Pathological Changes seen with Neoplastic Disease Flashcards
What is metastases
Spread of the tumour
Formed by cancer cells that have left the primary tumour and travelled through blood and lymphatic vessels
Invasion and metastasis are the major causes of cancer related morbidity and mortality
Parts of the Metastasis Cascade
Localised Invasion
Intravasation (cells enter blood)
Transport through circulation
Arrest in micro vessels of various organs
Extravasation
Formation of micro metastasis
Colonisation (formation of macro metastasis)
What is the transcoelomic pathway of metastases
dissemination of malignant tumours throughout the surfaces and organs of the abdominal and pelvic cavity covered by \peritoneum.
Which tumours are likely to spread transcoelomically
Cancers on the surface of abdominal organs
E.g. Mesotheliomas, ovarian/pancreatic adenocarcinomas
What is carcinomatosis
cancer in one part the body has spread, blanketing another part of the body with several new tumours
usually of epithelial origin
What is lymphatic metastases
Tumours metastasise to lymph nodes
Lymph nodes closest to the tumour are colonised earliest and develop the largest tumour masses
What is haematogenous metastases
Tumour spread through blood vessel walls
Tumours generally invade veins rather than arteries as the walls are easier to invade
They ultimately enter the lungs and liver
Tumour type likely to undergo haematogenous metastases
Sacaromas
Tumours likely to metastasise to lung (4)
Osteosarcoma
hemangiosarcoma
Melanoma
Mammary tumours
Others (thyroid, tonsillar and pancreatic)
Tumours likely to metastasise to Liver, spleen and kidney (2)
Mast cell tumours
Hemangiosarcoma
Tumours likely to metastasise to Bone (3)
Mammary gland tumours
Prostatic carcinoma
Urinary Bladder tumours
Tumours likely to metastasise to brain and adrenal glands (1)
RARE
Bronchogenic carcinoma
Direct effect of neoplasia
Space occupying lesion- puts pressure on surrounding tissues leading to pressure atrophy or necrosis
particular problem in areas defines by bone such as thorax, brain or bone marrow
Indirect effects of neoplasia/ paraneoplastic syndrome
Haematological, endocrinological and metabolic complications caused by cancer
Caused by products of tumours not the tumours themselves
these complications may be the main presenting sign
Cause a profound clinical problme
Can hallmark a particular tumour
What is cachexia
Weight loss- most common syndrome in cancer
Why does cancer cachexia occur
Results form altered carbohydrate, protein adn lipid metabolism
Complex pathogenesis die to TNF-a, IL-1, IL-6, prostaglnadins
Why does fever with cancer occur
tumour- induced production of cytokines (IL-1)
What is an endocrine neoplasm
Functioning endocrine tumour
-> hypoglycaemia: most common cause is insulinoma (beta cell/ islet cell carcinoma or adenoma)
what is a non-endocrine neoplasm
Tumour produces hormonally active substances which are not normally found in the tissue of the tumour origin
How can hypercalcaemia be caused by a non-endocrine neoplasm
Many tumours produce PTH-related protein
e.g. lymphoma,, multiple myelomas, adenocarcinoma of anal glands
What is hypertrophic pulmonary osteopathy
Radial periosteal new bone growth affecting distal limbs
Most commonly associated with lung tumours
What is myelofibrosis
Overgrowth of nonneoplastic fibroblasts in the bone marrow, which impairs normal haematopoiesis -> cytopenia ( low blood cell count)
Other paraneoplastic clinical syndromes
Vascular and haematological disorder
Epidermal necrosis- pancreatic and hepatic tumours
Nodular dermatofibrosis- renal adenocarcinoma
alopecia- pancreatic carcinoma
exfoliative dermatitis- thymoma
Myasthenia gravis- thymoma, hepatic carcinoma and osteogenic sarcoma
