Neoplasm

Question 1

What is adenoma and papilloma?

Answer 1

Adenoma is benign neoplasm of glandular epithelial cells.

Papilloma is benign neoplasm of non-glandular epithelium.

Question 2

What is malignant neoplasm of the epithelial cells known as?

Answer 2

Carcinoma.

Question 3

What is malignant neoplasm of connective tissue cells known as?

Answer 3

Sarcoma

Question 4

Name the benign and malignant neoplasms of blood vessels.

Answer 4

Benign neoplasm: Haemangioma

Malignant neoplasm: Angiosarcoma

Question 5

Name the malignant neoplasms of smooth muscle and striated muscle.

Answer 5

Smooth muscle: Leiomyosarcoma

Striated muscle: Rhabdomyosarcoma

Question 6

Is Hepatoma benign or malignant? Which cells are affected?

Answer 6

Hepatoma is malignant. Affects the liver cells.

Question 7

Is lymphoma benign or malignant?

Answer 7

Malignant. There is no benign lymphoma as the cancerous cells can travel all around the body.

Question 8

Is Seminoma benign or malignant? Which cells are affected?

Answer 8

Seminoma is malignant. Malignant testicular neoplasm.

Question 9

What is the difference between benign neoplasm and dysplasia?

Answer 9

A benign neoplasm forms a lump or mass that can be seen by the naked eye, but dysplasia can only be identified microscopically.

Question 10

What is the difference between malignant neoplasm and dysplasia?

Answer 10

Malignant neoplasms have invaded the neighbouring tissues.

But in dysplasia, the basement membrane is intact.

Question 11

Which organ is affected in Wilm’s tumour? Is it malignant or benign?

Answer 11

Wilm’s tumour: A malignant neoplasm of the kidneys

Question 12

What are affected in Burkitt’s lymphoma?

Answer 12

Cancer of the lymphatic system, particularly B lymphocytes in the germinal center. It affects the facial and maxillary bones.

Question 13

Name the neoplastic disease where there are swellings of lymphoid tissues, spleen and liver, with invasion of other tissues.

Answer 13

Hodgkin’s disease

Question 14

Define carcinoma in situ

Answer 14

An abnormal epithelium that has all the cellular features of malignancy (severe dysplasia) but has not invaded through the basement membrane.

Question 15

Lymphatic spread normally involves a sarcoma or carcinoma?

Answer 15

Carcinoma

Question 16

Haematogenous spread normally involves a sarcoma or carcinoma?

Answer 16

Both sarcoma and carcinoma

Question 17

What is the grade and stage of neoplasm?

Answer 17

Grade of the neoplasm describes the degree of malignancy of the neoplasm.

Stage of neoplasm describes the extent of spread of neoplasm.

Question 18

What is Duke’s staging used for? Describe Duke’s staging.

Answer 18

Duke’s staging is used for colorectal cancer.
Duke A: Confined to bowel wall
Duke B: Through bowel wall (invasive)
Duke C: Spread to local lymph nodes (metastasised)

Question 19

Grade of neoplasm depends on which three features?

Answer 19

1. Mitotic activity
2. Nuclear size and pleomorphism (variation in size and shape)
3. Degree of differentiation, i.e. how much it resembles the normal tissue

Question 20

What is growth fraction?

How does the growth fraction apply clinically?

Answer 20

The proportion of cells which remains in the proliferating pool.
The higher the growth fraction, the more effective chemotherapy which targets dividing cells will be.

Question 21

What is Li-Fraumeni syndrome?

Answer 21

Mutation to p53 gene on short arm of chromosome 17: Increased risk of various tumours

Question 22

What is Wilm’s tumour?

Answer 22

Nephroblastoma

Question 23

What are the 3 factors investigated in staging?

Answer 23

TNM staging:
T - Size of tumour
N - absence or presence and extent of regional lymph node metastasis
M - Absence or presence of distant metastasis

Question 24

What is Herceptin?

Answer 24

herceptin is a humanized monoclonal antibody used to treat women with metastatic disease whose cancer hads molecular alteration.

Question 25

Why is triple negative breast cancer dangerous?

Answer 25

Triple Negative breast cancer is dangerous due to resistant to treatments and can metastasise quickly

Question 26

Which genes are the most commonly mutated in breast cancer?

Answer 26

BRCA2 and p53 the commonest.

Question 27

What type of mutation occurs to the Ras gene leading to breast and colon cancer?

Answer 27

point mutation

Question 28

Which gene is affected in Burkitt's lymphoma? What type of mutation occured to this gene?

Answer 28

myc - translocation

Question 29

What is the genetic mutation to erb-B2 which can lead to breast cancer?

Answer 29

amplification

Question 30

What condition results from mutation to the p53 gene?

Answer 30

Li-Fraumeni syndrome

Question 31

Which gene inhibits apoptosis and which gene favours apoptosis?

Answer 31

Inhibits apoptosis: bcl-2 and bcl-xL | Favours apoptosis: bwx, bnd and bcl-xS

Question 32

Are DNA repair genes oncogenic? Explain.

Answer 32

No, DNA repair genes themselves are not oncogenic but their mutation can allow mutations in other genes.

Question 33

What do most carcinogens require in order to cause tumours?

Answer 33

Cofactors

Question 34

What is the difference between direct carcinogens and procarcinogens?

Answer 34

Direct carcinogens are in the active form when administered and can lead to cancers instantly. Procarcinogens must first undergo metabolic conversion to ultimate carcinogens.

Question 35

Define initiation and promotion.

Answer 35

Initiation: Mutagen induces genetic alterations. promotion: Clonal proliferation of transformed cell is stimulated.

Question 36

What are the 4 types of tissues particularly vulnerable to radiation carcinogenesis?

Answer 36

Haematopoietic tissue, thyroid, breast and bone

Question 37

Give examples of inorganic and organic carcinogens

Answer 37

Inorganic carcinogens: metals (nickel) or asbestos (mineral fibres) Organic carcinogens: nitrosamines, azodyes and aromatic amines, polycyclic aromatic hydrocarbons

Question 38

What are the cancers associated with the following chemical carcinogens? a) polycyclic aromatic hydrocarbons b) aromatic amines c) nitrosamines d) azodyes e) alkylating agents

Answer 38

a) polycyclic aromatic hydrocarbons: lung and skin cancer b) aromatic amines: bladder cancer c) nitrosamines: gut cancer d) azodyes: bladder and liver cancer e) alkylating agents: leukemia

Question 39

Burkitt's lymphoma is associated with which virus?

Answer 39

EBV

Question 40

What are the viruses that can cause cancers?

Answer 40

Herpes virus: EBV - Burkitt's lymphoma, nasopharyngeal carcinoma; HHV8: Kaposi's sarcoma Papova virus: HPV: Genital warts and cervical cancer Hepadna virus: HBV: Hepatocellular carcinoma

Question 41

What is malignant neoplasm of placental tissue called?

Answer 41

Choriocarcinoma

Question 42

Cancers expressing HER2 can be treated with what drug?

Answer 42

Trastuzumab, or otherwise known as Herceptin

Question 43

Where does cervical intraepithelial neoplasia develops in?

Answer 43

CIN develops in the metaplastic squamous epithelium of the transformation zone.

Question 44

How is cervical intraepithelial neoplasia graded? Describe the gradings.

Answer 44

Cervical Intraepithelial neoplasm is graded based on the level at which maturation occurs. a) CIN1 - Maturation of upper 2/3 of epithelium b) CIN2 - Maturation of upper 1/3 of epithelium c) CIN3 - No/Little maturation

Question 45

Describe the characteristics of familial cancer and inherited cancers respectively.

Answer 45

Familial cancers: 1. No specific phenotype marker 2. Have 1 or 2 close relatives affected 3. Inheritance pattern is unclear 4. Early age of onset Inherited cancers: 1. Autosomal dominant 2. Have a specific phenotype marker 3. Strong family history of (uncommon) cancer 4. Tumours affect specific sites and tissues 5. Incomplete penetrance, variable expressivity

Question 46

What is colposcopy?

Answer 46

A simple procedure used to look at the cervix

Question 47

What is the appropriate screening interval for the effectiveness of cervical screening?

Answer 47

3 years interval