Pathology: Neoplasms

Question 1

Neoplasia =

Answer 1

New growth

Question 2

Is a neoplasm an adaption?

Answer 2

NO, it needs mutations in the DNA (so that it can be a permanent change)

Question 3

5 most common cancers in men

Answer 3

1. Prostate
2. Bowel
3. Melanoma
4. Lung
5. Non-hodgkin Lymphoma

Question 4

5 most common cancers in women

Answer 4

1. Breast
2. Bowel
3. Melanoma
4. Lung
5. Uterine

Question 5

Is proliferation reversible?

Answer 5

Yes, if stimulus is removed

Question 6

Is metaplasia reversible?

Answer 6

Yes, if stimulus is removed

Question 7

Is dysplasia reversible?

Answer 7

Yes - pre-neoplastic

Question 8

Is neoplasia reversible?

Answer 8

NO - it’s an abnormal new growth, a permanent, genetic change

Question 9

Cancer development (diagram)

Answer 9

See screenshot

Question 10

How does cancer form?

Answer 10

By clonal expansion

Question 11

How are cells transformed to cancer cells?

Answer 11

Through a series of mutations and DNA changes (carcinogen - agent that can transform cells)

Question 12

Factors contributing to cancer development

Answer 12

Chemical carcinogen (e.g. cigarette smoke, hydrocarbons, aflatoxin, urethane)
Biological (viruses like EBV)
Physical (radiation, ionising, UV)

Question 13

Molecular pathway leading to cancer (6)

Answer 13

1. Faulty cell cycle genes
2. Fault genes that control apoptosis
3. Faulty DNA repair genes
4. Gain of function of oncogenes
5. Loss of function of tumour suppressor genes
6. Mutations in growth factors/receptors controlling growth and differentiation

Question 14

Bukitt’s lymphoma

Answer 14

Translocations active some oncogenes

Question 15

Benign tumour suffix

Answer 15

oma (e.g. fibroma)

Question 16

Malignant tumour suffix

Answer 16

sarcoma, carcinoma, adenocarcinoma

Question 17

Benign vs malignant

Answer 17

B: not cancerous/invasive
M: cancerous/invasive

Question 18

Cellular characteristics of malignancy: cellular pleimorphism

Answer 18

Increased variation in size and shape of cells

Question 19

Cellular characteristics of malignancy: nuclear pleimorphism

Answer 19

Increase in size and shape of nucleus

Question 20

Cellular characteristics of malignancy: nuclear hyperchromatism

Answer 20

Increased density of chromatin

Question 21

Cellular characteristics of malignancy: very active DNA

Answer 21

Increased nuclear cytoplasm ratio

Question 22

Cellular characteristics of malignancy: Anaplasia

Answer 22

Differing morphologically and functionally from cell of origin

Question 23

Benign vs Malignant: structure

Answer 23

B: well differentiated, typical of the tissue of origin. Little necrosis, plenty of support tissue (stroma)
M: undifferentiated, does not look like tissue of origin. Necrosis common, loose structure (poorly-formed stroma)

Question 24

Benign vs Malignant: mode of growth

Answer 24

B: Expansive, encapsulated
M: Infiltrated, expansive, invasive, not encapsulated

Question 25

Benign vs Malignant: rate of growth

Answer 25

B: Slow, little mitosis M: May be rapid, lots of mitosis. Variable

Question 26

Benign vs Malignant: end of growth

Answer 26

B: May be spontaneous M: Rare spontaneous stop to growth

Question 27

Benign vs Malignant: metastasis (present or not)

Answer 27

B: Absent M: Diagnostic feature

Question 28

Benign vs Malignant: clinical significance

Answer 28

B: Usually not fatal - depends on situation, complications M: Invasive, secondaries, infection, haemorrhage, cachexia, often causes death if growth is uncontrolled

Question 29

Leiomyoma

Answer 29

Common cause of uterine bleeding and pain

Question 30

How does cancer spread?

Answer 30

Requires metastasis - movement from site of original cancer to a new and different site

Question 31

Lymphatic spread

Answer 31

Pattern of lymph node involvement follows natural lymph node drainage

Question 32

Vascular spread

Answer 32

Usually veins but also arteries | Patters on vascular metastasis help diagnose cancer

Question 33

Features of a cancer diagnosis

Answer 33

- Is the tumour local or a metastasis? - Do the cells look like the cells of origin? - Then we can grade the tumour and diagnose the stage of development

Question 34

Grading of cancer growths

Answer 34

A measure of how much the tumour resembles normal tissue Grades of 1 (good) to 3 (Bad)

Question 35

Staging of neoplasms

Answer 35

1. Size and thickness of primary lesion 2. Spread to lymph nodes 3. Presence of metastases to distant site