Principles of Tumours Flashcards
Neoplasia
state of autonomous cell division
clonal proliferation - originates from a single cell which has acquired genetic mutations enabling ti to divide autonomously
behaviour of benign tumours
slower growing well circumscribed often encapsulated by a layer of compressed fibrous tissue not locally invasive no metastatic potential
behaviour of malignant tumours
faster growing poorly circumscribed non-encapsulated invasive growth metastatic potential
microscopic appearance for benign tumours
well differentiated
cells uniform throughout
few mitoses
normal nuclear:cytoplasmic ratio
microscopic appearance of malignant tumours
variable differentiation vary in shape and size many mitoses high nuclear:cytoplasmic ratio nuclear staining
Adenocarcinoma defining features
gland formation
mucin production
signet ring cells
Squamous cell carcinoma defining features
keratin formation
intercellular bridges between cells
sarcomas
malignant tumours arising from connective tissue
rare
metastasise via the blood stream
GRADE
reflects differentiation
correlates with aggressiveness of behaviour
Fuhrman - RCC
Gleason - prostatic cancer
STAGE
extent of anatomical spread by a tumour
single most important prognostic factor
TNM most commonly used system
FIGO system used for gynaecological cancers
Dukes used for colorectal carcinoma
Ann Arbor used for lymphomas
Principles of cancer management
urgent 2WW referral
tissue diagnosis for definite diagnosis
staging - CT, MRI
MDT meeting discussion
Paraneoplastic syndrome
a syndrome caused by substances produced by the tumour cells which act remotely from the tumour or its metastases
atrophy
reduction in the size of a tissue or organ
may occur by reduction in cell number or in cell size
Hypertrophy
increase in the size of cells
Hyperplasia
increase in the number of cells
Metaplasia
one mature cell type replaced by another mature cell type
columnar > squamous in cervix (acidic environment of vaigna)
columnar > squamous in bronchial tree (cigarette smoke)
squamous > columnar in oesophagus (gastric acid)
Dysplasia
disordered growth or differentiation
pre-malignant condition
classified/’graded’ by severity of changes seen on histology
sever dysphasia - carcinoma in situ
cervix pre-cancer and cancer
pre-cancer: cervical intraepithelial neoplasia
cancer: SCC
endometrium pre-cancer and cancer
pre-cancer: atypical hyperplasia
cancer: endometrial adenocarcinoma
bladder pre-cancer and cancer
pre-cancer: carcinoma in situ
Cancer: urothelial carcinoma
prostate pre-cancer and cancer
pre-cancer: prostatic intraepithelial neoplasia
cancer: adenocarcinoma
colorecutum pre-cancer and cancer
pre-cancer: low and high grade dysplasia
cancer: adenocarcinoma
breast pre-cancer and cancer
pre-cancer: ductal carcinoma in situ
cancer: invasive ductal carcinoma
skin pre-cancer and cancer
precancel: actinic keratosis
cancer: SCC
