Neoplasia

Question 1

Define neoplasm

Answer 1

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

Question 2

Define malignant neoplasms

Answer 2

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

Question 3

What is a tumour

Answer 3

Clinically detectable lump or swelling

Question 4

What is a metastasis

Answer 4

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

Question 5

True or false a cancer is any neoplasm

Answer 5

False - it’s any malignant neoplasms

Question 6

What is the primary site of a tumour

Answer 6

The original location to where a tumour grows

Question 7

What is the secondary site of a tumour

Answer 7

The place where a tumour spreads too

Question 8

why is dyplasia not neoplastic

Answer 8

because It is reversible so is pre-neoplastic instead

Question 9

true or false - neoplasia is irreversible

Answer 9

true

Question 10

what are benign neoplasms

Answer 10

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

Question 11

which neoplasms have the potential to metastasise

Answer 11

malignant neoplasms

Question 12

how do benign tumours cause damage

Answer 12

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

Question 13

what do malignant tumours look like

Answer 13

• irregular outer margin

- areas of necrosis and ulceration

Question 14

why do malignant tumours often have areas of necrosis

Answer 14

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

Question 15

what do benign tissues look like under a microscope

Answer 15

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

Question 16

what do malignant tumours look like under a microscope

Answer 16

ranges from well to poorly differentiated

Question 17

what are anaplastic cells

Answer 17

cells with no resemblance to any tissue

Question 18

what do cells with worsening differentiation look like

Answer 18

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

Question 19

what is pleomorphism

Answer 19

variations in cell size and shape

Question 20

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

Answer 20

false - cells with a higher grade are poorly differentiated

Question 21

what causes neoplasms

Answer 21

accumulated mutations in somatic cells

Question 22

what causes the mutations leading to a neoplasm

Answer 22

initiators which are mutagenic agents

Question 23

what cause cell proliferation in the making of neoplasms

Answer 23

promoters

Question 24

name some main initiators

Answer 24

chemicals, infections, radiation

Question 25

what is progression

Answer 25

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

Question 26

how do we know that neoplasms are monoclonal

Answer 26

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

Question 27

what are proto-oncogenes

Answer 27

cells which positively affect growth

Question 28

what happens with proto-oncogenes are abnormally activated

Answer 28

they become oncogenes which favour neoplasm formation

Question 29

what happens to tumour suppressing genes to favour neoplasm formation

Answer 29

they become suppressed

Question 30

what do benign neoplasms end in

Answer 30

oma

Question 31

what do malignant neoplasms in the epitheial end in

Answer 31

carcinoma

Question 32

what do stromal malignant neoplasms end in

Answer 32

sarcoma

Question 33

what are in-situ carinomas

Answer 33

neoplasms which have not invaded through the basement membrane

Question 34

what is leukaemia

Answer 34

malignant neoplasm of blood forming cells arising in the bone marrow

Question 35

what are lymphomas

Answer 35

malignant neoplasms of lymphocytes

Question 36

what is a myeloma

Answer 36

malignant neoplasm of plasma cells

Question 37

what are blastomas

Answer 37

neoplasms which arise from immature precursor cells

Question 38

what are papilloma shaped neoplasms

Answer 38

tumour with finger like projections

Question 39

name 3 types of benign epithelial neoplasms

Answer 39

- squamous papilloma - transitional papilloma - adenoma (glandular)

Question 40

what is tumour burden

Answer 40

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

Question 41

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

Answer 41

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

Question 42

what is colonisation

Answer 42

the growth of a new tumour at a secondary site

Question 43

what must malignant cells avoid when spreading

Answer 43

destruction by immune cells such as natural killer cells

Question 44

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

Answer 44

- altered adhesion - stromal proteolysis - motility

Question 45

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

Answer 45

E-cadherin expression

Question 46

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

Answer 46

integrin expression

Question 47

why do malignant cells require altered stromal proteases

Answer 47

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

Question 48

which proteases are commonly altered for invasion by malignant cells

Answer 48

matrix metalloproteinases

Question 49

what is a niche

Answer 49

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

Question 50

how is altered mobility achieved in malignant cells

Answer 50

changes to the actin cytoskeleton

Question 51

how do malignant cells reach distant sites

Answer 51

- through blood vessels - though lymphatics - through fluid in body cavities (transcoelmic spread)

Question 52

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

Answer 52

micrometasteses

Question 53

what is tumour dormancy

Answer 53

how apparently disease free people may harbour many micrometasteses

Question 54

what factors determine the site of a secondary tumour

Answer 54

- drainage of blood, lymph and fluid | - or there can be an unpredictable distribution of blood-borne metastases

Question 55

through what do carcinomas usually spread

Answer 55

through the lymphatics to the draining lymph node

Question 56

through what do sarcomas usually spread

Answer 56

blood vessels to the lungs, bone, liver and brain

Question 57

what are the effects of a neoplasm on the host

Answer 57

- local effects caused by primary and secondary neoplasms | - systemic effects

Question 58

what are the local effects caused by neoplasms

Answer 58

- direct invasion of normal tissue - ulceration of surface leading to bleeding - compression of adjacent structures - blocking tubes and orifices

Question 59

what are the systemic effects of neoplasms

Answer 59

- increasing tumour burden - secretion of hormones - miscellaneous effects (paraneoplastic syndromes)

Question 60

what hormones do small cell carcinomas often produce

Answer 60

ACTH and ADH

Question 61

give example of miscellaneous effects of neoplasms

Answer 61

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

Question 62

what can an increasing tumour burden lead to

Answer 62

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

Question 63

what is the TNM staging

Answer 63

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

Question 64

what is used for staging lymphoma

Answer 64

Ann Arbor staging

Question 65

what is used for staging colorectal carcinomas

Answer 65

Dukes staging

Question 66

what is adjuvant treatment

Answer 66

treatment given after surgery to eliminate micrometastasis

Question 67

what is neoadjuvant treatment

Answer 67

treatment given before surgery to shrink the primary tumour

Question 68

what are tumour markers

Answer 68

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

Question 69

what does screening attempt to do

Answer 69

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

Question 70

what type of treatment options can be used

Answer 70

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

Question 71

what are used in chemotherapy

Answer 71

antimetabolites, antibiotics, alkylation agents and plant derived drugs