PP: Neoplasia

Question 1

Define neoplasia.

Answer 1

An abnormal growth of cells that persists after the initial stimulus is removed.

Question 2

Define dysplasia.

Answer 2

A pre-neoplasticism alteration in cells which show disordered tissue organisation.

Question 3

Why is dysplasia not the same as neoplasia?

Answer 3

Dysplasia is reversible.

Question 4

Define cancer.

Answer 4

Any malignant neoplasm

Question 5

Define metastasis.

Answer 5

A malignant neoplasm that has spread from its original site to a new non-contiguous site.

Question 6

Define anaplasia.

Answer 6

Cells with no resemblance to any tissue.

Question 7

Define pleomorphism.

Answer 7

Increasing variation in size and shape of cells and nuclei.

Question 8

Define progression.

Answer 8

Accumulation of more mutations leading to a neoplasm.

Question 9

Define monoclonal population.

Answer 9

When all cells have come from the same founding cells.

Question 10

Define hyperchromasia.

Answer 10

Increased nuclear staining

Question 11

Describe the macroscopic features of a benign tumour.

Answer 11

They grow in confined local areas and so have a pushing outer margin.

Question 12

Describe the macroscopic features of a malignant tumour.

Answer 12

• Irregular outer margin
• May show areas of necrosis
• May show areas of ulceration

Question 13

Describe the microscopic features of a benign tumour. (Differentiation and grade)

Answer 13

• Well differentiated

- Often grade 1 (tubules present, no mitosis or nuclear pleomorphism)

Question 14

Describe the microscopic features of a malignant tumour. (Differentiation and grade)

Answer 14

• range from well to poorly differentiated

- Grade 3 when poorly differentiated (no tubules present, mitoses and nuclear pleomorphism present)

Question 15

What is the difference between in-situ and invasive malignancy?

Answer 15

In-situ doesn’t breach the epithelial basement membrane, whereas invasive does penetrate.

Question 16

Describe clonality of neoplasm.

Answer 16

They are monoclonal and result fro, a combination of initiators, promotors and progression.

Question 17

Describe the role of proto-oncogenes within neoplasia.

Answer 17

Proto-oncogenes become abnormally activated (meaning they are then called oncogenes) favouring neoplasm formation.

Question 18

Describe the role of tumour suppressor genes within neoplasia.

Answer 18

These genes usually suppress neoplasm formation, however in states of neoplasia these become inactivated.

Question 19

What is meant by adenoma?

Answer 19

Benign glandular tumour

Question 20

What is meant by papilloma?

Answer 20

Benign tumour with finger like projections

Question 21

What is meant by carcinoma?

Answer 21

Epithelial malignant neoplasm

Question 22

What is meant by sarcoma?

Answer 22

Stromal malignant neoplasm

Question 23

What is meant by gliomas?

Answer 23

Malignant brain neoplasm (yes I realise this doesn’t fit the rule, and no this is not a mistake)

Question 24

What is meant by lymphomas?

Answer 24

Malignant neoplasms of lymphocytes

Question 25

What is meant by germ cell tumours?

Answer 25

Arising from pluripotent cells, they mainly affect the testis or ovaries.

Question 26

What is meant by neuroendocrine tumours?

Answer 26

neoplasms that arise from cells of the endocrine (hormonal) and nervous systems. Many are benign, while some are malignant.

Question 27

What is meant by blastoma?

Answer 27

A blastoma is a type of cancer, more common in children, that is caused by malignancies in precursor cells, often called blasts

Question 28

Describe the process that leads to metastasis.

Answer 28

1. Grow and invade at the primary site 2. Enter a transport system and lodge at a secondary site 3. Grow at the secondary site to form a new tumour (colonisation)

Question 29

Name the alterations needed for invasion.

Answer 29

- Alteration in adhesions - Alteration in proteolysis - Alteration in motility

Question 30

What determines the site of a metastasis?

Answer 30

- Regional drainage of blood, lymph and coelomic fluid | - Seed and soil phenomenon

Question 31

Describe the routes and common sites of a metastasis. Comment on lymphatics, blood and coelomic.

Answer 31

Lymphatics: drainage to lymph nodes Blood: often the next capillary bed Coelomic: other areas in the coelomic space or adjacent organs.

Question 32

List the common sites for blood-borne metastasis.

Answer 32

- Lung - Bone - Liver - Brain

Question 33

List the neoplasms which most frequently spread to bone.

Answer 33

- Breast - Bronchus - Kidney - Thyroid - Prostate

Question 34

Describe the local effects of neoplasms.

Answer 34

- Direct invasion and destruction of normal tissue - Ulceration leading to bleeding - Compression of adjacent structures - Blocking tubs and orifices

Question 35

Describe the general systemic effects of neoplasms.

Answer 35

- Cachexia (reduced appetite and weight loss) - malaise - immunosupression - fever - finger clubbing - hypercalcaemia

Question 36

What adhesions are involved in malignant cells?

Answer 36

E-Cadherin between cells, intergrin between cells and the stromal proteins