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M1 Cancer > Neoplasia and Cancer Pathology > Flashcards

Neoplasia and Cancer Pathology Flashcards

1
Q

What is the difference between neoplasia and cancer?

A

Neoplasm can be benign (eg. BPH) or malignant (Cancer)

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2
Q

True or False. Tumours are often accompanied by blood vessels and connective tissue.

A

True

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3
Q

How can benign tumours complicate?

A

1) Site (eg. meningioma –> ^ intracranial pressure)
2) f(x) (eg. insulinoma –> hypoglycaemia)

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4
Q

What are the 4 main characteristic of benign tumours?

A

1) slow growth rate (by compression of surrounding tissue)
2) no infiltration, vascular invasion, or metastasis
3) High px survival rate after surgical excision
4) well-differentiated, resembling normal tissue of origin (uniform appearance)

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5
Q

Are all “-omas” benign?

A

No.
eg. Sarcoma, Carcinoma, Lymphoma, Hepatoma, Melanoma

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6
Q

Are malignant tumours well or poorly differentiated?

A

Poorly differentiated –> less resemblance to parent tissue

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7
Q

What are the 4 main characteristics of malignant tumours?

A

1) rapid growth rate (by invasion of surrounding tissue)
2) metastasizing
3) poor px survival rate after surgical excision + tendency for recurrence (local or distant
4) poorly-differentiated, irregular structures

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8
Q

What do multiple necrotic or discoloured circles in resected organs usually indicate?

A

Tumour metastasis

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9
Q

What are Blastomas?

A

Generally aggressive malignant tumours

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10
Q

What are the distinctive histological features of Blastomas?

A

Rosettes (primitive looking structures) which are small round cell tumours

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11
Q

What are Teratomas?

A

Tumours arising from totipotent germ cells in gonads

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12
Q

Where are Teratomas usually form?

A

Gonads (eg. testes, ovaries)

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13
Q

What are some local effects that can result from GIT-related tumours?

A

Obstruction, Perforation, Ulceration

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14
Q

How can a tumour result in a non-healing ulcer?

A

Destruction of epithelial surfaces (eg. GIT, mouth, bronchi)

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15
Q

Why do tumours cause pain and when would they not?

A

When tumours form/invade sites with sensory nerve endings.
They are initially painless only when in the brain and viscera.

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16
Q

What are the 3 broad clinical effects of Cancer?

A

1) Local/mechanical
2) Endocrine
3) Cancer cachexia

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17
Q

What are some possible endocrine effects of tumours?

A

1) Endocrine tumours producing excessive hormones
2) Paraneoplastic syndrome
3) Loss of f(x) by compression/destruction

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18
Q

What is cancer cachexia/wasting syndrome?

A

1) Cytokine-related (TNF, IL-1) progressive fat loss due to proteolysis-inducing factor
2) Anorexia due to excessive cytokine release
3) Anaemia w weakness due to autoimmunity or excessive bleeding

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19
Q

How can tumours cause edema?

A

Venous or lymphatic obstruction (eg. tumour embolism)

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20
Q

What is “paraneoplastic syndrome”?

A

Symptom complexes that are not attributable to:
(i) local or (ii) distant spread
(iii) hormonal effects indigenous to tissue of origin

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20
Q

What are some examples of paraneoplastic syndromes?

A

1) Endocrinopathies (eg. Cushing’s syndrome, SIADH, HyperCa2+)
2) Nerve and Muscle Syndromes (eg. Myasthenia, CNS/PNS disorders)
3) Dermatologic disorders (eg. Dermatomyositis, Acanthosis nigricans)
4) Osteoarthropathy and finger clubbing
5) Hematologic changes (eg. Anaemia, Thrombosis, non-bacterial thrombotic endocarditis)

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21
Q

What are tumour markers?

A

They are enzymes, hormones, oncofetal Ag that are used in biomarker assays in the screening of cancers.

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21
Q

Can tumour markers be used for definitive diagnosis?

A

No

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22
Q

What are the uses of tumour biomarker assays?

A

1) Detection of cancers
2) monitoring residual/reccurent tumours post therapy

23
Q

What are the types of tumour markers?

A

1) Hormones (eg. HCG, Calcitonin, Catecholamines, metabolites)
2) Oncofetal Ags (eg. AFP, CEA)
3) Isoenzymes (eg. Prostatic acid phosphatase, Neuron-specific enolase)
4) Proteins (eg. Igs, PSA)
5) Glycoproteins (eg. Mucins, CA-125/19-9/15-3)
6) p53, RAS mutations (in serum, sputum, stool, urine)

24
Q

What is Dysplasia?

A

Premalignant conditions resulting from disordered growth in epithelia

25
Q

Do all dysplasia progress to malignant tumours?

A

No, but it does predispose to cancer development

26
Q

What is the risk of px with Familial Adenomatous Polyposis (FAP) developing colon cancer?

A

100%

27
Q

What is the gene that causes FAP

A

APC gene (AD inheritance)

28
Q

What Virus can cause dysplasia?

A

Human Papillomavirus (HPV)

29
Q

How are cervical cancers screened for?

A

PAP smears for dysplastic cells

30
Q

How are tumours staged and graded?

A

Histologically

31
Q

What is the difference between tumour staging and grading?

A

Grading refers to the degree of differentiation
Staging refers to the degree of metastasis

32
Q

What is the significance of tumour staging

A

Higher stage cancers are more aggressive and have worse prognosis
This is impt for px counselling and treatment (need adjuvant)

33
Q

What is the TNM system?

A

The staging system to describe the invasiveness of the tumour.
T - tumour in primary site
N - Lymph nodes, regional
M - distant metastases

34
Q

What are the grades of a malignant tumour?

A

Grade 1: Well differentiated
Grade 2: Moderately differentiated
Grade 3: Poorly differentiated

*Some have grade 4

35
Q

How are tumours disseminated?

A

1) Local infiltration
2) Spread through body cavities (eg. seeding in body cavities, pagetoid/epithelial linins, Perineural infections)
3) Lymphatic spread
4) Hematogenous spread (eg. GIT–> Liver via portal vein, to Lung vis caval vein, to spine via paraverterbral venous plexus, to brain via arteries)

36
Q

Are enlarged regional lymph nodes indicative of metastatic cancer spread?

A

No, it could be a reactive hyperplasia to tumour Ags, or some other infection.

37
Q

Are the presence of only isolated cells in regional draining lymph nodes indicative of metastatic cancer spread?

A

No

38
Q

What type of cells form Carcinomas?

A

Epithelial Cells

39
Q

What cells form Sarcomas?

A

Endothelial cells

40
Q

What cells form Melanomas?

A

Melanocytes

41
Q

What cells form Lymphomas?

A

Lymphocytes (B or T cells)

42
Q

What cells form Lipomas?

A

Adipocytes

43
Q

What cells form Chondrosarcomas?

A

Cartilage

44
Q

What cells form Fibrosarcoma?

A

Fibrous Tissue

45
Q

What cells form Leiomyoma?

A

Smooth Muscle cells

46
Q

What cells form Haemangioma

A

Vascular endothelial cells

47
Q

What is a adenocarcinoma?

A

A gland forming malignant tumour

48
Q

What is a fibroadenoma?

A

A benign tumour formed from both fibrous and glandular tissue.

49
Q

What are the key histological features of malignant cells?

A

Infiltrative growth/Not well-circumscribed
Poorly differentiated/Anaplasia
High/abnormal mitosis
Hyperchromasia w large nucleolus and clumped chromatin
Pleomorphism
High N/C ratio
Metastasis
Necrosis and haemorrhage common

50
Q

What are the key histological features of benign tumours?

A

Non-infiltrative/compressive growth/Well-circumscribed
Well-differentiated
Few mitoses
Rare necrosis and haemorrhage

51
Q

What are the 4 key histological features of a Carcinoma?

A

1) Keratinisation
2) Keratin pearls
3) Intercellular Bridging
4) Cell Shape + eosinophilic cytoplasm

52
Q

What is the key histological feature of a Adenoma?

A

Intracellular mucin

53
Q

What differentiates a Carcinoma from a Carcinoma in-situ?

A

Carcinoma in-situ has yet to breach any basement membrane to invade underlying stroma

54
Q

What does the suffix “-oma” imply?

A

Epithelial or Mesenchymal origin

55
Q

What does the prefix “Adeno-“ imply?

A

Glandular origin

56
Q
A

M1 Cancer (4 decks)

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