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Pathology > Neoplasia - what is cancer? > Flashcards

Neoplasia - what is cancer? Flashcards

1
Q

what is neoplasia?

A

a lesion resulting from the autonomous or relatively autonomous abnormal growth of cells which persists after initialising stimulus removed
-literally means new growth
- can be benign or malignant

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2
Q

what is tumour?

A

just means swelling

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3
Q

how do tumours arise?

A

due to accumulation of genetic alterations & epigenetic changes

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4
Q

what are neoplasms usually comprised of?

A

neoplastic cells & connective tissue stroma (vascular supply important)

  • pseudo neoplasms & other abnormal growths also exist
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5
Q

what does malignant mean?

A

a neoplasm with potentially lethal, abnormal characteristics which has the ability to invade and metastasise

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6
Q

what does benign mean?

A

neoplasm which doesn’t have the ability to invade & metastasise (they’re not necessarily harmless)

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7
Q

what are the 4 factors to tell how bad a neoplasm is?

A
  1. differentiation (how different it looks from original tissue)
  2. rate of growth (look for rate of mitosis, necrosis etc)
  3. local invasion (how much it invades all the tissue & vessels around it)
  4. metastasis (is it eating into lymphatics & vessels - as if that happens more likely to spread through body)
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8
Q

what is differentiation in context of neoplasms?

A

extent to which neoplastic tissue resemble their corresponding normal tissue of origin

-> it has levels of well, moderate, poor and anaplastic (where well looks similar and anaplastic looks completely different)

  • any level can be benign or malignant
  • anaplastic may need special stains/molecular technique to diagnose
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9
Q

what are features of poorly differentiated tumours?

A
  • nuclear pleomorphism (variability in nuclear size & shape)
  • abnormal nuclear features
  • increased mitotic activity
  • loss of cellular polarity/order
  • tumour giant cells
  • necrosis
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10
Q

what are some examples of abnormal nuclear features in poorly differentiated tissues?

A
  • high nuclear : cytoplasmic ratio
  • clumped chromatin
  • prominent nucleoli (dots in nucleus)
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11
Q

what is classification of the tumour?

A

name = grade & stage

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12
Q

what is grade in classification of tumour?

A
  • measure of how differentiated the tumour appears
    well = grade 1
    moderately = grade 2
    poorly = grade 3
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13
Q

what is stage in classification of tumour?

A

a measure of extent of spread of a tumour
= prognostication/therapeutic decisions

(lower the number = better for the patient)

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14
Q

what is metaplasia?

A

change in phenotype of differentiated cells, often response to chronic irritation

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15
Q

what is hypertrophy?

A

increased cell and thus organ size, often in response to increased workload e.g. cardiac hypertrophy

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16
Q

what is hyperplasia?

A

increased cell numbers in response to stimulus e.g. hormones / growth factors e.g. endometrial

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17
Q

what is dysplasia?

A

term used to describe confined neoplastic change (mostly epithelia)

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18
Q

what are some features of dysplasia?

A
  • cytomorphological features of malignancy (all features - big nucleus, lots of mitosis →if all in epithelium but not invading then dysplasia, so not malignant yet but like gearing up)
  • confined within basement membrane
  • nuclear pleomorphism/architectural disruption
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19
Q

what is carcinoma- in situ?

A

really bad dysplasia
= cytomorphological features of malignancy but without invasion
= full thickness of epithelium
= basement membrane of dysplastic epithelium not penetrated (basement membrane separates blood/lymphatic vessels)

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20
Q

does dysplasia always lead to malignancy?

A

no, sometimes it can regress

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21
Q

what is the rate of growth like for malignant and benign neoplasms?

A
  • malignant neoplasms are often fast growing
  • benign neoplasms are usually slow growing
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22
Q

what are some features of rapid growth and why are they associated?

A

mitoses = because lots of cells are dividing rapidly
&
necrosis = because the tumour is growing so fast that the blood supply can’t keep up

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23
Q

what are some characteristics of benign tumours?

A
  • cohesive & expansile (not invading but just squishing)
  • localised
  • don’t metastasise
  • usually slow growth
  • may be encapsulated (rim of compressed connective tissue = fibrous capsule)
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24
Q

what are some characteristics of malignant tumour?

A
  • invasive
  • penetrate organ walls/tissues/ epithelial surfaces
  • next to metastases, invasiveness is the most reliable feature that differentiates malignant from benign tumours
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25
Q

what is metastasis?

A

spread of tumour to a site discontinuous from the source organ/tissue

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26
Q

what is growth rate for benign & malignant tumours?

A

benign = slow
malignant = fast

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27
Q

what is mitotic activity for benign & malignant tumours?

A

benign = low
malignant = high

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28
Q

what is differentiation for benign & malignant tumours?

A

benign = well
malignant = often poor

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29
Q

what is nuclear morphology for benign & malignant tumours?

A

benign = normal
malignant = pleomorphic

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30
Q

is there invasion for benign & malignant tumours?

A

benign = no
malignant = yes

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31
Q

what is border like for benign & malignant tumours?

A

benign = circumscribed and/or encapsulated
malignant = poorly defined/invasive

32
Q

what is necrosis like for benign & malignant tumours?

A

benign = rare
malignant = common

33
Q

what is ulceration like for benign & malignant tumours?

A

benign = rare
malignant = common

34
Q

what is growth direction for benign & malignant tumours?

A

benign = exophytic
malignant = endophytic

35
Q

are benign tumour always harmless?

A

no - some can be very locally destructive

e.g. meningioma, benign tumour of meninges, compressive effects in skull

36
Q

what is histogenic classification & nomenclature?

A

based upon tissue of tumour origin

37
Q

what are the different types of tissue of tumour origin?

A

epithelium:
- non glandular epithelia (protection)
- glandular epithelia (glands & ducts, secretion)

non epithelium:
- mesenchymal
- hematopoietic
- Neuroectodermal
- Germ cells
- Embryonal (blastomas)
- Mixed tumours

38
Q

what is the suffix of benign tumours and what are the exceptions?

A

OMA
-> melanoma, lymphoma, seminoma, mesothelioma etc

39
Q

what is adenoma?

A

type of benign tumour of glandular/secretory epithelium
(glands may or may not be present in the tumour)

40
Q

what is papilloma?

A

benign tumour of non-glandular/surface epithelium (it actually describes fingerlike or warty projections but most benign non-glandular epithelial tumours do this)

41
Q

what is squamous cell papilloma?

A

benign tumour of squamous epithelium (skin)

42
Q

what is colonic adenoma?

A

benign tumour of glandular epithelium of the colon

43
Q

how can you classify benign epithelial tumours?

A

first by if glandular or non-glandular (adenoma or papilloma) and then by name of cell type origin, epithelium source or cell type (e.g. squamous cell or colonic)

44
Q

what is thyroid adenoma?

A

benign tumour of a glandular epithelium of thyroid

45
Q

what is nomenclature for benign mesenchymal tumours?

A

cell of origin + OMA

46
Q

what is prefix & benign nomenclature for smooth muscle?

A

prefix = leiomyo
benign nomenclature = leiomyoma

47
Q

what is prefix & benign nomenclature for skeltal muscle?

A

prefix = Rhabdomyo
benign nomenclature = Rhabdomyoma

48
Q

what is prefix & benign nomenclature for adipose tissue?

A

prefix = lipo
benign nomenclature = lipoma

49
Q

what is prefix & benign nomenclature for blood vessel?

A

prefix = haemangio
benign nomenclature = haemangioma

50
Q

what is prefix & benign nomenclature for bone?

A

prefix = osteo
benign nomenclature = osteoma

51
Q

what is prefix & benign nomenclature for cartilage?

A

prefix = chondro
benign nomenclature = chrondroma

52
Q

what is prefix & benign nomenclature for fibrous tissue?

A

prefix = fibro
benign nomenclature = fibroma

53
Q

what do you call malignant epithelial tumours derived from glandular/ductural epithelium?

A

adenocarcinoma

54
Q

what do you call malignant epithelial tumour derived from surface non-glandular epithelia?

A

carcinoma

55
Q

what is squamous cell carcinoma?

A

malignant nomenclature for stratified squamous

56
Q

what is basal cell carcinoma?

A

malignant nomenclature for basal cells of the skin

57
Q

what is transitional cell carcinoma?

A

malignant nomenclature for transitional epithelium of the bladder

58
Q

what is colonic adenocarcinoma?

A

malignant nomenclature for glandular epithelium of colon

59
Q

what is breast adenocarcinoma?

A

malignant nomenclature for glandular epithelium of breast

60
Q

what are malignant mesenchymal tumours called?

A

sarcomas (that’s the suffix - like OMA for benign mesenchymal and sarcoma for benign mesenchymal)

61
Q

what is prefix and malignant nomenclature for smooth muscle?

A

prefix = leiomyo
malignant nomenclature = leiomyosarcoma

62
Q

what is prefix and malignant nomenclature for skeletal muscle?

A

prefix = rhabdomyo
malignant nomenclature = rhabdomyosarcoma

63
Q

what is prefix and malignant nomenclature for adipose tissue?

A

prefix = lipo
malignant nomenclature = liposarcoma

64
Q

what is prefix and malignant nomenclature for blood vessels?

A

prefix = angio
malignant nomenclature = angiosarcoma

65
Q

what is prefix and malignant nomenclature for bone?

A

prefix = osteo
malignant nomenclature = osteosarcoma

66
Q

what is prefix and malignant nomenclature for cartilage?

A

prefix = chondro
malignant nomenclature = chondrosarcoma

67
Q

what are teratomas? (other tumour type)

A

germ cell origin (gonads)
= contains cells representing ALL 3 germ layers (endoderm, mesoderm, ectoderm)

benign = teeth/hair/muscle/neural/cartilage
malignant = tissues more primitive

68
Q

what are precursor cell tumours? (& examples)

A

= histological resemblance to embryological tissue in which arise

  • RETINOBLASTOMA
  • NEPHROBLASTOMA (WILMS)
  • HEPATOBLASTOMA
    (often occur in young patients)
69
Q

what is mixed tumours?

A

epithelial & mesenchymal neoplasia
(single clone leads to both types of cells)

70
Q

what is an example of a malignant mixed tumour?

A

carcinosarcoma (has parts of epithelial & mesenchymal tumour)
= makes challenging to treat

71
Q

what is an example of benign mixed tumour?

A

ameloblastic fibroma

72
Q

what is hamartoma?

A
  • Non-neoplastic disordered overgrowth of normal tissue (benign)
  • Indigenous to the site of occurrence (don’t invade or destroy)
  • Developmental abnormalities
  • Port wine stain
73
Q

what is chrostoma?

A
  • Benign normal tissue but seen in abnormal location
  • E.g. normal (non-neoplastic) pancreas nodule in stomach, heterotropic rests (pancreas cells in weird places in body)
74
Q

what are hematolymphoid malignancies?

A

Lymphoma = malignancy of T or B cell origin (often begins in lymph nodes but can arise in other places) - hodgkin vs non hodgkin

myeloma = malignancy of plasma cells

leukaemia = malignancy of white blood cells that begin in bone marrow

75
Q

what are melanocytic neoplasms?

A

Melanoma
- Malignancy of melanocytes
- Cells which produce pigment in the skin

MELANOCYTIC NAEVUS
- Benign proliferation of melanocytes

Pathology (10 decks)

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