Pathology - Disorders of Growth Flashcards by Natasha Hadfield

What is hyperplasia?

Increase in cell number

May be physiological or pathological

Seen in hormonally sensitive organs such as the endometrium, breast and thyroid

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What effect may certain drugs have on gingival tissue?

Hyperplasia

within epithelium and underlying connective tissue

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What is hypertrophy?

Increase in cell size

May be physiological or pathological

Often seen in skeletal or cardiac muscle

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What is atrophy?

Reduction in cell size and number in an organ than was of normal size.

May be caused by ageing or lack of use/stimulation

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What is hypoplasia?

Reduced size of an organ than never fully developed to normal size

Developmental defect

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Give an example of hypoplasia

Pulmonary hypoplasia

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Which disorders of growth are potentially reversible?

Hyperplasia

Hypertrophy

Atrophy

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What is metaplasia?

Acquired form of altered differentiation from one mature cell type to another

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Give an example of metaplasia.

Barrett’s oesophagus

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What happens if environmental changes leading to metaplasia persist?

Leads to further changes that can manifest as dysplasia and progress to malignancy

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How are cells classified according to their population growth pattern?

Labile

Stable

Permanent

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What is characteristic of labile cells?

Continuously dividing

e.g. surface epithelia, haematopoetic cells

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What is characteristic of stable cells?

Low level of replication, but may divide rapidly if stimulated

e.g. Hepatocytes, fibroblasts, endothelium

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What is characteristic of permanent cells?

Non-dividing and unable to re-enter the cell cycle

e.g. neurones, skeletal and cardiac muscle

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What factors inhibit apoptosis?

Growth factors

Cell matrix components

Viral proteins

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What factors induce apoptosis?

Withdrawal of growth factors

Loss of matrix attachment

Viruses

Free radicals

Ionising radiation

DNA damage

Fas ligand/CD95 interaction

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What is p53 protein’s role in cell life?

It induces apoptosis

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How can neoplasia be classified?

Behavioural - benign or malignant

Histogenetic

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What are the features of benign neoplasia?

Do not metastasise

Well differentiated, resemble normal tissue

Expansile growth with no invasion

Encapsulated

No necrosis

Normal N;C ratio

Minimal pleomorphism

Few and normal mitotic figures

Diploid

Nuclei not hyperchromatic

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What is a squamous papilloma?

Usually benign papilloma affecting

skin, lip, oral cavity, tongue, pharynx, larynx

oesophagus, cervix, vagina, anal canal

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What are the features of malignant neoplasms?

May metastasis

Invasive growth pattern

Not encapsulated

Variable degree of differentiation

Necrosis

Increased N:C ratio

More frequent and abnormal mitotic figures

Hyperchromatic nuclei

Aneuploid

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What is a squamous carcinoma?

Cancer

skin, digestive tract, lungs

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What is the name given to a benign and malignant glandular neoplasm?

Adenoma

Adenocarcinoma

How are benign and malignant squamous neoplasms named?

Squamous papilloma

Squamous carcinoma

How are benign and malignant neoplasms of fat tissues named?

Lipoma Lipo*sarcoma*

How are benign and malignant neoplasms of endothelium named?

Angioma Angiosarcoma

How are benign and malignant neoplasms of smooth muscle named?

Leiomyoma Leiomyosarcoma

How are benign and malignant neoplasms of skeletal muscle named?

Rhabdomyoma Rhabdomyosarcoma

Give examples of malignant tumours which aren't named according to the rules

Glioma Lymphoma Melanoma Seminoma Mesothelioma

What is a teratoma?

May be benign or malignant Encapsulated tumour with cells of more than one germ layer Tissues of teratoma are normal in themselves, but not where they belong e.g. teeth, hair

What is a hamartoma?

Benign tumour Tissue elements normal for the site, but growing in a disorganised mass Often an incidental finding

What are the key events in cancer development?

Tumour growth Angiogenesis Invasion and metastasis

What are the key elements of tumour growth?

Replication Escape from senescence Evasion of apoptosis Limitless replicative potential

What are the components of a neoplasm?

Neoplastic cells Blood vessels Inflammatory cells - macrophages, lymphocytes, polymorphs Fibroblasts Stroma

What does the term monoclonal mean?

A group of cells all derived from the same single ancestor cell

What is dysplasia?

Premalignant process Abnormal development but still confined to the original tissue

What is invasive growth?

Migration of cells that have detached from the primary tumour mass

What is required for invasive growth of a group of cells?

Cell-cell adhesion and communication Inner cells are protected from immunological assault High levels of autocrine pro-migratory factors and proteolytic enzymes Group of cells may be heterogenous

How do single cells migrate?

Mesenchymal migration - proteolysis, traction Amoeboid movement

What is desmoplasia? What characteristic does it give to tumours?

Growth of fibrous or connective tissue Gives the firm, craggy feel of cancer

Angiogenesis is required to provide oxygen and nutrition to tumour cells. How is it modulated, and what is characteristic of the new blood vessels?

Modulated by VEGF, FGF, TNFα Inhibited by thrombospondin-1 Vessels formed are abnormal

What is the normal route of metastasis for carcinomas?

Lymphatics

What is the normal route of metastasis for sarcomas?

Haematogenous

In what species does rous sarcoma virus cause cancer?

Chickens ## Footnote **not humans**

Give an example of a DNA virus that causes squamous carcinoma in humans.

Human Papilloma Virus

How do DNA viruses causes malignancy?

They encode proteins that bind to and inactivate host proteins

Give examples of oncogenes.

Platelet Derived Growth Factor Epidermal Growth Factor Receptor ras src myc Bcl2 Pim kinases

Give examples of tumour supressor genes

p53 pRB APC BRCA-1 NF-1 WT-1

What is the difference in inheritance between classical oncogenes and tumour supressor genes?

Oncogenes - dominant Tumour supressors - recessive

Which genes are involved in cancer?

Oncogenes Tumour Supressor Genes DNA Repair Genes Drug Metabolism

What are the features of retinoblastoma?

Mutation of a tumour supressor gene Autosomal dominant Variable penetrance - not everyone with mutation has the disease Can be an isolated case

What is the two-hit hypothesis of cancer?

Two mutations are required to develop cancer. Mutations may be inherited or acquired.

What is the role of BRAF in melanoma?

Activation of BRAF activates KRas pathway

Which gene is strongly linked to breast and ovarian cancer? What is its role?

BRCA1 DNA strand repair

What type of protein is p53?

Tumour suppressor