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Pathology Basic abcdefg > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

Metastasis

A

spread to distant sites

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2
Q

Invasive

A

tumor capable of destroying structures

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3
Q

Cancer

A

is a malignant neoplasm

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4
Q

Proliferatation:

A

Cell division

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5
Q

Differentiation

A

: Functional and structural maturity of cells

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6
Q

Growth

A

: Increase in size due to synthesis of tissue components

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7
Q

Controls of Growth

A 
Growth factors – PDGF, FGF
Growth Inhibitors. 
Cyclins, Cyclin dependent kinases (CDK).
Cancer suppressor genes – p53
Oncogenes – c-onc, p-onc, v-onc etc.
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8
Q

Growth factors

A

PDGF , FGF

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9
Q

Cancer suppressor genes

A

P53

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10
Q

Oncogenes

A

c-onc, p-onc, v-onc etc.

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11
Q

Non-Neoplastic Proliferation

Controlled & Reversible processes:

A

Hypertrophy – increase in cell size
Hyperplasia – increase in cell number
Metaplasia – change of cells type
Dysplasia – disordered cells

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12
Q

Neoplastic Proliferation characteristics

A

Uncontrolled & Irreversible
Progressive, purposeless, pathologic, proliferation of cells characterized by loss of control over cell division.
DNA damage at growth control genes is central to development of neoplasm.

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13
Q

How do we get cancer

A 
Damage to genetic material
Affects different sites in the genome 
Evolution of more aggressive clones
(
Carcinogens (Chemical, radiation, viruses) 
 DNA damage 
 Neoplasm)
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14
Q

Neoplasm definition:

A

“An abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues, and persists in the same excessive manner after cessation of the stimuli which evoked the change”

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15
Q

Neoplasm normal and abnormal properties

A 
Normal properties loss:
Increased proliferation.
Decreased cell death.
Failure to differentiate.
Abnormal properties develop:
Invasion.
Metastasis.
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16
Q

Tumors have two basic components:

A 
1) Parenchyma: 
made up of neoplastic cells 
from which the tumor derives its name
2) Stroma:
supporting, host-derived, non-neoplastic
made up of connective tissue and blood vessels
provides support for the growth of parenchyma
crucial to the growth of the neoplasm
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17
Q

The classification of neoplasm

A 
Behaviour- benign and malignant
Extent of spread- Primary and secondary
The cell of origin or histogenesis:
epithelial
mesodermal/connective tissue
hematopoietic
nervous system
germ cells
embryonic tissue
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18
Q

Localized, non-invasive, patient usually survives

A

Benign

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19
Q

Spreading, Invasive, may result in early death of the patient

A

Malignant cancer

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20
Q

Malignant characteristics

A 
Large size
Not encapsulated
Poorly circumscribed
Loss of differentiation
Cells lose normal functions
Invasion of normal tissue
Necrosis
Many mitosis 
potentially lethal
Metastasising
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21
Q

Benign characteristics

A 
Small size
maybe encapsulated 
well circumscribed 
well differentiated tissues
Cells retain normal functions
no invasion 
no necrosis 
few mitosis 
nonlethal 
non metastasizing
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22
Q

Tumours invade lymphatics, blood vessels or through peritoneal or other surfaces to form

A

secondary tumours (metastasis)

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23
Q

Papilloma tissue origin

A

Squamous or transitional (epithelial )

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24
Q 
What is the malignant name of
Adenoma
Papilloma
Fibroma
Lipoma
Osteoma 
Chondroma
Leiomyoma 
Rhabdomyoma
Hemangioma
A 
Adenocarcinoma 
(Squamous cell carcinoma or Transitional cell carcinoma)
Fibrosarcoma
Liposarcoma
Osteosarcoma 
Chondrosarcoma
Leiomyosarcoma
Rhabdomyosarcoma 
Angiosarcoma
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25
Q

is a benign neoplasm growing on any surface, composed of epithelial cells forming finger like projections.

A

Papilloma

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26
Q

Adenoma

A

Applied to benign epithelial neoplasms producing gland patterns.
E.g. Surface epithelium (stomach, small intestine & colon)
Applied to benign neoplasms derived from glands but not necessarily exhibiting gland patterns.
E.g. Solid glandular epithelium (endocrine and exocrine) and ducts (Thyroid, kidney, liver)

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27
Q

Germ cell tumor

Malignant*

A

Teratoma

Seminoma

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28
Q

Pediatric tumors

Malignant*

A

Hepatoblastoma
Nephroblastoma
Retinoblastoma

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29
Q

Hematopoietic

Malignant*

A

Leukemias

Lymphomas

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30
Q

Brain tumors

Malignant*

A

Glioma

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31
Q

Tumors can be distinguished by:

A

Differentiation and anaplasia
Rate of growth
Local invasion
Metastasis

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32
Q

Well-differentiated tumors:

A

contain cells that resemble the normal cells of origin and retains its functional capacity

33
Q

Poorly-differentiated or undifferentiated tumors:

A

contain cells that do not resemble their normal cells of origin

34
Q

Differentiation: extent to which parenchymal neoplastic cells resemble normal cells morphologically and functionally, while ……. does not aid in the separation of benign from malignant.

A

Stroma

35
Q

Tumor composed of well-differentiated cells.

A

Benign

36
Q

tumors are characterized by a wide range of cellular differentiation (well, moderate, poor, undifferentiated).

A

Malignant

37
Q

: malignant neoplasms that are composed of undifferentiated cells

A

Anaplasia

38
Q

Histological Features of anaplasia:

A 
Cellular pleomorphism 
Giant cells 
Hyperchromatic nuclei
Nuclear- cytoplasmic ratio may approach 1:1  
Nuclear pleomorphism 
Mitosis is numerous and/or atypical 
Loss of cell polarity
39
Q

a non-neoplastic proliferation

A

Dysplasia

40
Q

is an abnormal type of excessive cell proliferation characterized by loss of normal tissue arrangement and cell structure in epithelium.

A

Dysplasia

41
Q

Dysplasia may or may not…

A

Progress to cancer

42
Q

In epithelia, represents a state between hyperplasia and carcinoma in situ (pre-invasive neoplasia)
*Pleomorphism & mitoses are more prominent than in the normal

A

Dysplasia

43
Q

……have a slower rate of growth than moderately-differentiated and poorly-differentiated malignant tumors.

A

Benign and well-differentiated malignant tumors

##There are exceptions. 
Malignant tumors sometimes grow slowly for years and suddenly enter a phase of rapid growth
44
Q

Factors that can affect the growth rate of tumor:

A

Blood supply
Site
hormonal stimulation

45
Q

Leiomyomas: influenced by………, increase during pregnancy, and cease growing or atrophy after menopause

A

Estrogen

46
Q

Some induce formation of dense fibrous stroma (desmoplasia)

A

Malignant

47
Q

Next to metastases, …….. is the most reliable feature that distinguishes malignant from benign tumors.

A

Local invasiveness

48
Q

Not all cancers have equivalent ability to metastasize, e.g

A

Basal cell carcinoma

49
Q

“rodent ulcer.”

A

Basal cell carcinoma (BCC): skin cancer that is common and slow growing. Grossly, the tumor begins as papules with rolled margins but can ulcerate and locally invade underlying structures and bone. Hence, the name “rodent ulcer.”

50
Q

~ 30% of newly diagnosed patients with solid tumors present with …

A 
clinically evident metastases. 
#In general, the more anaplastic and the larger the primary neoplasm, the more likely is metastatic spread
51
Q

Methods of spread

A

Direct Spread
Seeding of body cavities: ovarian tumors
Hematogenous spread: favored pathway for sarcomas. The liver and lung are the most frequently involved secondary sites.
Lymphatic spread: is more typical of carcinomas

52
Q

Invasion and Metastasis sequence

A

Invasion of the basement membrane
Movement through extracellular matrix
Penetration of vascular or lymphatic channels
Survival and arrest within the circulating blood or lymph
Exit from the circulation into new site
Survival and growth as a metastasis

53
Q

Seeding of body cavities
Occurs when neoplasms invade a natural body cavity.
Examples:
Carcinoma of the colon may penetrate the wall of the gut and reimplant at distant sites in the …… cavity.
Lung cancers in the ……. cavities.
Cancers of the ovary in the …….. cavity.

A

Peritoneal
Pleural
Peritoneal

54
Q

It is the most feared consequence of a cancer.

It is the favored pathway for sarcomas

A

Hematogenous spread

55
Q

In hematogenous spread
arteries are penetrated ….. than veins.
Liver & lungs are the most frequently involved secondary sites

A

Less

56
Q

Hematogenous Spread
Examples:

Renal cell carcinoma to the .....
Hepatocellular carcinomas to the ....
Colon cancer to the ....
Prostatic carcinoma preferentially spreads to the....
Bronchogenic carcinomas to the....
Neuroblastomas spread to the .....
A

Renal cell carcinoma to the lung
Hepatocellular carcinomas to the lung
Colon cancer to the liver
Prostatic carcinoma preferentially spreads to bone
Bronchogenic carcinomas to the adrenals and the brain
Neuroblastomas spread to the liver and bone

57
Q

Lymphatic spread

Idk wtf, just read the other side

A

Example: Lung and breast carcinoma
Skip metastases:
The cancer cells seem to traverse the lymphatic channels within the immediately proximate nodes to be trapped in subsequent lymph nodes
The cells may traverse all of the lymph nodes to reach the blood via the thoracic duct.

58
Q

The necrotic products of the neoplasm and tumor antigens often evoke reactive changes in the lympth nodes:

A

Lymphadenitis

Sinus histiocytosis

59
Q

Indicates how aggressive it is

How much different it looks from the tissue of origin

A

Grading (microscopic)

60
Q

How advanced the cancer is

How far it has spread

A

Staging (clinical)

61
Q

….. usually has prognostic value.

A

Staging

62
Q

Malignant neoplasms Grading

A 
Low grade, is relatively non-aggressive
high grade, likely to grow and spread quickly. 
1 well differentiated 
2 moderately differentiated 
3 poorly differentiated 
4 undifferentiated (anaplastic)
63
Q

Features used to grade malignant neoplasms

A
  1. Degree of tissue differentiation.2. Number of mitoses.3.Host response in terms of lymphocytic infiltration.4.Invasive margin of the tumor.5.Degree of nuclear pleomorphism
64
Q

Why do we grade & stage cancer?

A

To estimate the prognosis
i.e. how long the patient may survive
To decide how to treat the tumor
More advanced/ aggressive tumors are given more radical treatment
To compare treatments or prognostic factors in research
Do males die earlier of a certain tumour than females?

65
Q

Tumours are staged using ?..

A 
TNM System
T	Extent of primary Tumour
N	Regional lymph Node metastasis
M	Distant Metastases 
An overall stage is allocated I to IV
Each organ has different staging
66
Q

T staging of breast cancer

A 
Tis in situ disease
T1.. <2c
T2  ...2 – 5 cm
T3.. > 5cm
T4.. Involving skin or chest wall
67
Q

N staging for breast cancer

A

N0 ..no node
N1 .. ipsilateral nodes
N2.. contralateral notes

68
Q

M staging for breast cancer

A

M0 no distant metastasis

M1 distant metastasis

69
Q

The Dukes staging system for colorectal cancer

A 
Four stages 
A 	Confined to bowel wall
B	Through bowel wall
C	Regional lymph node metastases
D	Distant metastases
70
Q

Smoking is a factor for cancer in

A

Mouth, pharynx, oesophagus, lip,

larynx, lung, bladder

71
Q

Alcohol is a factor for cancer in

A

Mouth, pharynx, larynx,

oesophagus, colorectal

72
Q

Cancer iatrogenic factors and where
Estrogens..
Androgens..
Radiotherapy..

A

Endometrium, vagina, breast
Prostate
carcinoma of breast & Bronchus

73
Q

Liver (hepatocellular carcinoma)

Is associated with

A

Hepatitis B or C virus

74
Q

Burkitt’s lymphoma
Hodgkin’s lymphoma
Associated with

A

Epstein–Barr virus

75
Q

Stomach (gastric cancer)

Associated with

A

Helicobacter pylori

76
Q

Breats cancer is associated with

A

High fat diet

77
Q

Environmental Carcinogens

A

Drugs: immune suppressing etc..
Organic chemicals: Insecticides, herbicides, aromatic hydrocarbons, etc..
Cigarette Smoke
Ethanol
Heavy Metals
Sexually transmitted viruses: Herpes simplex, Human papilloma virus
Radiation: Ultraviolet light

78
Q

Inherited Cancer Syndromes

A

Autosomal Dominant
Autosomal Recessive Syndromes
Familial Cancers

Pathology Basic abcdefg (10 decks)

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