neoplasm 1

Question 1

define neoplasia

Answer 1

• process of uncontrolled growth

- accumulation of cells due to proliferation or evasion of apoptosis

Question 2

define neoplasm/tumor

Answer 2

• abnormal mass of tissue
• growth exceeds and is uncoordinated with normal tissue
• persists in same excessive manner after cessation of stimuli which evoked the changed

Question 3

describe the features of neoplasms

Answer 3

• Progressive, PURPOSELESS, Pathological, proliferation of cells
• loss of control over cell division
• DNA damage at growth control genes (“checkpoints”) is central to development of neoplasm
• Carcinogens cause DNA damage and DNA damage leads to neoplasm

Question 4

describe benign tumors

Answer 4

• neoplasm that grows without invading adjacent tissue/spreading to distant sites ( NO metastasis)
• usually well-circumscribed (with lack of invasion)
• generally amenable to local surgery

Question 5

describe malignant tumors

Answer 5

• neoplasm that INVADES surrounding normal tissue
• usually spreads to distant sites (metastasis)
• may be treated successfully or can follow a deadly course

Question 6

define intermediate tumors (local malignant)

Answer 6

• locally invasive - not bening

- no tendency for metastasis

Question 7

define carcinoma in situ (dysplasia)

Answer 7

• pre-invasive cell proliferation

- cytological features of malignancy

Question 8

describe parenchyma

Answer 8

• comprised of clonal neoplastic cells
• this determines its biologic behavior
• tumor derives its name based on the parenchymal component

Question 9

• describe stroma

Answer 9

• comprised of connective tissue, blood vessels, macrophages and lymphocytes (tumor infiltrating lymphocytes, TILs)
• this determines the growth and evolution of tumor
• -> stroma scant = tumor soft and fleshy
• -> abundant collagenous stroma (desmoplasia) = stony hard (scirrhous)

Question 10

describe the components of neoplasm

Answer 10

• Parenchyma = clonal neoplastic cells

- stroma = connective tissue, blood vessels, macrophages and lymphocytes

Question 11

describe the nomenclature of benign tumurs and the exceptions

Answer 11

• add suffix -oma to proliferating cell type
• examples = fibroma, chondroma, osteoma
• EXCEPTIONS = melanoma and lymphoma, carcinoma

Question 12

define cystadenomas

Answer 12

• adenomas with cavities or cysts

Question 13

define polyp

Answer 13

• club-shaped growth
• benign epithelial tumor or hyperplasia
• tumor projects from mucosal surface into lumen of a hollow viscus
• benign epithelial tumors from surface lining - based on gross appearance

Question 14

define papilloma

Answer 14

• benign epithelial tumors from surface lining - based on gross appearance
• benign tumors (squamous, transitional, ductal epithelium)
• PRODUCES FINGER-LIKE/WARTY projections from epithelial surfaces - branching pattern
• E.G. papilloma of urinary bladder, skin

Question 15

Define Choristoma

Answer 15

• tumor like conditions
• ectopic rest of normal tissue
• normal tissue in a foeign location
• Example = rest of adrenal cells under kidney capsule, or in lungs or ovaries or pancreatic tissue in mucosa of stomach or small intestine

Question 16

define Hamartoma

Answer 16

• tumor like condition
• non-neoplastic tumor-like lesion with disorganized and haphazard growth of tissues normally found at a given site.
• ex: pulmonary hamartoma = jumbled cartilage, bronchial epithelia and CT

Question 17

describe general features of malignant tumors

Answer 17

• capsule generally absent
• rapid growth
• invasion present with metastatic potential
• atypical mitosis present
• well-differentiated or poorly diff
• suffix used = carcinoma/sarcoma

Question 18

describe general features of benign tumors

Answer 18

• capsule generally present
• slow growth
• invasion absent, non-metastatic
• no atypical mitosis seen
• well-differentiated
• suffix used = oma

Question 19

what is the cell origin of Sarcoma

Answer 19

• Mesenchymal origin

- initially spread via hematogenous

Question 20

what is the cell origin of carcinoma

Answer 20

• epithelial cell origin

- spreads via lymphatics

Question 21

define lymphoma

Answer 21

• cancer derived from lymph nodes or lymphoid tissue
• most are non-hodgkin’s lymphoma
• stomach is the most common extranodal site for a primary malignant lymphoma

Question 22

define leukemia

Answer 22

• cancer derived from the bone marrow stem cells
• CLL is the most commona dult keukemia and overall leukemia
• ALL is the most common childhood leukemia and cancer

Question 23

define teratoma

Answer 23

• tumor composed of more than one parenchymal cell type
• derived from MORE THAN ONE germ layer
• originates from totipotent cells (in gonads)

Question 24

Define Peutz-Jeghers Syndrome

Answer 24

• Type of Hamartoma
• also called hereditary intestinal polyposis syndrome
• an autosomal dominant genetic disease
• characterized by the development of benign hamartomatous polyps in the GI tract + hyperpigmented macules (lips+ oral mucosa)

Question 25

define monoconality

Answer 25

• origin of tumors from a single precursor cell

- All tumors (benign and malignant) are monoclonal

Question 26

how do new subclones arise

Answer 26

• arise from the descendants of the original transformed cells by multiple mutations, BUT, all neoplasms arise from monoclonal population derived from a single cell

Question 27

describe how to differentiate between a benign and malignant neoplasm

Answer 27

• differences based on appearance of tumor and behavior
• 4 criteria:
• -> rate of growth
• -> differentiation and anaplasia
• -> local invasion
• -> metastasis