Onco. 1. Flashcards
What cellular process does cancer affect?
Cell proliferation.
What is cancer?
A loss of the normal control of cell proliferation.
Why do cancerous cells continue to proliferate?
As they undergo genetic mutations/alterations.
This makes them unable to respond normally to the signals that control proliferation.
What are the 6 hallmarks of cancer?
Self sufficiency in growth signals.
Insensitivity to antigrowth signals.
Ability to evade apoptosis.
Limitless replicative potential.
Sustained angiogenesis.
Capacity to invade tissues and metastasise.
Will cancer be either localised or systemic?
It can be one or the other or both.
What 3 things define localised cancer?
A measurable mass in 1 location.
Can be treated with local therapy.
May or may not metastasise.
What 2 things define systemic cancer?
Widespread at the time of diagnosis.
A local tumour with high
potential to spread and metastasise systemically.
What are benign tumours?
Clusters of abnormal cells that may compress but never invade surrounding tissues.
What are malignant tumours?
Cells that possess the ability to invade surrounding tissues and spread to distant sites.
Spindle cells are what kind of tumours?
Mesenchymal.
What do spindle cells look like?
Single fusiform cells with a round to oval nucleus.
They do not have distinct borders and they have cytoplasmic tails.
A sarcoma is made up of what cells?
Mesenchymal spindle cells.
What do round cells look like?
Discrete cells with distinct borders.
What are 5 tumours created by round cells?
Lymphoma.
TVT.
Plasmacytoma.
Mast cell tumour.
Histiocytoma.
What are 2 tumours that are sometimes created by mast cells?
Malignant melanoma.
Basal cell tumour.
What do epithelial cells look like?
Round to ovoid cells with a round nucleus.
These are sheet like groups of
keratinised cells with indistinct borders.
These cells often form clumps.
What cancer cells may form ducts or acini?
Epithelial cells.
What cancer cells for a carcinoma?
Epithelial cells.
Do we use nuclear or cytoplasmic criteria to judge malignancy?
Nuclear.
How many nuclear criteria is a good indication of malignancy?
3 or more.
What are the 8 nuclear criteria for malignancy?
Anisokaryosis or anisonucleoliosis.
Increased nuclear:cytoplasmic ratio.
Multinucleation.
Coarse chromatin.
Macrokaryosis or macronucleoli.
Increased or abnormal mitotic figures.
Nuclear moulding.
Angular nucleoli.
What 3 general characteristics can be an indicator of malignancy?
Anisocytosis and macrocytosis.
Pleomorphism.
Hypercellularity.
What does the acronym CHANG stand for?
Cyst.
Hyperplasia.
Abscess.
Neoplasia.
Granuloma.
What are the 3 benign tumours?
Lipoma.
Histiocytoma.
Basal cell tumour.
What abnormality can we use a FNA on?
Any mass.
What does an FNA tell us?
If it is inflammation or neoplasia.
Does an FNA tell us if something is benign or malignant?
No.
When do we not do an FNA?
When there is bleeding.
If there is a cavity.
If there is seeding e.g. in a TCC.
What are 2 reasons why we would we do an FNA with the syringe on?
To get negative pressure.
For masses with poor exfoliation.
For what masses would we do an FNA with the syringe off?
Most masses.
Do benign or malignant tumours have slow or fast growth?
Benign tumours grow slow.
Malignant tumours grow fast.
How do benign tumours appear on PE?
Soft and well encapsulated.
What 3 things are seen on histopath in benign tumours?
Low mitotic rate.
Uniform cell size.
Well - differentiated cells.
What suffix indicates a benign tumour?
Oma.
What 2 things are seen on PE of malignant tumours?
Ill defined margins.
Ulcerated and/or necrotic.
What 3 things are seen on histopath in malignant tumours?
Necrotic.
Infiltrative.
High mitotic rate.
Poorly differentiated.
What suffix indicates a malignant tumour?
Carcinoma or sarcoma.
What 3 things would indicate doing an incisional biopsy?
Change the treatment type
Tumor in a difficult area.
Change owners willingness to treat.
What 2 things would indicate doing an excisional biopsy?
Treatment is not altered by the tumour type.
Just as easy to remove en bloc as to do incisional biopsy.
What kind of food can cause SCC in cats?
Canned food.
What does TNM stand for on staging a tumour?
T: Size of primary Tumor.
N: Assessment of regional lymph Nodes.
M: Assessment of Metastasis.
For what tumour should we check all body cavities for?
Hemangiosarcoma.
For what tumour should we check regional lymph nodes and lungs?
Oral squamous cell carcinoma.
What kind of carcinomas are found in the lymphatics?
Round cell, carcinomas.
What is the route of metastasis for round cell carcinomas?
Regional lymph nodes
Liver, spleen, mesenteric lymph nodes.
Thoracic cavity lymph nodes.
What is the route of metastasis for round cell hematogenous sarcomas?
Lungs.
What diagnostic technique should we use for hematogenous sarcomas?
Thoracic radiographs.
How does metastasis from lymph and blood circulation differ?
Lymphatic circulation usually produces metastasis to regional lymph nodes.
Hematologic circulation usually produces metastasis to distant sites and organs.
Which vets usually carry out staging and grading?
Staging = Clinician.
Grading = Pathologist.
What is the aim of staging?
To determine the extent of disease.
How do we grade the mitotic index?
Number per 10 high power fields.
What 4 histopathological characteristics are taken into account when grading a tumour?
Differentiation
Mitotic index.
Necrosis.
Nuclear pleomorphism.
What is the best therapy for cancer?
Surgery if possible.
What do we need for surgery to be successful?
Complete margins.
What are 3 things that would indicate a tumour should undergo radiation therapy?
Incomplete margins.
Unresectable.
Palliation.
What are the 3 cancer commandments?
Do not let them hurt.
Do not let them vomit or have diarrhoea.
Do not let them starve.
What are the 3 complications of chemotherapy?
Bone marrow (myelo) suppression.
Alopecia.
Gastrointestinal upset.
When do the side effects of chemo kick in?
Gastrointestinal (3 -5 days later).
Myelosuppression (7-10 days later).
What are 3 anti-emetics that can be given to chemo patients?
Reglan.
5HT3.
Mirtazepine.
