principles

Question 1

5 features of benign tumours vs malignant tumours

Answer 1

KEY: do not invade or metastasise; encapsulated (easy to remove), usually well differentiated, slowly growing (low mitotic rates), normal mitoses

Question 2

6 occasions when benign tumours are fatal

Answer 2

when in dangerous place e.g. meninges (e.g. blocking lateral to III ventricle, causing hydrocephalos), pituitary (optic chiasma); when secrete something dangerous e.g. insulinoma (B-cells in pancreas); when something gets infected e.g. bladder; when causes bleeding e.g. stomach; when it ruptures e.g. liver adenoma; when it torts e.g. ovarian cyst

Question 3

6 features of malignant tumours vs benign tumours

Answer 3

KEY: invade surrounding tissues, spread to distant sites (depends if caught early); no capsule, well->poorly differentiated, rapidly growing, abnormal mitoses

Question 4

define metastasis

Answer 4

discontinuous growing colony of tumour cells, at some distance from the primary cancer (local treatment not enough)

Question 5

what does metastasis depend on

Answer 5

lymphatic and vascular drainage of primary site

Question 6

what involvement has a worse prognosis with metastasis

Answer 6

lymph node

Question 7

colon metastasis: Dukes A vs B prognosis

Answer 7

A only in bowel wall - 90%, B in lymph nodes - 30%

Question 8

what can distinguish benign from malignant tumours

Answer 8

degree of differentiation, speed of growth, capsulation, invasiveness

Question 9

what are well differentiated tumours characterised by

Answer 9

small number of mitoses, lack of nuclear polymorphism, relatively uniform nuclei, close resemblance to corresponding normal tissue

Question 10

what 4 substances present can indicate normal function of malignant tumour (e.g. adenoma/adenocarcinoma)

Answer 10

keratin, mucin, bile, hormones

Question 11

what 3 locations can grading systems be used

Answer 11

breast, prostate, colon

Question 12

define anaplastic

Answer 12

cancer cells that divide rapidly and have little or no resemblance to normal cells (no differentiation)

Question 13

define grade of a tumour

Answer 13

degree of differentiation

Question 14

define stage of a tumour

Answer 14

how far it has spread

Question 15

relationship between grade and stage

Answer 15

higher the grade, typically higher the stage

Question 16

what is more important (grade or stage) when determining prognosis

Answer 16

stage

Question 17

what system can be applied, and individualised, to tumour in all sites when calculating grade and stage

Answer 17

TNM (tumour, node, metastasis) system

Question 18

TNM for organs

Answer 18

for each organ TNM is different (as T stage increases, tumour tends to get bigger)