Neoplasia II Flashcards
Differentiation
How much the tumor cells resemble its cell of origin
If a tumor cell resembles its cell of origin it is _______.
Well-differentiated
If a tumor cell sort of resembles its cell of origin it is ____.
Moderately-differentiated
If a tumor cell doesn’t resemble its cell of origin at all it is ____.
Poorly-differentiated
Benign tumors are usually _____ differentiated.
Well
What type of differentiation can malignant tumors be?
Any level
Anaplasia
A state of complete un-differentiation
Really it means that the individual cells are poorly-differentiated which almost always indicates malignancy
If a cell shows anaplasia what would you see?
Pleomorphism (multiple sizes and shapes) Hyperchromatic (deeply colored) Bizarre nuclear shapes, distinct nucleoi Lots of mitoses, atypical mitoses "Architectural anarchy"
Dysplasia
Disordered growth
Used to describe disorderly changes in non-neoplastic epithelial cells, is a step toward cancer
How is dysplasia measured?
Mild (frequently reversible)
Moderate (usually reversible)
Severe (usually progresses into carincoma in situ
What would you see in dysplasia?
Pleomorphism
Hyperchromatic, large nuclei
Lots of mitoses
Architectural anarchy
What is tumor growth dependent on?
Blood supply
Hormonal factors
Emergence of aggressive sub-clones
Which grows faster; malignant or benign?
Malignant
Which grows faster; poorly or well defined?
Poor
Growth fraction (GF)
Cells that are actively dividing
Describe the tumor growth based on its age?
Early (subclinical) - GF high
Late (clinically detectable) - GF low
Which types of cancers have a high growth fraction?
Leukemias, lymphomas, small-cell lung cancer
Which types of cancers have a low growth fraction?
Breast, colon
If you are presented with a high GF tumor, what is the treatment?
Chemotherapy/radiation
If you are presented with a low GF tumor, what is the treatment?
Treat by debulking with chemotherapy/radiation
What is the characteristic of a local invasion by a benign tumor?
Stay where it is
Can’t invade or metastasize
Usually encapsulated
What is the characteristic of a local invasion by a malignant tumor?
Infiltrate, invade and destroy surrounding tissue
Metastasize to other body parts
Not encapsulated
Metastasis
Development of secondary tumor implants in distant tissue
How many pts with have malignancies at stage 4 by the time its located?
1/2
What does a metastasis depend on?
Type of tumor
Size of tumor
Degree of differentiation of tumor
Which types of tumor will metastasize the fastest?
Neuroendorcine > adeno > squamos
What are the three types of metastasis?
Seeding (direct extension)
Lymphatic spread
Hematogenous spread
What is seeding metastasis?
Tumor invades body cavity (plueral, pericardial, peritoneal, intracranial)
Bits break off and surface implants
What is lymphatic spread?
Tumor spreads to local lymph nodes
Sentinel lymph node first
Moves through thoracic duct
Empties into subclavian vein
What is hematogenous spread?
Veins are easier to invade arteries
Liver and lungs are most common sites
How do carcinomas like to spread?
Lymphatic spread
How do sarcomas like to spread?
Hematogenous spread
