principles of neoplasia Flashcards

lecture 35

1
Q

define atrophy

A

the diminution of growth due to a decrease in the size or number of the cells of a tissue

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2
Q

define hypertrophy

A

the increase in the size of an organ or tissue due to an increase in the size of the cells

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3
Q

define hyperplasia

A

an increase in the size of an organ due to an increase in the number of component cells. it persists only as long as its cause

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4
Q

what extrinsic factors control tissue integrity

A

1 - ligand receptor competence factors, allow it to enter the cell cycle
2 - physical interactions with the ECM
3 - cell cell adhesion
4 - commitment factors (hormones and ligands) allow progress through cell cycle

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5
Q

what protein families regulate cell cycle

A

1 - cyclin dependent kinases (CDKs)
2 - cyclins
- regulated by cyclin dependent kinase inhibitors (CKIs)

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6
Q

describe G1

A
  • high metabolic activity, much replication.
  • duration depends on external factors
  • contains checkpoint for commitment to mitosis and after this the cell is independent of external factors
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7
Q

3 cell cycle options in G1

A

1 - replicate
2 - enter G0
3 - terminally differentiate and loose the ability to replicate

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8
Q

3 classifications of cells

A

1 - permanent cells - terminally differentiated like neurons and striated myocytes
2 - conditional renewal populations - in G0, can enter G1 following loss or injury or raised funciton
3 - continually self renewing - replace the terminally differentiated pool

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9
Q

which populations of cells contain - stem cells, transit amplifiers, terminally differentiated?

A

skin, gut, urinary, genital, bone marrow, lymphoid

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10
Q

process of intestine epithelial renewal?

A

slowely dividing stem cell compartment at the bottom of a crypt.
- rapidly dividing transit amplifying cells
- non dividing, fully differentiated cell at the top.
process takes 3 - 5 days. apoptosis at the top of the villus.

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11
Q

an example on why extracellular support is needed for cell function?

A

in most tissues the position of the cell is critical for the retention of the stem cell phenotype eg bone marrow stem cells depend on the stromal cells.

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12
Q

what are the key characteristics of stem cells?

A

1 - undergo renewing mitotic divisions
2 - the number of daughter cells that retain the stem cell phenotype is strictly controlled eg wounding
3 - the stem cell pool is replenished but not expanded.

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13
Q

define metaplasia

A

the replacement of one differentiated cell type with another

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14
Q

when does metaplasia ususally occur?

A

almost always a response to persistent injury, commonly glandular epithelium to a squamous one. is reversible if the injurious stimulus is removed.
2 particular sites - exposure of bronchial epithelium persistently to tobacco smoke
- exposure of endocervix of the uterus to acid pH, infection, semen. leads to squamous metaplasia.

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15
Q

what is dysplasia?

A

part of the spectrum of changes of preinvasive neoplasia. they do not necessarily revert to normal when the stim is removed.

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16
Q

morphology of dysplasia

A

1 - regular organised appearance of the epithelium disturbed by variations in shape and size of the cells
2 - increased nucleus to cytoplasm ratio
3 - pleomorhpism - irregularity with variation in nuclear size, shape, chromatin staining.
4 - hyperchromatic nuclei
5 - increased mitosis
6 - distortion of the proliferating vs non-proliferating compartment

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17
Q

define tumour

A

classically defined as a swelling but generally speaking is referring to a neoplasm

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18
Q

define a neoplasm

A

an abnormal mass of tissue, the growth of which exceeds and is uncordinated with that of the normal tissue that persists in the same excessive manner after the stimulus is removed.
- they are ireversible

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19
Q

the hallmarks of cancer vs neoplasia

A

the ability to invade and metastasise. these tumours are malignant

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20
Q

define benign neoplasm

A

they proliferate and divide but do not invade surounding tissues. are relatively predictable and usually cause symptoms by compression or obstruction or excessive hormone production.

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21
Q

symptoms and signs of destructive invasive growth by cancers

A
  • blood loss
  • pressure and destruction of adjacent tissue
  • obstruction or constriction of flow in vital organs.
  • metabolic effects such as cachexia (sig weight loss 1-3 stone) or specific tumour products ie T3,T4.
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22
Q

7 neoplastic shapes

A
sessile 
polyp
pedunculated polyp
papillary
fungating
ulcerated
annular
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23
Q

benign vs malignant characteristics

A

B - intact surface, exophytic growth, homogenous cut suface, cicumscribed or encapsulated edge. low mitotic rate.

M - heterogenous cut surface due to necrosis, ulcerated surface, endophytic growth, vascular permeation, irregular infiltrative edge. poorly demarcated. rapid growth. hyperchromatic. usually aneuploid.

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24
Q

how is a tumour primarily described?

A

benign/malignant and cel/tissue of origin

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25
Q

what does -oma mean?

A

indicates a tumour or neoplasm

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26
Q

papilloma

A

benign squamous epithelia eg skin, cervix, oesophagus

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27
Q

adenoma

A

benign glandular epithelium eg colon, breast, ovary.

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28
Q

lipoma

A

benign connective tissue from adipocytes

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29
Q

fibroma

A

benign connective tissue from fibrocytes

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30
Q

chondroma

A

benign connective tissue from chondrocytes

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31
Q

leiomyoma

A

benign connective tissue from smooth muscle

32
Q

rhabdomyoma

A

benign connective tissue from striated muscle

33
Q

osteoma

A

benign connective tissue from bone

34
Q

teratoma

A

benign connective tissue from germ cells (contianing derivatives of all three germ layers)

35
Q

carcinomas

A

malignant tumours of epithelia

36
Q

squamous cell carcinoma

A

malignant tumours of squamous epithelia - skin, oesophagus, cervix. or from cells that can mature in squamous ie bronchus which forms squamous metaplasia

37
Q

adenocarcinoma

A

malignant tumours of epithelia arising from glandular epithelium such as colon, breast, stomach, pancreas, ovary etc

38
Q

sarcomas

A

malignant tumours arising from connective tissues

39
Q

fibrosarcoma

A

malignant tumours arising from connective tissues from fibrocytes

40
Q

osteosarcoma

A

malignant tumours arising from connective tissues from osteoblasts

41
Q

chondrosarcoma

A

malignant tumours arising from connective tissues from cartilage cells

42
Q

leiomyosarcoma

A

malignant tumours arising from connective tissues from smooth muscle cells

43
Q

rhabdomyosarcoma

A

malignant tumours arising from connective tissues from striated muscle

44
Q

teratocarcinomas

A

malignant tumours arising from the germ cells

45
Q

melanoma

A

A tumor of melanin-forming cells, malignant.

46
Q

lymphoma

A

any neoplastic disorder of lymphoid tissue. Often used to denote malignant l., classifications of which are based on predominant cell type and degree of differentiation

47
Q

seminoma

A

malignant tumour of the testis

48
Q

what is malignant neoplasm grading?

A

categorising how much the differentiation of the neoplasm looks like the normal tissue. grade often relates to how aggressive the neoplasm is.

49
Q

what is the stroma?

A

the vascularised connective tissue supporting the neoplastic cells of a tumour. it is not in itself neoplastic but is a response to tumour growth. cancer associated fibroblasts secrete desmoplastic stroma. the extent and composition of the stroma depends upon the molecular signals from the tumour cells.

50
Q

what does the -aemia suffix mean?

A

haemopoietic system tumours.

51
Q

leukaemia

A

cancer of the WBCs.classification is acute/chronic (clinical course) and myeloid/lymphoid (cell lineage)

52
Q

3 routes of metastasis

A

1 - haematogenous (either embolic or by growing along the vessel). the thick elastic walls of arteries and arterioles are resistant however.
2 - lymphatic (causes distention often)
3 - transcoelomic to the peritoneum.

53
Q

describe cancer staging

A

TNM
- tumour size 1-4
- degree of lymph node involvement 0-2 (0, 1 or two, loads)
- extent of metastasis 0-2 (0, isolated, multiple)
often the most important determinant of post operative treatment.

54
Q

change in hilar lymph nodes when lung cancer spreads?

A

normally black due to carbon taken there by macrophages from air pollution but if they go white and expand then theyre full of tumour.

55
Q

rhabdomyoma

A

benign connective tissue from striated muscle

56
Q

osteoma

A

benign connective tissue from bone

57
Q

teratoma

A

benign connective tissue from germ cells (contianing derivatives of all three germ layers)

58
Q

carcinomas

A

malignant tumours of epithelia

59
Q

squamous cell carcinoma

A

malignant tumours of squamous epithelia - skin, oesophagus, cervix. or from cells that can mature in squamous ie bronchus which forms squamous metaplasia

60
Q

adenocarcinoma

A

malignant tumours of epithelia arising from glandular epithelium such as colon, breast, stomach, pancreas, ovary etc

61
Q

sarcomas

A

malignant tumours arising from connective tissues

62
Q

fibrosarcoma

A

malignant tumours arising from connective tissues from fibrocytes

63
Q

osteosarcoma

A

malignant tumours arising from connective tissues from osteoblasts

64
Q

chondrosarcoma

A

malignant tumours arising from connective tissues from cartilage cells

65
Q

leiomyosarcoma

A

malignant tumours arising from connective tissues from smooth muscle cells

66
Q

rhabdomyosarcoma

A

malignant tumours arising from connective tissues from striated muscle

67
Q

teratocarcinomas

A

malignant tumours arising from the germ cells

68
Q

melanoma

A

A tumor of melanin-forming cells, malignant.

69
Q

lymphoma

A

any neoplastic disorder of lymphoid tissue. Often used to denote malignant l., classifications of which are based on predominant cell type and degree of differentiation

70
Q

seminoma

A

malignant tumour of the testis

71
Q

what is malignant neoplasm grading?

A

categorising how much the differentiation of the neoplasm looks like the normal tissue. grade often relates to how aggressive the neoplasm is.

72
Q

what is the stroma?

A

the vascularised connective tissue supporting the neoplastic cells of a tumour. it is not in itself neoplastic but is a response to tumour growth. cancer associated fibroblasts secrete desmoplastic stroma. the extent and composition of the stroma depends upon the molecular signals from the tumour cells.

73
Q

what does the -aemia suffix mean?

A

haemopoietic system tumours.

74
Q

leukaemia

A

cancer of the WBCs.classification is acute/chronic (clinical course) and myeloidlymphoid (cell lineage)

75
Q

3 routes of metastasis

A

1 - haematogenous (either embolic or by growing along the vessel). the thick elastic walls of arteries and arterioles are resistant however.
2 - lymphatic (causes distention often)
3 - transcoelomic to the peritoneum.

76
Q

describe cancer staging

A

TNM
- tumour size 1-4
- degree of lymph node involvement 0-2 (0, 1 or two, loads)
- extent of metastasis 0-2 (0, isolated, multiple)
often the most important determinant of post operative treatment.

77
Q

change in hilar lymph nodes when lung cancer spreads?

A

normally black due to carbon taken there by macrophages from air pollution but if they go white and expand then theyre full of tumour.