neoplasm on the host

A
  • local effects caused by primary and secondary neoplasms

- systemic effects

58
Q

what are the local effects caused by neoplasms

A
  • direct invasion of normal tissue
  • ulceration of surface leading to bleeding
  • compression of adjacent structures
  • blocking tubes and orifices
59
Q

what are the systemic effects of neoplasms

A
  • increasing tumour burden
  • secretion of hormones
  • miscellaneous effects
    (paraneoplastic syndromes)
60
Q

what hormones do small cell carcinomas often produce

A

ACTH and ADH

61
Q

give example of miscellaneous effects of neoplasms

A

neuropathies affecting the brain and peripheral nerves, pruritis, abnormal pigmentation, fever, finger clubbing

62
Q

what can an increasing tumour burden lead to

A

reduced appetite, weight loss, malaise, immunosuppression and thrombosis due to the parasitic effect of the tumour cells and the factors like cytokines they release

63
Q

what is the TNM staging

A

T - tumour size
N - regional metastasis
M - distant metastasis

64
Q

what is used for staging lymphoma

A

Ann Arbor staging

65
Q

what is used for staging colorectal carcinomas

A

Dukes staging

66
Q

what is adjuvant treatment

A

treatment given after surgery to eliminate micrometastasis

67
Q

what is neoadjuvant treatment

A

treatment given before surgery to shrink the primary tumour

68
Q

what are tumour markers

A

substances released by cancer cells which are used to monitor tumour burden

69
Q

what does screening attempt to do

A

detect cancers as early as possible where the chance of curing is highest

70
Q

what type of treatment options can be used

A

surgery, chemotherapy, radiation, hormone therapy, molecular specific treatment

71
Q

what are used in chemotherapy

A

antimetabolites, antibiotics, alkylation agents and plant derived drugs

Phase 1 - S2 Pathology (13 decks)

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