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Y3 IWB > PATHOLOGY- Neoplasia > Flashcards

PATHOLOGY- Neoplasia Flashcards

1
Q

Name the 4 most common types of cancers

A

Breast
Prostrate
Lung
Bowel

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2
Q

Which age group is more prone to developing cancers

A

Mostly over 60

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3
Q

How many deaths are due to cancer in the uK?

A

1 in 4 deaths (1 death every 3 mins)

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4
Q

How many deaths are caused by cancer annually

A

165,000 per year

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5
Q

As a dentist at which stages of examining a patient should you more diligently check for cancers

A
  1. Soft tissue exam for oral cancers

2. External exam can flag up malignancies especially in the lymph nodes

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6
Q

As a GDP name some tumours you nay be first in line screening for presentation of

A
  1. Oral squamous cell tumour
  2. Salivary gland tumour
  3. Odontogenic tumours
  4. Benign soft tissue tumours
  5. Sarcomas
  6. Lymphomas
  7. Melanomas
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7
Q

Define neoplasia

A

A new formation/new growth

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8
Q

What is another term for neoplasm

A

Tumour

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9
Q

What is a tumour

A

A swelling associated with inflammation

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10
Q

What is oncology

A

The study of tumours

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11
Q

Define neoplasm

A

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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12
Q

What is the persistent growth of a tumour after the stimulus has been removed caused by?

A
  1. Non lethal genetic alterations in key genes
  2. Passed down to the progeny of the tumour cells
  3. Excessive and unregulated proliferations
  4. Autonomous (independent of physiological growth stimuli)
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13
Q

Define benign

A

An entity that has features suggesting indolent behaviour

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14
Q

Define malignant

A

An entity that is invasive and has potential to metastasise

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15
Q

What can malignant tumours be split into

A

Primary
Secondary

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16
Q

What is a primary tumour

A

The original tumour present at the origin site

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17
Q

What is a secondary tumour

A

A tumour that has metastasised and migrated to a different part of the body

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18
Q

What does carcinogenesis require?

A
  1. Self sufficiency in growth signals
  2. Insensitivity to growth inhibitory signals
  3. Altered cellular metabolism
  4. Evasion of apoptosis (cell death)
  5. Limitless replicative potential
  6. Sustained angiogenesis (own blood supply)
  7. Ability to invade/ metastasise
  8. Ability to evade host immune response
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19
Q

What causes cancer?

A
  1. Carcinogenic substances
  2. Radiation exposure
  3. Pathogens
  4. Genetic predisposition
  5. Other factors eg age, obesity
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20
Q

Give examples of some oncogenic pathogens

A
  1. HPV
  2. EBV
  3. HEP C and B
  4. HEP B
  5. HHV8
  6. HTLV1
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21
Q

Give examples of some carcinogenic substances

A
  1. Tobacco
  2. Ethanol
  3. Coal
  4. Drugs
  5. Air pollution
  6. Silica dust
  7. Arsenic
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22
Q

In older patients what is the origin of most of their cancers?

A

Epithelial in origin (carcinomas)

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23
Q

Why are cancers more common in older people

A
  1. Increasing somatic genetic mutations
  2. Loss of immune competence
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24
Q

Are epithelial cancers in children common?

A

No

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25
Q

Which cancers are more common in children?

A

Acute leukaemia
Primitive CNA neoplasms
Small blue cell tumours (retinaoblastoma etc)

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26
Q

What is obesity defined as?

A

A BMI of over 30

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27
Q

Name the 2 biggest preventable causes of cancer in the uK

A
  1. Smoking
  2. Obesity
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28
Q

Which cancers are highly associated with obesity

A
  1. Breast
  2. Bowel
  3. Endometrial
  4. Oesophageal
  5. Pancreatic
  6. Kidney, liver and stomach
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29
Q

Why is there a link between obesity and cancers

A

Excess fat leads to increase in hormones and growth factors which increase cell division
Increased rate of cell division increases the opportunity for genomic instability

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30
Q

Alongside environmental factors name another factor that causes cancer

A

Hereditary factors

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31
Q

Name the 4 distinguishing features we use to describe neoplasia

A
  1. Differention
  2. Rate of growth
  3. Local invasion
  4. Metastasis
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32
Q

What is anaplasia

A

Poor differentiation

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33
Q

Give some features of anaplasia

A
  1. Nuclear pleomorphism
  2. Abnormal nuclear features
  3. Increases mitotic activity
  4. Loss of cellular polarity/ order
  5. Tumour giant cells
  6. Necrosis
  7. Haemorrhage
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34
Q

What is nuclear pleomorphism

A

Variability in nuclear size

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35
Q

List some abnormal nuclear features

A
  1. High nuclear: cytoplasmic ratio
  2. Clumped chromatin
  3. Prominent nucleoli
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36
Q

Name the 3 terms we use to categorise tumours in terms of differentiation

A
  1. Well differentiated
  2. Poorly differentiated
  3. Undifferentiated/ anaplastic
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37
Q

Describe a well differentiated tumour

A
  1. Closely resembles normal tissue of origin
  2. Little of no evidence of anaplasia
  3. BENIGN and occasional malignant
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38
Q

Describe a poorly differentiated tumour

A
  1. Little resemblance to tissue of origin
  2. Highly anaplastic appearance
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39
Q

Describe an undifferentiated/ anaplastic tumour

A

Cannot be identified by morphology alone so you need to carry out molecular tests to identify the tumour

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40
Q

When we are talking about the classification of a tumour what are we referring to?

A

The name of the tumour decided by the WHO

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41
Q

When we are talking about the GRADE of a tumour what are we referring to?

A

Referring to how bad the tumour is based on differentiation and clinical features

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42
Q

What is the grade of a tumour a measure of?

A

How differentiated the tumour appears

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43
Q

How many grades are there when we are looking at tumours and what do they mean

A

3 grade:
Grade 1 (low)= well differentiated
Grade 2 (intermediate) = moderately differentiated
Grade 3 (high)= Poorly differentiated

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44
Q

When we are talking about the STAGE of a tumour what are we referring to?

A

Referring to how much the Tumour has spread

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45
Q

What is the stage of a tumour a measure of?

A

The spread of the tumour

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46
Q

What is the significance of the stage of a tumour

A

It determines the prognosis of the tumour

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47
Q

What does a low stage tumour mean?

A

Means the tumour hasn’t spread that much so has a better prognosis

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48
Q

What do we mean by differentiation when referring to tumours?

A

Differentiation is the extent to which neoplastic tissues resemble their corresponding normal tissue of origin

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49
Q

What is a lack of differentiation called?

A

Anaplasia

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50
Q

Define metaplasia

A

Change in the phenotype of undifferentiated cells often in response to chronic irritation

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51
Q

Are metaplasia and neoplasia the same thing?

A

NO
But often sites of metaplasia can be less stable and so are more vulnerable to accumulate genetic changes that LEAD to neoplasia

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52
Q

Define hypertrophy

A

Increased cells and thus organ size often in response to increased work load

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53
Q

What is hypertrophy usually a response to?

A

Increased work load

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54
Q

Define hyperplasia

A

Increased cell numbers in response to a stimulus eg hormones

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55
Q

What is hyperplasia usually a response to ?

A

A stimulus such as hormones or growth factors

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56
Q

Give an example of a common hypertrophy

A

Cardiac hypertrophy (increased work load on the heart)

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57
Q

What is dysplasia

A

It is a term used to describe confined neoplastic changes

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58
Q

Define dysplasia

A

Abnormal growth

59
Q

What can epithelial dysplasia lead to?

A

Potentially malignant lesions

60
Q

Is epithelial dysplasia a malignant tumour

A

No the process has not yet tipped over into being malignant and the lesion is still confined with in the basement membrane

61
Q

What conditions must a tumour fulfil to be termed invasive malignant?

A

Needs to breach the basement membrane

62
Q

What is the difference between dysplasia and carcinoma in situ

A

A carcinoma has breached the basement membrane, cytomorpholigcal features of malignancy but without invasion. Basement membrane of dysplastic epitheloum not penetrated
a dysplasia has not

63
Q

Do dysplasia always lead to malignant/ invasive tumours

A

no sometimes they can regress

64
Q

What does the growth rate of a tumour correlate with?

A

Correlates with level of differentiation

65
Q

Do malignant tumours have a fast or slow rate of growth?

A

Usually fast as you can see increased mitosis

66
Q

Do benign tumours have a fast or slow rate of growth?

A

Slow

67
Q

Give some features of a rapidly growing tumour

A
  1. Mitosis
  2. Necrosis
  3. Ulceration
68
Q

Why do tumours with a fast growth rate lead to necrosis and ulceration

A

As the tumour is growing faster than the vascular supply can repair at

69
Q

List 4 features of benign tumours

A
  • Cohesive and expansile masses
  • Localised
  • Cannot invade or metastasize
  • Grow and expand slowly
70
Q
A
71
Q

What is a grade 1 tumour

A

A low grade well differentiated tumour

72
Q

What is a grade 2 tumour

A

An intermediate grade moderately differentiated tumour

73
Q

What is a grade 3 tumour

A

A high grade poorly differentiated tumour

74
Q

Do benign tumours have a high or low mitotic activity and what does this suggest about their growth rate?

A

They have low mitotic activity leading to a slow growth rate

75
Q

Are benign tumours well or poorly differentiated

A

Well differentiated

76
Q

Describe the nuclear morphology of benign tumours

A

Normal

77
Q

Describe the border of a benign tumour

A

It is circumscribed and or encapsulated
* Rim of compressed connective tissue= fibrous capsule

78
Q

Describe the growth direction of benign tumours

A

Exophytic

79
Q

Do malignant tumours have a high or low mitotic activity and what does this suggest about their growth rate?

A

They have high mitotic activity leading to a rapid growth rate

80
Q

Are malignant tumours well or poorly differentiated

A

Often poor

81
Q

Describe the nuclear morphology of malignant tumours

A

Pleomorphic

82
Q

Are malignant tumours invasive

A

Yes and they frequently metastasise

83
Q

Describe the growth direction of malignant tumours

A

Endophytic

84
Q

How are tumours usually classified

A

Based on their tissue of tumour origin

85
Q

Give the 2 broad classification all tumours are first split into

A

Epithelial origin (carcinomas)
Non epithelial origin

86
Q

What is the suffix associated with benign tumours

A

OMA (but their are several exceptions)

87
Q

What are benign tumours of glandular/ secretory epithelium called?

A

Adenoma

Glands may or may not be present in the tumour

88
Q

What are benign tumours of non glandular/ surface epithelium called?

A

Papilloma

papilloma describes fingerlike or warty projections but most benign non-

89
Q

After identifying a non glandular surface benign epithelial tumour what is the tumour further classified by?

A

Further identified by name of the cell type of origin (eg squamous cell)

90
Q

After identifying a glandular benign epithelial tumour what is the tumour further classified by?

A

Name of the glandular tissue of origin

e.g. colonic

91
Q

Give examples of some origin tissues for benign epithelial tumours

A
  1. Stratified squamous epithelium (eg skin, anus, cervix)
  2. Transitional epithelium of the bladder
  3. Glandular epithelium of colon
  4. Glandular epithelium of thyroid
92
Q

What is the nomenclature of a Stratified squamous benign epithelium tumour

A

Squamous cell papilloma

93
Q

What is the nomenclature of a Transitional epithelium benign tumour of the bladder

A

Transitional cell papilloma

94
Q

What is the nomenclature of a benign tumour on the Glandular epithelium of the colon

A

Colonic adenoma

95
Q

What is the nomenclature of a benign tumour on the Glandular epithelium on the thyroid

A

Thyroid adenoma

96
Q

What are malignant epithelial tumours called

A

Carcinomas

97
Q

What are malignant epithelial tumours derived from glandular ductular epithelium called?

A

Adenocarcinomas

98
Q

How are malignant epithelial tumours derived from surface glandular epithelia names

A

Named by prefixing carcinoma with the cell of origin

99
Q

Give examples of some origin tissues for malignant epithelial tumours

A
  1. Stratified squamous epithelium (eg skin, anus, cervix)
  2. basal cells of the skin
  3. Glandular epithelium of colon
  4. Glandular epithelium of breast
  5. Transitional epithelium of the body
100
Q

What is the nomenclature of a Stratified squamous malignant tumour

A

Squamous cell carcinoma

101
Q

What is the nomenclature of a basal cell malignant tumour

A

Basal cell carcinoma

102
Q

What is the nomenclature of a malignant tumour on the transitional epithelium of the bladder

A

Transitional cell carcinoma

103
Q

What is the nomenclature of a malignant tumour on the glandular epithelium on the colon

A

Colonic adenocarcinoma

104
Q

What is the nomenclature of a malignant tumour on the glandular epithelium on the breasts

A

breast adenocarcinoma

105
Q

all beingn mesenchymal tumours have what suffix

A

-oma

106
Q

What is the prefix for benign mesenchymal tumours affecting smooth muscle

A

Leiomyo

107
Q

What is the prefix for benign mesenchymal tumours affecting skeletal muscle

A

Rhabdomyo

108
Q

What is the prefix for benign mesenchymal tumours affecting adipose tissue

A

LIPO

109
Q

What is the prefix for benign mesenchymal tumours affecting blood vessel

A

Haemangio

110
Q

What is the prefix for benign mesenchymal tumours affecting bone tissue

A

Osteo

111
Q

What is the prefix for benign mesenchymal tumours affecting cartilage tissue

A

Chondro

112
Q

What is the prefix for benign mesenchymal tumours affecting fibrous tissue

A

Fibro

113
Q

What is a benign tumour affecting smooth muscle called?

A

Leiomyoma

114
Q

What is a benign tumour affecting striated muscle called?

A

Rhabdomyoma

115
Q

What is a benign tumour affecting adipose tissue called?

A

Lipoma

116
Q

What is a benign tumour affecting blood vessels called?

A

Haemangioma

117
Q

What is a benign tumour affecting bone tissue called?

A

Osteoma

118
Q

What is a benign tumour affecting cartilage tissue called?

A

Chondroma

119
Q

What is a benign tumour affecting fibrous tissue called?

A

Fibroma

120
Q

malignant mesenchymal tumours are called what

A

sarcomas

121
Q

What is a malignant tumour affecting smooth muscle called?

A

Leiomyosarcoma

122
Q

What is a malignant tumour affecting striated muscle called?

A

Rhabdomysarcoma

123
Q

What is a malignant tumour affecting adipose tissue called?

A

Liposarcoma

124
Q

What is a malignant tumour affecting blood vessels called?

A

Angiosarcoma

125
Q

What is a malignant tumour affecting bone tissue called?

A

Osteosarcoma

126
Q

What is a malignant tumour affecting cartilage muscle called?

A

Chondrosarcoma

127
Q

What is a malignant tumour affecting fibrous tissue called?

A

Fibrosarcoma

128
Q

What are teratomas

A

Germ cell tumours

129
Q

Why are teratomas strange

A

As they can contain cells reprising all three germ cell layers

130
Q

Name the 3 germ cell layers

A

Endoderm
Mesoderm
Ectoderm

131
Q

What can benign teratomas affect

A

Teeth
Hair
Muscle
Cartilage

132
Q

describe ovarian teratomas

A

benign/cystic

133
Q

describe testicular teratomas

A

malignant/solid

134
Q

Give examples of some brain tumours

A
  1. Glioblastoma multiforme
  2. Meningioma
  3. Neurinoma
  4. Ependynoma
  5. Medulloblastoma
  6. Oligoendroglioma
  7. Astrocytoma
135
Q

What are hamartomas

A

NON NEOPLASTIC disordered overgrowth of normal tissue (NOT TUMOURS)

136
Q

What are hamartomas indigenous to?

A

The sire of occurrence

137
Q

What are Choristomas

A

Bengin normal tissue but seen in an abnormal location

138
Q

What is another term for Choristomas

A

Heterotropic rests

139
Q

Give an example of a Choristomas

A

A normal pancreas module found in the stomach

140
Q

Give examples of malignant tumours with benign sounding names

A
  1. Melanoma
  2. Mesothelioma
  3. Myeloma
  4. Lymphoma
141
Q

What is a melanoma

A

A malignant tumour of melanocytes

142
Q

What is a Mesothelioma

A

A malignant tumour in the lungs

143
Q

What is a Myeloma

A

A type of blood cancer

144
Q

Lymphoma

A

A type of blood cancer

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