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Eye Disease > ocular tumours > Flashcards

ocular tumours Flashcards

1
Q

what does neoplasia mean

A

new growth

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2
Q

what is a tumour known as

A

a swelling

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3
Q

what suffix is attached to a tumour

A

oma

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4
Q

define a neoplasm

A

is an abnormal mass of tissue, the growth of which exceeds and is uncoordinated with that of the normal tissues and persists in the same excessive manner after cessation of the stimuli which evoked the change

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5
Q

what three things do all tumours that are benign or malignant consist of

A
  • Clonal Neoplastic cells that constitute the parenchyma
    ie. The cells from which the tumour derives
  • Reactive stroma: made up of blood vessels and connective tissue
    All tumours need blood supply and connective tissue to grow.
  • Significant cross talk between the parenchyma and reactive stroma
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6
Q

name the 6 types of tumours of epithelial origin

A
  • stratified squamous
  • basal cells of skin or adnexa
  • epithelial lining of glands or ducts
  • respiratory passages
  • renal epithelium
  • liver cells
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7
Q

name the benign and malignant version of a stratified squamous epithelial tumour

A

benign: squamous cell papilloma
malignant: squamous cell carcinoma

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8
Q

what is a basal cell carcinoma a tumour of

A

malignant tumour of basal cells of skin or adnexa

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9
Q

name the benign and malignant version of the epithelial lining of glands or ducts, epithelial tumour

A

Glands:

benign: adenoma papilloma
malignant: adenocarcinoma papillary carcinoma

Ducts:

benign: cystadenoma
malignant: cystadenocarcinoma

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10
Q

name the benign and malignant version of a tumour of the respiratory passages, epithelial tumour

A

benign: bronchial adenoma
malignant: bronchogenic carcinoma

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11
Q

name the benign and malignant version of a renal epithelium tumour

A

benign: renal tubular adenoma
malignant: renal cell carcinoma

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12
Q

name the benign and malignant version of liver cells, epithelial tumour

A

benign: liver cell adenoma
malignant: hepatocellular carcinoma

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13
Q

name the benign and malignant version of tumours of melanocytes

A

benign: nevus
malignant: malignant melanoma

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14
Q

what are the 4 things you would differentiate on a basis of a benign tumour form a malignant tumour

A
  • Differentiation & Anaplasia
  • Rate of Growth
  • Local Invasion
  • Metastasis
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15
Q

how would you classify the differentiation between a benign and a malignant tumour

A

how different does the neoplastic tissue differ from the parenchyma

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16
Q

how would you differentiate the rate of growth between a benign and malignant tumour

A

a malignant tumour has a fast/high growth rate

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17
Q

how would you differentiate local invasion between a benign and malignant tumour

A

malignant tumours tend to metastasise and that tells you it is more aggressive and malignant

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18
Q

what is anaplasia

A

the degree to which the parenchyma does not resemble the clonal cell

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19
Q

what two types of differentiation can malignant tumours be

A

poor or well differentiated

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20
Q

what is a sign of malignancy i.e. undifferentiated cells

A

the level of anaplasia i.e. degree to which the parenchyma does not resemble the clonal cell

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21
Q

how does the rate of growth define malignancy

A

the doubling time of the cell population:

  • cell cycle becomes deranged
  • usually the higher the growth rate, the more malignant
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22
Q

what sign marks a tumour as malignant

A

metastasising (tumours in other parts of the body) - which makes them hard to treat

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23
Q

what can cause a normal cell to transform and become a tumour

A

uv

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24
Q

what happens to the cells in a proliferative pool and what can they become within a tumour

A

they divide

they can go into the non-proliferative pool and can either differentiate (some into a more malignant form) or die

25
Q

what happens to a differentiated cell within the non-proliferated pool in a tumour

A

some can differentiate into a more malignant form i.e. malignant cells that are produced don’t resemble with the original tumour that it derived from, and become anaplastic so they are not the same as when it derived from the original parenchyma

26
Q

which tumour is the most common malignancy

A

basal cell carcinoma

27
Q

out of all skin cancers, how much does a basal cell carcinoma account for

A

two thirds of all skin cancers

28
Q

what is the growth rate of a basal cell carcinoma

A

slow, over months or years

29
Q

what does the incident rates increase with a basal cell carcinoma

A

increases with age, however BCC can occur in people in their 20s

30
Q

how much % of squamous cell carcinomas metastasise

A

20%

31
Q

how many % of eyelid tumours do squamous cell carcinomas account for

A

5-10%

32
Q

what causes an increase in developing a squamous cell carcinoma

A

immunocompromised

33
Q

how many % of skin cancers does squamous cell carcinoma account for

A

one-third of skin cancers

34
Q

what is the growth rate of a squamous cell carcinoma

A

quickly over several months

35
Q

what age group is squamous cell carcinomas found most frequently in

A

40’s and incidents increases with age

36
Q

on which part of the body do squamous cell carcinomas have a high risk of spreading

A

if its on the lips and ears

37
Q

what are squamous cell carcinomas not as dangerous as

A

melanomas

38
Q

what can happen if a squamous cell carcinoma is left untreated

A

spread to other parts of the body

39
Q

what is the least common but most aggressive form of skin cancer

A

melanoma

40
Q

what is the growth rate of a melanoma

A

rapid and spread rapidly

41
Q

where can a melanoma start from

A

normal skin, a mole or a freckle

42
Q

which part of the body does a melanoma usually grow

A

anywhere in the body, not just parts exposed to the sun

43
Q

how many % of melanomas can be cured if treated

A

95%

44
Q

what does the histology of a melanoma show

A

shows large atypical melanocytes within the dermis.

45
Q

what is a DDX of a nodular melanoma on the eyelid

A

karposi sarcoma

46
Q

when will you suspect malignancy of a choroidal naevus

A

if it grows in adulthood

47
Q

which type of people is a choroidal naevus very rare in

A

dark skinned people

48
Q

how many % of caucasians does a choroidal naevus present in

A

5-10%

49
Q

when will a choroidal naevus be symptomatic

A

only when on the macula (otherwise asymptomatic)

50
Q

list 3 DDX of a choroidal melanoma

A
  • Congenital Hypertrophy of RPE (CHRPE)
  • Melanocytoma of Choroid – can’t tell difference from large naevus
  • Small melanoma associated with serous detachment and orange lipofuscin
51
Q

in which type of people are iris melanomas more common in, and by a factor of how much

A

3x more common in, blue/grey eyed people

52
Q

which age group does a iris melanoma develop

A

40s or 50s

53
Q

what two types of iris melanomas are there

A

pigmented or non pigmented

54
Q

how large is an iris melanoma

A

> 3mm in diameter and >1mm thick

55
Q

what is an iris melanoma always associated with

A

pupil distortion/ectropian uveae

cataract may be present
also with naevi

56
Q

list the 8 features alerting a clinician to an ocular melanoma, and explain each feature

A
  • Melanoma visible externally: shadow or blob on the eye
  • Eccentric visual phenomena: flashing lights or distortion, as the melanoma is growing on the choroid
  • Lens abnormalities: cataract in periphery
  • Afferent pupillary defect: tumours of retro bulbar or optic nerve
  • No optical correction: distortion of retina and can’t correct va’s
  • Ocular hypertension: high IOP if tumour affects aqueous outflow in iris
  • Melanocytes: difference in colour of iris i.e. iris naevus
  • Asymmetric episcleral vessels: blood supply going into tumour beneath the globe
57
Q

how many % of patient’s who has a choroidal melanoma, complain of blurred vision

A

20-30%

58
Q

how many % of eyes end up enucleated if a choroidal melanoma is undetected by an optometrist

A

45% end up enucleated

59
Q

how many % of eye end up enucleated if a choroidal melanoma is DETECTED by an optometrist

A

30% end up enucleated

Eye Disease (10 decks)

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