Neoplasm Numeclature & Epidemiology Flashcards
What are the Role of Genes in Health and Disease
Synthesis of Proteins:
- Structural Proteins: Form the framework of cells and tissues.
- Regulatory Proteins: Control various cellular processes, including cell division and growth.
- Enzymes: Catalyze biochemical reactions necessary for cellular function.
- Cell Division and Growth Control:
Intrauterine Development: Genes guide the development of the embryo.
- Replenishing Cells: Labile and stable cells are constantly renewed or maintained.
- Healing: Genes regulate the repair of tissues after injury.
Genes in Disease:
- Genetic Aberrations/Mutations: Includes trisomies, deletions, single gene disorders, and polygenic inheritance.
- Epigenetic Changes: Modifications that affect gene expression without altering the DNA sequence.
What’s Tumor & it can occur due to?
Tumor: General term for an abnormal swelling, which can be due to:
Development in an Embryo: Abnormalities during embryonic development.
Inflammation: Swelling due to the body’s response to infection or injury.
Hyperplasia: Increase in the number of cells in an organ or tissue, causing its enlargement.
What’s Neoplasm & it’s characteristics?
Neoplasm: An abnormal mass of tissue with excessive and uncoordinated growth relative to surrounding tissue, continuing even after the initial stimulus is removed (as defined by Willis).
Key Characteristics of Neoplasm:
Purposeless Growth: The growth does not serve a useful function.
Progressive Growth: The growth continues and increases over time.
Parasitic Growth: The growth occurs regardless of the body’s needs.
Aberration of Cell Growth and Loss: Results from a disruption in the normal processes of cell division (mitosis) and cell death (apoptosis).
Clonal Evolution: The tumor evolves from a single cell through mutations.
Differentiation: The extent to which tumor cells resemble normal cells (grading).
What are cancers, Harmatoma & Choristoma
Cancer: A term specifically used for malignant tumors (derived from the Latin word for crab).
Hamartoma: A non-neoplastic malformation resembling a tumor, composed of cells native to the tissue of origin but arranged in a disorganized manner.
Choristoma: A non-neoplastic malformation consisting of normal cells located in an abnormal (ectopic) site.
Composition:
The cells in a hamartoma are the same as those normally found in the organ or tissue, but they are mixed together in an abnormal way.
For example, in a Pulmonary Hamartoma (found in the lungs), you might find a mixture of cartilage, fat, and connective tissue all jumbled together rather than neatly organized as they are in normal lung tissue.
Example:
Pulmonary Hamartoma: Found in the lungs, and made of cartilage, fat, and connective tissue.
Peutz-Jeghers Polyps: Found in the intestines, composed of an abnormal mix of the tissue types normally found in the intestines.
Choristoma
Definition:
A choristoma is also a non-cancerous growth.
It consists of normal cells and tissues, but these cells are growing in a place where they don’t normally belong (ectopic site).
Composition:
The tissue in a choristoma is normal in structure and function, but it’s located in an unusual place.
For example, in an Ocular Choristoma (found in the eye), you might find tissue types like bone or skin that are normal in themselves but are out of place in the eye.
Example:
Ocular Choristoma: Normal bone or skin tissue found in the eye.
Osseous Choristoma: Normal bone tissue found in soft tissues like the tongue.
What’s teratoma?
Teratoma: A type of germ cell tumor that typically contains multiple types of cells derived from one or more of the three germ layers (ectoderm, mesoderm, and endoderm).
Classification of Neoplasm
Benign: usually localised non-invasive tumours
Skin – papilloma
Uterus – Leiomyoma (fibroid)
Malignant (cancers): tumours grow by infiltrating surrounding tissues + metastasize
Breast (ductal epithelium) – cancer
Bone (mesenchymal cell) – Sarcoma
Lymph node (lymphoid cell) – Lymphoma
Adenomatous polyp
Benign tumour - Leiomyoma
Breast - Fibroadenoma
Hepatic Adenoma
Breast – IDC (cancer)
Bone - Osteosarcoma
Features of Benign and Malignant Neoplasms
Feature
Benign
Malignant
Growth pattern
Expansile (expansive) remained localized
Local infiltration, spread to distant sites (metastasis)
Growth rate
slower
faster
Clinical effects
Local pressure or hormonal secretion
Local pressure, infiltration, inappropriate hormonal secretion & metastasis
Histology
Resembles tissue of origin (well differentiated)
Usually differ from tissue of origin (moderate to poorly differentiated
Nuclei
Small, uniform/regular to mild irregularity
Large and pleomorphic
Mitosis
Few and normal
Numerous and atypical
Treatment
Local excision
Local excision & systemic treatment
Lipoma
Leiomyoma
Schwannoma
Schwannoma
SCC
What are the Classification of Neoplasms with examples
Benign Neoplasms:
Definition: These tumors are usually localized and do not invade surrounding tissues.
Examples:
Skin: Papilloma
Uterus: Leiomyoma (fibroid)
Colon: Adenomatous polyp
Breast: Fibroadenoma
Liver: Hepatic adenoma
Malignant Neoplasms (Cancers):
Definition: These tumors grow by infiltrating surrounding tissues and have the potential to spread to distant sites (metastasize).
Examples:
Breast: Invasive Ductal Carcinoma (IDC)
Bone: Osteosarcoma
Lymph Node: Lymphoma
Features of Benign and Malignant Neoplasm
Benign
Expansile (expansive) remained localized
Growth rate: slower
Clinical Effects: Local pressure or hormonal secretion
Histology: Resembles tissue of origin (well-differentiated)
Nuclei: Small, uniform/regular to mild irregularity
Mitosis: Few and normal
Treatment: Local excision
Malignant
Growth Pattern: Local infiltration, spread to distant sites (metastasis)
Growth Rate: faster
Clinical Effects: Local pressure, infiltration, inappropriate hormonal secretion & metastasis
Histology: Large and pleomorphic (varying shapes and sizes)
Mitosis: Numerous and atypical
Treatment: Local excision & systemic treatment
Benign Tumors:
Growth Pattern: Benign tumors grow in a confined space and do not invade surrounding tissues. For example, a lipoma (a benign tumor of fat tissue) will push surrounding tissues aside but not infiltrate them.
Growth Rate: They tend to grow slowly.
Clinical Effects: They can cause symptoms due to their size or by secreting hormones, but these effects are usually localized. For example, a leiomyoma (fibroid) in the uterus can cause pressure effects and menstrual irregularities.
Histology: Under the microscope, benign tumors resemble the normal tissue from which they originate. For example, a fibroadenoma in the breast has well-differentiated fibrous and glandular tissue.
Nuclei: The cell nuclei are small and uniform, indicating less aggressive growth.
Mitosis: Cell division is infrequent and normal.
Treatment: Benign tumors are typically treated with local excision.
Malignant Tumors:
Growth Pattern: Malignant tumors invade and destroy surrounding tissues and can spread to distant parts of the body (metastasis). For example, Invasive Ductal Carcinoma (IDC) of the breast can infiltrate surrounding breast tissue and spread to lymph nodes.
Growth Rate: They tend to grow more rapidly.
Clinical Effects: They can cause significant local damage, systemic effects, and can secrete hormones inappropriately. For example, an osteosarcoma in the bone can cause pain, swelling, and fractures.
Histology: Under the microscope, malignant tumors often look quite different from the normal tissue, showing poor differentiation. For example, a squamous cell carcinoma (SCC) may show irregular, abnormal squamous cells.
Nuclei: The cell nuclei are often large and vary in shape and size, indicating aggressive growth.
Mitosis: Cell division is frequent and often abnormal.
Treatment: Malignant tumors require more extensive treatment, including surgery, radiation, and chemotherapy
Additional Examples:
Benign:
Schwannoma: A benign nerve sheath tumor.
Malignant schwannoma is called?
When schwannoma becomes cancerous, it is known as malignant peripheral nerve sheath tumor (MPNST).
Spread of malignant tumours
Local spread
Invasion
Penetration
Metastasis: definition
Route of metastasis
Lymphatic spread (carcinomas)
Haematogenous – Blood (sarcomas)
Peritoneal (ovarian and gastric tumours)
Transepithelial (Paget’s disease of breast)
Nomenclature of tumours
Based on tissue of origin (histogenesis)
Parenchymal cells
Stromal cells
Both parenchymal and stromal cells
Benign tumours – mesenchymal origin, the suffix ‘oma’ is added to the cell of origin:
Fibroblastic cell – fibroma
Chondrocyte – chondroma
Adipose tissue (lipocyte) – lipoma
What are the mechanisms by which malignant tumors spread
Local Spread:
Invasion: Malignant cells infiltrate surrounding tissues, breaking through normal barriers.
Penetration: Tumor cells penetrate the walls of nearby structures or organs.
Metastasis:
Definition: Metastasis is the process by which cancer cells spread from the original (primary) site to distant parts of the body, forming new (secondary) tumors.
What are metastasis route?
Routes of Metastasis:
Lymphatic Spread: Common in carcinomas. Cancer cells enter lymphatic vessels and travel to nearby lymph nodes.
Haematogenous Spread (Blood): Common in sarcomas. Cancer cells invade blood vessels and are transported via the bloodstream to distant organs.
Peritoneal Spread: Seen in ovarian and gastric tumors. Cancer cells spread within the peritoneal cavity, seeding the peritoneal surfaces.
Transepithelial Spread: Seen in Paget’s disease of the breast. Cancer cells spread across epithelial surfaces.
List examples of Benign Tumors of Mesenchymal Origin: & Benign Tumours of Epithelial Origin:
Mesenchymal Origin: These tumors arise from connective tissues. The suffix ‘-oma’ is added to the cell of origin:
-Fibroblastic Cell: Fibroma
- Chondrocyte: Chondroma
- Adipose Tissue (Lipocyte): Lipoma
Benign Tumours of Epithelial Origin: These tumors can be classified based on their cell of origin, microscopic appearance, or macroscopic patterns:
- Adenoma: A benign tumor of glands (e.g., pituitary adenoma, thyroid adenoma).
- Papillomas: Benign tumors that form finger-like projections or have a warty surface (e.g., skin papillomas).
- Cystic Tumours (Cystadenoma): Benign tumors that form cysts (e.g., ovarian cystadenoma).
- Papillary Cystadenoma: Tumors with both cystic and papillary features.
- Polyp and Polypoid Cancer: Polyps are growths that protrude from a mucous membrane. While polyps can be benign, they have the potential to become malignant, leading to polypoid cancer
What’s Sarcomas?
Sarcomas are malignant tumors arising from mesenchymal tissues (connective tissues) and typically have little supporting stroma (the supportive tissue surrounding tumor cells).
What’s the names of malignant tumors in this location?
Fibrocytic tumors
Lipocutic tumors
Smooth muscles tumors
Skeletal muscle tumors
Cartilage tumors
Bone tumors
Peripheral Nerve Tumor
Fibrocytic Tumor:
Fibrosarcoma: Malignant tumor derived from fibrocytes (fibrous tissue).
Lipocytic Tumor:
Liposarcoma: Malignant tumor derived from lipocytes (fat cells).
Smooth Muscle Tumor:
Leiomyosarcoma: Malignant tumor arising from smooth muscle cells.
Skeletal Muscle Tumor:
Rhabdomyosarcoma: Malignant tumor derived from skeletal muscle cells.
Cartilage Tumor:
Chondrosarcoma: Malignant tumor arising from cartilage cells.
Bone Tumor:
Osteosarcoma: Malignant tumor derived from bone cells.
Peripheral Nerve Tumor:
Malignant Peripheral Nerve Sheath Tumor (MPNST): Malignant tumor arising from the cells surrounding peripheral nerves.
What’s are carcinomas?
Carcinomas are malignant tumors derived from epithelial cells, which can originate from any of the three embryonal germ layers.
Ectoderm (e.g., Epidermis):
Squamous Cell Carcinoma (SCC): Malignant tumor of squamous epithelium, often found in the skin or mucous membranes.
Mesoderm (e.g., Renal Tubules):
Renal Cell Carcinoma (RCC):
Malignant tumor originating from the epithelial lining of the renal tubules in the kidney.
Endoderm (e.g., Lining of the Gastrointestinal Tract):
Endoderm (e.g., Lining of the Gastrointestinal Tract):
Adenocarcinoma: Malignant tumor arising from glandular epithelium, such as that lining the gastrointestinal tract.
Mucin Production: Some adenocarcinomas produce mucin (a component of mucus).
Mucinous Adenocarcinoma: Tumor cells produce significant amounts of mucin.
Signet Ring Cell Carcinoma: Characterized by cells that contain a large vacuole of mucin, pushing the nucleus to one side, giving a signet ring appearance
Mixed Tumors
Mixed tumors contain elements of both epithelial and mesenchymal tissue.
Some malignant tumors have names that do not follow the usual naming conventions:
Examples?.
Melanoma: Malignant tumor of melanocytes (pigment-producing cells).
Hepatoma: Malignant tumor of liver cells (hepatocytes); also known as hepatocellular carcinoma.
Lymphoma: Malignant tumor of lymphoid tissue
Epidemiology is the study of the distribution and determinants of health-related events, conditions, and behaviors in specified populations. Its aims include understanding patterns of diseases, injuries, and risk factors, informing public health interventions, and improving overall health outcomes.
Distribution
Frequency and Pattern: Examines how often and in what patterns cancer occurs across different populations, regions, age groups, and genders.
Determinants
Broad Factors: These are factors that broadly contribute to the occurrence of cancer. Examples include ?
infections such as Human Papillomavirus (HPV),
Human Herpesvirus 8 (HHV8),
Epstein-Barr Virus (EBV), and
Hepatitis viruses.
Specific Characteristics: Risk factors are characteristics that increase the likelihood of developing cancer. These can be
Modifiable: Examples include smoking and diet.
Non-Modifiable: Examples include age and genetics
Prevalence
Definition: The total number of cancer cases in a population at a specific time.
Incidence
Definition: The number of new cancer cases occurring within a defined period.
Screening/Early Detection
Examples:
PSA (Prostate-Specific Antigen) test for prostate cancer.
Pap smear for cervical cancer.
Mammography for breast cancer.
Cancer Clusters
Definition: Unusual concentration of cancer cases in a specified geographical area, community, or time frame.
What’s the Epidemiology of cancer
General Trends
Age: Cancer predominantly affects middle-aged and elderly individuals.
Onset in Africans: Cancer tends to occur 10–15 years earlier in African populations.
Incidence Variation: The incidence of cancer varies among different populations.
Predisposition Factors: Multiple factors, including genetic and environmental influences, contribute to cancer predisposition.
What’s the Geographic and Racial Factors that Predisposes one to Cancer
Gastric Cancer: Higher incidence in Japan.
Breast Cancer: More common in the USA and Western countries.
Liver Cancer: Predominantly affects Asians and Africans.
Prostate Cancer: Higher rates in African Americans.
Hereditary Predisposition
Familial Retinoblastoma: An inherited form of eye cancer.
Familial Adenomatous Polyposis Coli (FAP): Inherited condition leading to colon cancer.
Breast Cancer: Mutations in ___,____&____ genes increase risk.
Multiple Endocrine Neoplasia (MEN): Inherited disorders affecting endocrine glands.
BRCA1, BRCA2, and P53
What are Acquired Preneoplastic Disorders
These conditions increase the risk of developing cancer but are not themselves cancerous.
Cervical Dysplasia: Abnormal growth of cells on the cervix.
Cirrhosis of the Liver: Scarring of the liver, often due to chronic liver disease.
Proliferative Fibrocystic Changes (FCC) of the Breast: Especially with atypical hyperplasia, indicating a higher risk of breast cancer.
Endometrial Hyperplasia: Thickening of the uterine lining, which can lead to endometrial cancer.
Chronic Atrophic Gastritis: Long-term inflammation of the stomach lining.
Schistosomiasis: Parasitic infection that can lead to bladder cancer.
Ulcerative Colitis: Chronic inflammatory bowel disease that increases the risk of colon cancer
