PoD - Tumour Pathology Flashcards
what is a tumour?
- an abnormal growing mass of tissue
- it’s growth is uncoordinated with that of surrounding normal tissue
- it’s growth continues after the removal of any stimulus which may have caused the tumour - capable of autonomous growth
what types of tumours are there?
- benign (don’t cause any significant or pathological problems - mostly pressure)
- malignant (cancer)
what is the definition of cancer?
- a fundamental property of cancer is its ability to invade into adjacent tissue and to metastasise and grow at other sites within the body
what are metastases?
- secondary tumours
- will resemble the primary tumour
- it is harder to treat patients’ cancers that have metastasised - not feasible to surgically remove all of them
what are the most common cancers in the UK?
- male = prostate
- female = breast
- overall = breast
how are tumours classified?
- based on tissue of origin (epithelium, connective tissue, blood cells, lymphoid tissues, melanocytes, neural tissue, germ cells)
- benign or malignant
how are epithelial tumours named?
- 2 broad types of epithelium which tumours can originate from
- any type of malignant epithelium is a CARCINOMA
- glandular
benign = adenoma
malignant = adenocarcinoma - squamous
benign = squamous papilloma
malignant = squamous carcinoma
how are connective tissue tumours named?
- bone, fat or fibrous tissue
- any type of malignant connective tissue is called a SARCOMA
- bone
benign = osteoma
malignant = osteo-sarcoma - fat
benign = lipoma
malignant = lipo-sarcoma - fibrous tissue
benign = fibroma
malignant = fibro-sarcoma
how are blood cell tumours named?
- only WBCs can develop a tumour
- there are no benign tumours
malignant
= leukaemia
how are tumours of lymphoid tissue named?
- there are no benign tumours
malignant
= lymphoma
how are tumours of melanocytes named?
- benign tumours = naevus
- malignant tumour = melanoma
how are neural tissue tumours named?
- central nervous system = astrocytoma
peripheral nervous system
= schwannoma
what are germ cell tumours called?
- tumour composed of various tissues - indicates the pluripotent capability of germ cells = teratomas - develop in ovary/testis - ovarian teratomas = benign - testicular teratomas = malignant
list features of malignant tumours
- invasive growth pattern
- no capsule/capsule breached by tumour
- cells look abnormal
- cancers poorly differentiated - lack of normal tissue left
- loss of normal function
- metastases
- frequently cause death
what is a tumour suppressor gene?
- keep cells under regulatory control
- loss of these = tumour formation (normally need to lose both to cause cancer)
- examples = retinoblastoma (RB1), breast cancer (BRCA1)
what is an oncogene?
- oncogene activates abnormal cell division
e. g B-raf, cyclin D1, erbB2, k-ras
what happens to tumour cell links?
- loss of cell-cell adhesion (normal cells stick together, but this fails in cancer cells which allows them to invade and spread)
- altered cell-matrix adhesion
- production of tumour biomarkers
what are tumour biomarkers useful for?
- screening - detecting cancers while still asymptomatic
- diagnosis
- prognostic - identifying a patient’s outcome
- predictive - identifying how patients will respond to a particular therapy
list the tumour biomarkers currently used clinically
- alpha-fetoprotein
= teratoma of testis
= hepatocellular carcinoma - carcinoma-embryonic antigen (CEA)
= colorectal cancer - oestrogen receptor
= breast cancer - prostate specific antigen
= prostate cancer
what are clinically useful predictive tumour markers?
- Kras = colorectal c
- Braf = melanoma
- EFGR = lung c
- PD-L1 = lung c
- Her2 = breast/gastric x
how do tumours grow?
- balance between angiogenesis and apoptosis
- angiogenesis = new blood vessel formation, required to sustain growth via nutrients, O2, also provides a route for metastases
- apoptosis = mechanism of programmed cell death, regulates tumour growth
how do tumours spread?
- invasion and metastasis
- need to create a track to move through = increased matrix degradation by proteolytic enzymes
- need to be able to move = altered cell-cell/cell-matrix adhesion
what happens in tumour invasion?
- tumour invasion occurs when adhesion has broken down, allowing invasion into connective tissue the into the lymph/blood vessels
what happens in tumour metastasis?
- lymphatic metastasis occurs when there is adhesion of tumour cells to lymph vessels, they invade into the lymph node, form metastasis in lymph node
- metastasis via blood = adherence of tumour cells to blood cells, invasion from BVs, invasion into tissue and formation of metastasis