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Pathological processes > Session 8 > Flashcards

Session 8 Flashcards

1
Q

What is the definion of a neoplasm?

A

A neoplasm is an abnormal growth of cells that persists after the initial stimulus is removed.

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2
Q

What is a malignant neoplasm?

A

A malignant neoplasm is an abnormal growth of cells that persists after the initial stimulus is removed AND invades surrounding tissue with potential to spread to distant sites.

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3
Q

What generic term is used to describe malignant neoplasms?

A

cancer

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4
Q

What is a tumour?

A

a tumour is any clinically detectable lump or swelling.

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5
Q

What is a neoplasm in relation to a tumour?

A

a tumournis a type of neoplasm.

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6
Q

What is a metastasis?

A

a metastasis is a malignant neoplasm (= cancer) that has spread from its original site to a new non-contiguous site.
The original site = primary site
Place to which it has spread = secondary site

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7
Q

To which sort of neoplasm do the terms primary and secondary site belong?

A

to a malignant neoplasm that has metastasised.

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8
Q

What is a dysplasia?

A

dysplasia is a pre-neoplastic alteration in which cells show disordered tissues organisation. It is not neoplastic because the change is reversible.

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9
Q

Why is dysplasia not neoplastic?

A

because it is reversible

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10
Q

Is neoplasm reversible?

A

no

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11
Q

Give an example of a non-neoplastic tumour.

A
  • abcess

- haematoma

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12
Q

What is the major difference between dysplasia and neoplasia?

A 
Dysplasia = reversible
Neoplasia = irreversible
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13
Q

What is the difference between benign neoplasms and malignant neoplasms?

A

Benogn neoplasms remain confined to their site of origin and do not produce metastases.
Malignant neoplasms have to potential to metastasise.

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14
Q

by definition, if something metastasises, it is ….

A

malignant

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15
Q

Why can even a benign tumour have severe conseqeunces on the host?

A

Because even if it stays confined to a local area, , the physical size and growth of the tumour can push on structures around it and damage them.

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16
Q

How do benign and malignant tumours differ macroscopically?

A

Benign tumours grow in a comfined local area and so have a pushing outer margin. Ie. they are contained in a fibrous capsule around them and have a regular border. This is why they are so rarely dangerous
Malignant tumours have an irregular outer margin and shape and may show areas of necrosis and ulceration (if on a surface).

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17
Q

Why do some malignant cancers show areas of necrosis?

A

because the tumour has generated new cells, but no new vessels to feed them. Or because it is creating new vessels but not fast enough to keep up with the cellular growth.

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18
Q

What sort of neoplasm was well differenciated cells?

A

A benign neoplasm.

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19
Q

What are anaplastic cells?

A

anaplastic cells are cells that bare no resemblance to any tissue

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20
Q

In which type of neoplasm can one find anaplastic cells?

A

In certain malignant neoplasms

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21
Q

Do malignant neoplasms always have anaplastic cells?

A

No. Malignant neoplasms range from well differenciated (like a benign neoplasm) to poorly differenciated.

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22
Q

Do well differentciated cells in a neoplasm mean that the tumour is benign?

A

No. Malignant neoplasms can range from well differenciated to poorly differenciated.

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23
Q

What sort of features are seen in an anaplastic cell population?

A
  • cellular and nuclear size variatiom
  • nuclear hyperchromasia (++ staining)
  • increased nuclear to cytopalsmic ratio
  • more mitoses (sometimes abnormal forms) called pleomorphism
24
Q

What is the term “grade” used for?

A

Clinicians use the term grade to indicate differenciation.

High grade = poorly differenciated

25
Q

Which risk factor bear the most weight in developing neoplasia? Extrinsic or intrinsic?

A

Extrinsic! About 85% of cance rrisk is de to environmental/extrinsic factors.

26
Q

What is the cause of neoplasia?

A

Accumulation of mutations in somatic cells.

27
Q

To create a monoclonal population of mutant cells, 2 major Ingredients are required?

A
  1. Initiator: mutagenic agent

2. Many promoters, which cause cell proliferation

28
Q

What need to ccur for neoplasm to emerge from monoclonal population?

A

A process called progression.
Progression = accumulation of yet more mutations.
We don’texactly know how many mutaitons are needed, but only about 2-3 for benign tumours, less than 10 more malignant.

29
Q

What are proto-oncogenes?

A

They are genes that once abnormally activated (mutated) will favour neoplasm formation.
= now called oncogene

30
Q

How many alleles of a prot-oncogene need to be mutated to drive excessive proliferation?

A

Only 1 is sufficient to drive excessive proliferation!

31
Q

All Benign neoplasms end in …

A

-oma (epithelial and connective benign neoplasms)

32
Q

Epithelial malignant neoplasms end in …

A

-carcinoma

33
Q

Stromal malignant neoplasms end in …

A

-sarcoma

34
Q

What is a carcinoma “in situ”?

A

“In-situ” = no invasion through epithelial basement membrane

35
Q

What is an “invasive” carcinoma?

A

It is a carcinoma that has penetrated through the basement membrane.

36
Q

What is a Leukaemia?

A

Leukaemia is a malignant neoplasm of blood-forming cells arising in the bone marrow.

37
Q

What are lymphomas?

A

Lymphomas are malignant neoplasms of lymphocyte, mainly affecting lymph nodes.

38
Q

What is a myeloma?

A

Myeloma is a malignant neoplasm of plasma cells.

39
Q

What are Germ line neoplasms?

A

Germ line neoplasms arise from pluripotent cells, mainly in the testis or ovaries.

40
Q

What sort of tumours are those called “-blastomas”?

A

They occur mainly in children and are formed from immature precursor cells.

41
Q

90% of cancer affect which type of tissue?

A

Epithelial, and so end in -carcinoma

42
Q

Name 3 examples of connective benign neoplasms.

A
  1. Osteoma
  2. Condroma
  3. Fibroma
43
Q

What sort of tissue does adenoidal affect?

A
  • oma = epithelial
    Adeno- = glandular

=> glandular epithelium

44
Q

Give an example of a transitional papilloma.

A 
oma- = epithelial
Transitional = bladder

=> bladder mucosa

45
Q

What sort of tumour does the word “papilloma” describe?

A

Any tumour with finger-like projections

46
Q

Name 2 germ cell neoplasms.

A
  1. Malignant teratoma (testis)

2. Benign teratoma such as a dermoid cyst.

47
Q

What are neuroendocrine tumours?

A

They arise from cels distributed throughout the body such as adrenal gland tumours.

48
Q

“Stage” is used to describe what in the context of tumours?

A

Tumour burden

49
Q

What are the (2) most lethal features of a malignant neoplasm?

A

Invasion and metastasis

50
Q

Do benign tumours metastasise?

A

No.

51
Q

Which are the 3 steps for malignant cells to get from primary site to a secondary site?

A
  1. Grow and invade at the primary site
  2. Enter a transport system and lodge at secondary site
  3. Grow at secondary site to form a new tumour
52
Q

Is metastasis an efficient process?

A

No, not at all. The vast majority of cells that are shed from a tumour are destroyed.

53
Q

The growth of a metastasis at a secondary site is called?

A

Colonisation

54
Q

Which 3 important alterations are involved in invasion of a tissue by a carcinoma?

A
  1. Adhesion
  2. Stromal proteolysis
  3. Motility
    These 3 changes, together, create a carcinoma cell phenotype that sometimes appears more like a mesenchymal cell than an epithelial cell. This is called Epithelial-to-mesenchymal transition = EMT
55
Q

What is EMT (epithelial-to-mesenchymal transition)?

A

It is the combination of 3 alterations leading to tissue invasion b a carcinoma.

  1. Adhesion (malignant to malignant, and malignant to site)
  2. Stromal proteolysis
  3. Motility
56
Q

Altered adhesion is one of the alteration required for tissue invasion by a carcinoma. Which molecules precisely are altered (2)?

A

E-cadherin expression is decreased (between malignant cells).
Integrin expression is altered (between malignant and stromal proteins).

57
Q

Stromal protease alteration is an essential feature of tissue invasion by a carcinoma. Which proteases are precisely involved?

A

Matrix metalloproteases MMPs.

Pathological processes (4 decks)

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