Neoplasm Conditions Flashcards
1
Q
Colorectal cancer predisposing factors, presentation, macroscopic/microscopic, principles of staging, tumour marker, screening program
A
- Predisposing Factors – Obesity, smoking, alcohol, age, familial history, previous colorectal carcinoma
- Presentation – Blood stool, persistent abdominal pain/discomfort, weakness, fatigue, unexplained weight loss
- Macroscopic Appearance – Ulceration, irregular outline and surface, possibly exophytic
- Microscopic Appearance – Irregular tubular structures w/ multiple lumens, pleomorphism, reduced stroma
- Principles of Staging – Duke’s Staging: A: Invasion, not through muscularis propria; B: Invasion through muscularis propria; C: Lymph node involvement; D – Distant Metastases
- Tumour Marker – CEA (Carcinoembryonic Antigen)
- Screening Programme – Faecal occult blood test, every 2 years, 60-74 years
2
Q
Uterine leiomyoma/fibroids - presentation, macroscopic/microscopic
A
- Presentation – Abdominal cramps/pains, heavy/panful periods, lower back pain
- Macroscopic Appearance – (often multiple) circular or irregular masses in and around uterus
- Microscopic – Interwoven smooth muscle fibres (fusiform)
3
Q
Osteosarcoma - presentation, macroscopic/microscopic
A
- Presentation – Pain in bone often following exertion, microfractures, swelling
- Macroscopic Appearance – Pale or haemorrhagic, granular mass invading marrow space
- Microscopic appearance – Abnormal osteoid, pleomorphic osteoblasts, vascular invasion, and necrosis
4
Q
Ovarian teratoma/dermoid cyst of ovary - presentation, macroscopic/microscopic
A
- Presentation – Often asymptomatic and incidentally identified, however may have abdo pain, mass/swelling, abnormal uterine bleeding, GI disturbances, and bladder symptoms.
- Macroscopic Appearance – 88% are unilocular. Often filled with sebaceous material, hair, rudimentary tissues/organs eg teeth
- Microscopic Appearance – Epithelial and glandular features eg sebaceous glands, dermis – resembles skin
5
Q
Chronic lymphocytic leukaemia - description, presentation
A
- What it is – Neoplasm of (B) Lymphocytes, resulting in increased proliferation and release of functionally incompetent B Lymphocytes
- Presentation – Lethargy, breathlessness (compensating for anaemia, heart failure, enlarged hilar nodes), pale, frequent/severe infections, anaemia, bleeding and bruising easily, lymphadenopathy, hepatosplenomegaly, and unintentional weight loss
6
Q
Malignant Melanoma - predisposing factors, presentation, macroscopic/microscopic
A
- Predisposing Factors - UV exposure eg agricultural workers, genetic predisposition, fair skin, comorbidities eg XP
- Presentation – Pre-existing mole has changed shape/colour, itching, non-healing sores
- Macroscopic Appearance - irregularly shaped/asymmetrical ‘mole’; multiple colours within boundary; larger than 1⁄4”
- Microscopic Appearance – Subtly grey/brown-staining cells, melanin deposits, pleomorphism of melanocytes
7
Q
Pancreatic adenocarcinoma - macroscopic/microscopic, complications
A
- Macroscopic Appearance – Poorly defined, fibrotic, white-yellow masses
- Microscopic Appearance – poorly differentiated cells, rudimentary glands
- Complications – Metastasis to the liver resulting in jaundice and hepatic symptoms; DVT secondary to increased hypercoagulability
8
Q
Neuroendocrine tumour (carcinoid tumour) - presentation, complications
A
- Presentation – Intermittent abdominal pain, diarrhoea, sweating, and flushing. Though obviously differs depending on site
- Complications – Ischaemia of bowel/surrounding tissue, metastasis to liver – ‘Carcinoid Syndrome’ due to inability of liver to metabolise hormones released
9
Q
Burkitt’s lymphoma - description, predisposing factors
A
- What it is – Neoplasia of B-Cells = B-Cell proliferation
- Predisposing Factors – EBV infection, Malarial infection
10
Q
Familial adenomatous polyposis - description, genetic changes, macroscopic, complications, treatment
A
- What it is – Autosomal dominant condition involving 00s-000s of colonic adenomas at or soon after birth which progress to cancer
- Genetic Changes – APC gene on chromosome 5q21 which is a tumour suppressor gene which normally binds microtubule bundles, preventing proliferation
- Macroscopic Appearance – Sessile, plaque-like polyps blanketing colon
- Complications – Colon cancer, other cancers, dental problems
- Treatment – Supportives eg NSAIDs but ultimately colectomy required
11
Q
Hereditary non-polyposis colorectal cancer - description, genetic change
A
- What it is – Autosomal dominant familial syndrome (Lynch Syndrome) leading to increased risk of colorectal and extraintestinal cancer. Early presentation of adenomas. Multiple associated colonic malignancies
- Genetic Changes – Mutations in DNA mismatch repair genes - microsatellite instability
12
Q
Retinoblastoma - pathophysiology, presentation
A
- Pathophysiology – Mutation in multipotential cell leading to neoplasia of retinal cells
- Presentation – ‘Cat’s eye reflex’ (Leukocoria), secondary conditions eg inflammation, glaucoma, proptosis
13
Q
Xeroderma pigmentosum - genetic changes, presentation
A
- Genetic Changes – Autosomal recessive condition: mutation in DNA nucleotide excision repair gene - nucleotide instability
- Presentation – Intense photosensitivity, pigmentary changes, premature skin ageing, tumour development
14
Q
Malignant mesothelioma - description, predisposing factors, macroscopic
A
- What it is – Neoplasia of mesothelial cells lining serous membranes
- Predisposing Factors – Previous asbestos exposure, zeolites, radiation, possibly SV40 virus
- Macroscopic Appearance – Visceral layer of pleura covered with small nodules, ring formed around lung which obliterates pleural space
15
Q
Cervical carcinoma - predisposing factors, pathophysiology, screening program
A
- Predisposing Factors – HPV, oestrogen-progesterone contraceptives, HIV type I, smoking
- Pathophysiology – HPV employs host cell mechanisms to express E6 and E7 proteins which inactivate p53 and pRb respectively, allowing dysregulated cell growth. Pathologically, the first sign is koilocytes (normal squamous cells with viral infection), followed by dysplasia, leading to full thicken dysplasia (carcinoma in-situ), which progresses to carcinoma
- Screening program – Women ages 25 and over are invited for smear test
