Pathology Week 3

Question 1

Characteristics of benign tumors

Answer 1

slow/limited growth, well circumscribed, lobulated, encapsulated, discrete, mobile, easily removed, localized to original tissue. Can be lethal.

Question 2

Characteristics of malignant tumors

Answer 2

limitless growth, invasion or destruction of adjacent tissues including basement membrane, poorly demarcated margins

Question 3

What is a hamartoma?

Answer 3

Disorganized growth/mass of indigenous tissue. Cells in right place but growth disorganized. Not a neoplasm

Question 4

What is a Choristoma?

Answer 4

normal architecture in wrong location, congenital anomaly. Not a neoplasm.

Question 5

What is the parenchyma?

Answer 5

functional part of tissue of an organ as distinguished from the connective and supporting tissue. In tumor, transformed neoplastic cells

Question 6

What is the stroma?

Answer 6

Host: surrounding supportive (connective) tissue

Question 7

What is dysplasia?

Answer 7

Loss of cell uniformity/orientation (epithelial)

Question 8

What is desmoplasia?

Answer 8

Stromal reaction (fibrosis-collagen) to invasion

Question 9

What is anaplasia?

Answer 9

Complete lack of differentiation (malignancy)

Question 10

Epithelial neoplasms?

Answer 10

carcinomas

Question 11

mesenchymal neoplasms?

Answer 11

sarcomas

Question 12

Characteristics of differentiation?

Answer 12

size/shape, nuclear morphology, proliferative activity, glandular architecture

Question 13

What are some characteristics of poor differentiation?

Answer 13

• Cells and nuclei become less uniform, acquire variation in size and shape
• Nuclei become large, irregular, hyperchromatic; ↑ nucleus/cytoplasm ratio
• Mitoses increase in number, become easy to find, with atypical shapes
• Glands become irregular with loss of polarity/orientation, haphazard growth

Question 14

What does pleomorphic mean?

Answer 14

having more than one shape or form.

Question 15

How does grading of tumors work?

Answer 15

Based on level of differentiation, from well differentiation (grade 1) to undifferentiated/anaplastic (grade 4)

Question 16

What is a carcinoma in situ?

Answer 16

Shows marked dysplastic changes, involves full thickness of the epithelium, but is pre-invasive in that it has not invaded the basement membrane yet.

Question 17

What are the 3 kinds of metastasis?

Answer 17

• lymphatic spread to regional lymph nodes (carcinomas)
• hematogenous spread to liver and lungs (carcinomas and sarcomas)
• Seeding of adjacent cavities (peritoneum, pleura) (carcinomas, typical of ovary)

Question 18

What is E-cadherin?

Answer 18

It’s inactivation is believed to facilitate tumor invasion and metastasis because it helps mediate cell-cell interactions, which must be loosened to allow movement of malignant cells

Question 19

What do metalloproteinases do?

Answer 19

Metalloproteinase degrades the extracellular matrix, facilitating cellular movement

Question 20

How do chemokine receptors affect metastasis?

Answer 20

Chemokine receptors stimulate the movement of tumor cells through the extracellular matrix and help determine the target tissues for metastases.

Question 21

How does VEGF affect metastasis?

Answer 21

Vascular endothelial growth factor stimulates the growth of new blood vessels to support metastatic foci.

Question 22

How is tumor staging done?

Answer 22

TNM: T (primary tumor’s size), N (regional nodes, number, location), M (metastases, number, sites). Mainly used for carcinomas. Staging more important than grading.

Question 23

What is a paraneoplastic syndrome?

Answer 23

is a disease or symptom that is the consequence of cancer in the body but, unlike mass effect, is not due to the local presence of cancer cells

Question 24

What is an example of a paraneoplastic syndrome?

Answer 24

Venous thrombosis (trousseau sign) as a result of a hypercoagulable state from pancreatic cancer and others

Question 25

How do tumors evade death/apoptosis?

Answer 25

p53, BCL2, BAX mutations

Question 26

What do metastases look like?

Answer 26

Metastatic cancer commonly looks histologically like its primary. This principle is important for patient management, when biopsies may be helpful in identifying a source of a metastatic lesion of unknown primary.