Pathology Flashcards
Define dysplasia
Pre-cancerous change - cells are not normal but not autonomous yet
Define neoplasia
Tumour
What is a cancer
A malignant neoplasm
Define anaplasia
Total loss of cell characteristics - lack of differentiation
Define involution
Opposite of hyperplasia, ie. A decrease in the cell mass due to a decreasing number of cells
Define metaplasia
Cell changes TYPE
Define carcinoma and what is meant by a carcinoma in situ
an epithelial cancer/tumour
carcinoma in situ is a non invasive epithelial cancer/tumour
What is an intraepithelial neoplasm
same as a carcinoma in situ (a non-invasive epithelial cancer/tumour)
What is meant by ‘differentiation’ and why is it important in malignancy
It refers to the level of cellular characteristics. A lack of differentiation is a sign of malignancy, and a poor prognosis
Why are death rates for ovarian cancers so much higher than uterine (despite them having a similar incidence)
Ovarian cancers tend to be relatively hidden and are therefore diagnosed much later
What is the peak incidence of cervical cancer
CIN (cervical intraepithelial neoplasm): 30
Invasive carcinoma: 45-50
How are cervical cancers staged?
CIN: stages I-III (based on degree of differentiation - CIN I = mild dysplasia, II = moderate, and III = severe)
Invasive carcinoma: stages I-IV (I = confined to cervix, II = beyond the cervix, but not to the pelvic wall, III = to pelvic wall, IV = involving bladder/rectum/beyond pelvis)
Describe the types of tumours most likely to occur in the endocervix and the ectocervix
Endocervix (10%) has mucous secreting columnar epithelium (like the uterus), therefore ADENOCARCINOMA (of the glandular cells in the endocervix)
Ectocervix (90%) has stratified squamous epithelium (like the vagina), therefore SQUAMOUS CARCINOMA (in the transformation zone)
The uterus consists of an endometrium, and a myometrium. Which cancers affect these two layers
Endometrium: cuboidal columnar shape arranged as glands - therefore ADENOCARCINOMA
Myometrium: smooth muscle, therefore fibroids (LEIOMYOMA)
Which cancers (and tumours) can be found in the ovaries?
Carcinoma: in the outer covering of cuboidal epithelium
Serous tumour: arising from the outer serous layer
Mucinous tumour: arising from the other parts of the epithelium
Mesothelioma: arising from the coelomic mesothelium covering the ovary (very nasty tumour)
Stromal tumours: affect hormone production
Metastases from elsewhere
Why is the cervix vulnerable to cancer?
There are normal cellular changes that occur (especially at puberty and during pregnancy, but also as part of the monthly cyclical changes).
Repositioning of the squamo-columnar junction (exposing the columnar cells to the low pH of the vagina) leads to:
- Squamous metaplasia of cells in the transformation zone
- these cells are more vulnerable to dysplasia and neoplasia
Cervical cancer is also linked to the human papilloma virus (HPV) types 16 and 18, which is sexually transmitted. Persistent infection leads to cytological changes
Name and describe 2 common benign uterine neoplasms
Polyps - endometrial outgrowth with an associated stroma (not a problem unless they bleed)
Fibroids - smooth muscle tumour - very well encapsulated. Under the control of oestrogen (not a problem unless big and many of them)
A uterine carcinoma can be associated with oestrogen, how does this affect prognosis?
A carcinoma with oestrogen receptors has a better prognosis as it is easier to target, and will be better differentiated
What is a teratoma?
A neoplasm of germ cell origin
- mixture of mature tissues mainly derived from ectoderm (hair, skin, teeth, etc) - can occasionally have tissues derived from endoderm (respiratory and gut epithelium), and mesoderm (bone/cartilage)
90% are benign and occur in patients younger than 20
- presence of immature (less differentiated) tissues indicate malignancy, but this is more rare
