neoplastic effects Flashcards
- A neoplastic change in epithelium which shows some of the microscopic features of malignancy but does not involve the full thickness of the epithelium which is an — manifestation of malignancy is known as —
- the grades can be :
dysplasia
early
mild moderate severe
- neoplasm forms a continuum from — to —
- —- is a term used for dysplasia in cytological preparation
- examples of commoner sites of dysplasia:
dysplasia
invasive carcinoma
Dyskaryosis
examples:
* Dysplasia of cervix
* In the cervix, the term intraepithelial neoplasia has been introduced to highlight the fact that dysplasia is neoplastic.
* GIT, Gastric/Colonic
* Skin actinic keratosis
* Bronchus
* Urinary tract
* A diagnosis of dysplasia usually requires surgery
carcinoma in situ within epithelium :
* All layers of the epithelium show features of — .
* It does not invade beyond the —-
therefore no access to lymphatics or blood vessels-
* No — potential at this stage but if not removed is “capable” of metastasis
* Cancers are — at this stage
* Why are they called malignant if they have not metastasised?
neoplasia
basmeent memrbrnae
metastatic
curable
haematology effects of malignancy on host:
Anaemia:
* — (commonest)
– Blood loss
* Megaloblastic anaemia
– — drugs interfering with DNA synthesis
* Hypolastic anaemia
– Marrow — by tumour
– or —- of haemopoietic cells
– or — destruction of haemopoietic cells
* Haemolytic anaemia
– — mediated - destruction of —
iron deficiency anaemia
cytotoxic
infiltration
chemotherapy or radiotherapy destruction
immune
RBC
haematology effects of malignancy on host:
1- * Increased — e.g. DVT
* Mechanisms
– Tumour activates:
* — factors
* —
* — cells
– Tumour inhibits:
* —
2- * Polycythaemia
– — concentration of – blood cells in your blood
– increased — due to an increase in the number of —
3- * —- production
– e.g. renal cell carcinoma.
clotting
clothing
platelets
endothelial
fibrinolysis
high
red blood cells
haemoglobin
rbc
erhropoiten
hormonal effects of malignancy on patient:
1- * — indigenous to the tissue from which the tumour arose
– – HCG from a choriocarcinoma
2- * — syndrome
– A group of signs and symptoms caused by a substance that is
produced by a – or in reaction to a tumour
– Effects are not due to — tumour, — , – effects or —
hormones
beta
Paraneoplastic
tumour
primary tumour metastases local effect or treatment
- Hormone is – if it is produced by cells which do not normally produce that hormone
ectopic
hormones effects of neoplasm:
* Cushing’s Syndrome ( — )
* Syndrome of inappropriate –
* —- - Squamous cell carcinoma lung
* Gynaecomastia - —-
* — - Insulinomas of pancreas
ACTH
ADH
hypercalcaemia
osterogen
hyperinsuluinism
common clinical emergency causes of hypercalcaemia in malignant neoplasm:
1. – METASTASES - Bone
destruction by the tumour causes the release of — into the blood.
2. Excess — or similar type hormone
(PTHrP)
bone
calcium
PTH
- Peripheral Neuropathy
- Myopathy
- Dermatomyositis
- Cerebellar Degeneration
- P.U.O (Pyrexia of Unknown Origin)
- Night sweats
are all examples of:
paraneoplastic syndrom exmaples
pathogenesis of paraneoplastic syndrome:
* — mediated
* — induced
* — tumour
* Most likely cause is an – or —
mediated response
* —- : – substance that are secreted by immune cells and have effects
on other cells (chemical messengers)
* Some tumours cause development of abnormal— that attack normal tissues E.g. anti-cerebellar antibodies (very rare)
immune
cytokine
microscopic
immune or cytokine mediated
cytokine
antibodies
malganat melanoma :
* Malignancy of —
* New – nodule
* Change in —
– A - —
– B – border — / —
– C – —
– D – —
– E– — / –
*Cell of differentiation is —
* Sites:
– Skin
– Anal margin
– Eye
– Others
* Aetiology
– —
– ?Other
melonocytes
black
mole
asymmetry
irregular or bleeding
color
diameter
elevation / evolution
melonocytes
sunlight
prognosis of malignant melanoma:
* Thickness of invasion in skin - – Thickness. which determines the –
- > — mm -very poor prognosis (<0.76mm (98% cure).
* Clarkes level of – assesses level into different parts of dermis
breslow
t stage
2mm
invasion
Malignant tumour arising from mesenchymal tissue
* Mesenchyme (noun)
* A loosely organized, mainly mesodermal embryonic
tissue which develops into connective and skeletal
tissues, including blood and lymph.
this is known as –
types are:
* Rhabdomyosarcoma – — muscle
* Leiomyosarcoma – – muscle
* Osteosarcoma – –
* Chondrosarcoma – —
* Angiosarcoma – —
* Kaposi’s sarcoma – —-
– Herpes virus type 8
* Malignant schwannoma – –
* Liposarcoma – –
- aetiology of sarcoma:
* — < 1% post therapy.
* Mean – 10 years
*—-
* —-
*—-
*—-
* —-
sacroma
skeletal muscle
smooth muscle
bone
cartlige
blood vessel
blood n lymph vessel
nerve
fat
* Radiotherapy
* Mean latency 10 years
* Chemicals
* Herbicides
* Pesticides
* Asbestos
* Genetic
- Li Fraumeni Syndrome
– P53 germline defect - Von Recklinghausen disease
– Neurofibromatosis-1 (NF-1)
– Chromosome 17
– Neurofibrosarcomas 3%
both are – association of – - the sites of sarcoma are: —- and present in — issue lump or –
- prognosis of sarcoma are:
- treatment of sarcoma:
- Wide local –
*— - +—
- Only a limited role for—
- Targeted Tx— for GIST
genetic
sarcoma
sites: limbs trunk abdomen anywhere
deep or metastasis
prognosis:
* Stage
* Type
* Size
* Site
* Grade
* Completeness of excision
* Wide local excision
* Radiotherapy
* + chemotherapy
* Only a limited role for chemotherapy
* Targeted Tx Imatinib for GIST
—- are neoplasm w endocrine function and neural features
* Tumours showing differentiation of – cells and — cells
* Some highly — and — ( – cell
carcinoma)
* Some of low — ( –tumour)
- these neoplasms are recognised by — identifies a specific neuroendocrine marker (chromogranin).
- theses nopelasms can begin or malignant benign as — and — , maliganant as:
neuroendocrine
neural n endocrine cells
aggressive n lethal
small cell
low aggression
carcinoid
Immunohistochemistry
benign : insulionma n parathyroid adenoma
malignant:
* Carcinoid tumour
* Small cell ca lung
* Pancreatic islet cell neoplasms (only ~10%)
* Parathyroid carcinoma
* Phaeochromocytoma
* Medullary carcinoma thyroid
—- are all are biologically malignant low grade neuroendocrine neoplasms. Also calledow grade — neoplasms.
Sites
Appendix
Ileum
Bronchus
Anywhere
All are capable of — but may not do so for many years. They are less – than the usual
carcinoma.
caricnoid tumour
neuroendocrine
metastasis
less aggressive
1- carcinoid of appendix PC:
– finding
– appendicitis
Metastases in– (rarely)
2- carcinoid bronchus PC :
—. Why?
Collapse of lobe with —
consolidation due to —.
Why?
3- carcinoid syndrom :
Carcinoid syndrome develops due to the effects of –
— regulates intestinal— and also causes—
Serotonin is detoxified in – and to a lesser extent in the — .
Syndrome develops when liver is— or when the ability of the liver to — is overwhelmed by tumour
- carcinoid syndrom effects of serotonin:
- biochemical diagnosis of carcinoid syndrom :
-Increased — 5 HIAA’s
– These are a breakdown product of —.
incidental
acute
liver
haemptysis
secondary
obstruction
serotonin
serotonin
movements
bronchospasm
detoxified
liver
lung
by passed
detoxify
effects:
Facial flushing
Diarrhoea
Bronchospasm
Pulmonary stenosis
urinary
serotonin
-multiple edocirne neoplasm ( men):
— inherited
More than – – neoplasm
in the one patient
Types 1 and 2
- —- tumours arising from germ cell sites as tests m ovaries , thymus , pineal , retroperitneum . these tumours are derived from cells which can recapitulate 3 germ cell layers which are
genetically
1 neruoedocirne
germ cell tumours
endoderm mesoderm ectoderm
- Seminoma ( –) / Dysgerminoma ( – )
- Teratoma
- Choriocarcinoma
- Yolk sac Tumour
- Embryonal Carcinoma
- Mixed Tumours
are examples of classifications of –
tests
ovary
germ cell tumours
- seminomas :
- All are –
- Age –
- Have a characteristic — response and – response
- Usually do not need – unless late stage
- presentation of germ cell tumours:
1- primary as —- in testis
2- metastasis eschpeially — aka haemptomysis - classifications of teratoma:
- — and –
- Most teratomas in adult
testis are— - Most teratomas in adult
ovary are– (dermoid cyst) - Malignancy is due to the
presence of – or– components in
the tumour at—
malignant
20-40
lymphotic
host
chemotherapy
mass/lumps
pulmonary
bengin or malignt
malignant
benign
immature or malignant
histology
choriocacrima:
* Derived from –
* — appressive
* Associated with – production
trophoblast
highly
HCG
1-germ cell tumours : tumour markers:
* Found in – and—
* Alpha-fetoprotein
–> —
* —
—> Choriocarcinoma
2- prognosis of germ cell tumours :
* Revolutionised with – .
* Long term follow up now available with regular analysis of – tumour markers.
serum n tissue
yolk sac
HCG
chemptherapy
serum
embryonic tumours:
* What are they?
* Occur in –
* – tumours
* Consist of one — cell
* Neuroblastoma - – tissue
* Nephroblastoma – —
* Retinoblastoma - —
* Medullablastoma - –
chidlren
aggressive
embryonal -like
neural
kidney
retina
cerebellum
