Pathology Part 5 Flashcards
What implies a non-malignant lesion?
Round Smooth edges Symmetrical Encapsulated- takes a while to form, suggests slow growing homogenous cut surface
What implies a malignant lesion?
Irregular
Infiltrative
Destructive
Heterogenous
What might cause a heterogenous lesion?
Haemorrhage
Necrosis
What is significant about the N:C ration
Higher N may suggest malignancy
What else may suggest malignancy?
Pleiomorphism
Hyperchromasia
Active mitosis
Necrosis
What is the meaning of mesenchymal?
Connective tissue
What is the meaning of haematopoietic?
White cells
What are the big taxonomy groups?
Epithelial Mesanchymal Haematopoietic Melanocytic Brain (glial)
What kind of tumours are found in the epithelium
Carcinomas
What kind of tumours contain glandular epithelial cells?
Adenoma vs adenocarcinoma
What kind of tumours contain squamous epithelial cells?
Papilloma vs SCC
What kind of tumours are found in the epithelium of the bladder?
transitional cell carcinoma (TCC)
Sometimes called urothelial cell carcinoma
What are malignant legions of the connective tissue?
Sarcoma
What are examples of connective tissues?
Bone, cartilage, peripheral nerves, fat, fibrous tissue, smooth muscle, skeletal muscle, miscellaneous others
What are benign tumours of fat called?
Lipoma
What are malignant tumours of the fat called?
Liposarcoma
How common is liposarcoma?
Rare
Retroperitoneum, testicular
What is a benign tumour of the bone called?
Osteoma
What is a malignant tumour of the bone called?
Osteosarcoma
What is a benign tumour of the cartilage called?
Endochondroma
What is a malignant tumour of the cartilage called?
Chondrosarcoma
What is a benign tumour of the skeletal muscle called?
Rhabdomyoma
What is a malignant tumour of the skeletal muscle called?
Rhabdomyosarcoma
What is a benign tumour of the smooth muscle called?
Leiomyoma
Very common
What is a malignant tumour of the smooth muscle called?
Leiomyosarcoma
What is a benign tumour of the nerves called?
Neurofibroma, schwannoma
What is a malignant tumour of the nerves called?
Malignant peripheral nerve sheath tumour
What is a benign tumour of the blood vessels called?
Haemangioma
What is a malignant tumour of the blood vessels called?
Angiosarcoma, kaposi’s sarcoma
What are tumours of the CNS called?
Gliomas
What is the medical term for a freckle?
Ephelis
What is the medical term for a mole?
Naevus
What is a malignant tumour of a mole or freckle called?
Melanoma
What is the name of malignant blood tumours?
All malignant
- leukaemia
- lymphomas
What can be done to analyse genetics?
Karyotype- culture cells and can see full complement
Cytogenetics- look at chromosome FISH
Molecular genetics
Look at oncogenes
Why are oncogenes relevant?
Diagnosis, prognosis, therapy
How can we stage cancer?
TNM staging
Tumour
Node
Metastasis
How do we grade cancer?
Differentiation
Well differentiated- low grade
Poorly differentiated- high grade
Describe some mass effects of cancers?
Local problems due to size
Compression of adjacent structures
Anatomically dependant
Brain- VERY BAD
Blocking of vessels
Blocking of airways
Blocking of bile ducts
What kind of tumours can present early and why?
Vocal cord- changes in voice early
Skin cancers- you can see them
Breast cancers- self- examine
Testicular cancer- self examine
What is a useful warning sign of a tumour?
Loss of function
- hoarseness
- jaundice
What is a result of colon cancer?
Obstruction
Perforation
What are the results of lung cancer?
Decreased area of healthy lung
Decreased oxygen consumption
If patient has pre-existing lung disease may not notice a change
When and how does lung cancer often present?
Late occurrence
Large and multiple tumours
What can be secondary to lung cancer?
Infection- secondary to obstruction
Like a pond without flowing water- stagnates
What can occur as a result of bladder and kidney tumours?
Obstruction Can't drain urine Backwards pressure Kidney stops functioning Build up of toxins and abnormal electrolyte balance
What can occur as a result of brain tumours?
Respiratory depression
Loss of control of HR
Increased intracranial pressure
Seizures- don’t breathe
What is different about tumours and normal tissue?
Divide frequently
Very metabolically active
Require energy
What is weight loss in cancer known as and caused by?
Cachexia
Energy use of tumours
Tumours produce molecules that result in increased metabolism throughout the body- TNFa
What is infiltration?
Direct invasion of other structures
Name some types of infiltration
Organs Fistula and sinuses Pooh in wrong places Brain Lung cancers through chest wall Nerves- loss of function
What can nerve infiltration cause?
Motor- swallowing, diaphragm
Sensory- pain (late sign) or loss of sensation
Other- autonomic function
What can infiltration of blood vessels cause?
Catastrophic Haemorrhage
What can infiltration of bone marrow cause?
White cell production
Folate requirements increase
What is a paraneoplastic syndrome?
Caused by hormones produced by tumour
What can paraneoplastic syndromes result in?
Electrolyte disturbances
High calcium
Low sodium
Name a paraneoplastic syndrome?
Osteoarthropathy- big fingers
Skin rash
Fever- endogenous pyrogenes
What is the relationship between tumours and immunosuppression?
express proteins that are not normally expressed.
stimulate an immune response
a strong immune response=good prognosis
What are cancer patients at high risk for?
Infection
What are metastasis known to be?
More problematic than primary
How can bone metastases present?
Pathological fracture
Calcium metabolism
High levels of calcium- arrhythmia
Kidney problems
