Principles of tumours

Question 1

what is neoplasia?

Answer 1

A state of cell division without any external stimuli.

Question 2

what is hypertrophy?

Answer 2

An increase in cell size

Question 3

what is a neoplasm?

Answer 3

An abnormal mass of tissue with uncoordinated cell growth with no purpose

Question 4

what are the characteristics of a benign tumour?

Answer 4

Slow growing
Well circumscribed
Encapsulated by a layer of compressed fibrous tissue
not locally invasive
no metastatic potential

Question 5

what are microscopic characteristics of a benign tumour?

Answer 5

well differentiated as they closely resemble the cell of origin
The cells are uniform throughout the tumour
Few mitoses
normaly nuclei: cytoplasmic ratio

Question 6

what are characteristics of a malignant tumour?

Answer 6

Fast growing
poorly circumscribed
metastatic potential
non-encapsulated

Question 7

what are the microscopic characteristics of a malignant tumour?

Answer 7

Variable differentiation
pleomorphism 
many mitoses
nuclear staining
high nuclear: cytoplasmic ratio

Question 8

what are the main two characteristics of cancer?

Answer 8

Invasive growth

metastatic potential

Question 9

what is a malignant epithelial tumour called?

Answer 9

Carcinoma

Question 10

what is a malignant squamous epithelium tumour?

Answer 10

Squamous cell carcinoma

Question 11

what is a malignant tumour of glandular epithelium?

Answer 11

adenocarcinoma

Question 12

what is a benign tumour of glandular epithelium?

Answer 12

Adenoma

Question 13

what is the most common type of malignant tumour in the adult population?

Answer 13

carcinoma; arising from the epithelium

Question 14

how do carcinomas tend to metastasise?

Answer 14

via the lymphatic tissue

Question 15

what is the most common type of carcinoma?

Answer 15

adenocarcinoma

squamous cell carcinoma

Question 16

what are properties of an adenocarcinoma?

Answer 16

Gland formation
mucin production
signet ring cells

Question 17

what are properties of a squamous cell carcinoma?

Answer 17

Keratin formation

intracellular bridges between cells.

Question 18

what is grade an assessment of?

Answer 18

Differentiation

Question 19

what does grade reflect?

Answer 19

how closely it resembles the normal tissue from which its arised.

Question 20

who can grade tumours?

Answer 20

only a pathologist because you have to look down the microscope to measure differentiation

Question 21

What does tumour grade correlate with?

Answer 21

How aggressive the behaviour is

Question 22

what grading is used for most carcinomas?

Answer 22

A 3 tier system depending on the degree of differentiation

Question 23

what grading system is used for renal cell carcinoma?

Answer 23

the Fuhrman system which is 4 tier

Question 24

what grading system is used for prostatic carcinoma?

Answer 24

The gleason system which is 5 tiers.

Question 25

What type of carcinomas aren't graded at all?

Answer 25

small cell lung carcinomas | basal skin carcinomas

Question 26

what is staging?

Answer 26

The process of determining how much cancer there is in the body and where it's located. A measure of spread

Question 27

in carcinoma what is the single most prognostic factor?

Answer 27

Stage

Question 28

why do we stage patients?

Answer 28

- plan treatment - prognostics - help doctors communicate - identify clinical trials

Question 29

how do we stage a patient?

Answer 29

1. clinical; physical exam 2. radiologically; CT/MRI/PET 3. surgical 4. pathological

Question 30

what is the most common system for staging?

Answer 30

TNM

Question 31

what is required for a definite diagnosis of cancer?

Answer 31

A tissue for histology.

Question 32

what are local symptoms of cancer?

Answer 32

Symptoms related to tissue destruction at the site of the cancer for example lung carcinoma causing cough

Question 33

what are metastatic symptoms of cancer?

Answer 33

Related to secondary deposits of the cancer at distant organs

Question 34

what are systemic symptoms of cancer?

Answer 34

Due to release of cytokines from tumour cells. prolonged fever, weight less etc

Question 35

what is paraneoplastic syndrome?

Answer 35

syndromes caused by substances that are produced by tumour cells.

Question 36

what are four ways cells can adapt to their environment?

Answer 36

Atrophy hyperplasia hypertrophy metaplasia

Question 37

what is metaplasia?

Answer 37

one mature cell type replaces another mature cell type meaning a change in the pattern of differentiation

Question 38

What metaplasia can be caused in the cervix due to vaginal acid?

Answer 38

Columnar glandular epithelium becoming squamous epithelium

Question 39

what is dysplasia?

Answer 39

Disordered growth or differentiation. it's pre-malignant

Question 40

what is carcinoma in situ?

Answer 40

Despite carcinoma this doesn't mean epithelial cancer. it's severe dysplasia.

Question 41

T/F; have cells that have dysplasia/ carcinoma in situ invaded through the cell membrane?

Answer 41

NO

Question 42

what are characteristics of cells showing dysplasia?

Answer 42

Larger nuclei, pleomorphism.

Question 43

why are dysplasia and carcinoma in situ not considered cancer?

Answer 43

There are two main characteristics of cancer: invasive and ability to metastase. dysplasia and carcinoma in situ haven't cross the basement membrane so aren't invasive.

Question 44

why is carcinoma considered cancerous?

Answer 44

it has crossed the basement membrane so shows invasive growth and metastatic potential

Question 45

what is barretts oesophagus?

Answer 45

There is squamous mucosa in the oesophagus, GORD causing metaplasia into glandular mucosa.