Session 8 - Neoplasia 2

Question 1

Explain how malignant cells undergo metastases?

Answer 1

1. The tumour must invade at the primary site
2. The tumour must travel through the circulation/lymphatics/cellular fluids and lodge at a secondary site
3. The tumour must then grow at that secondary site (colonisation)

Question 2

What alterations does a cancer require to invade into other tissues?

Answer 2

1. altered adhesion
2. stromal proteolysis
3. altered motility

Question 3

What is epithelial to mesenchymal transition (EMT)?

Answer 3

This is the transition between a cell undergoing three changes.

• altered adhesion
• altered proteolytic activity
• altered motility

This as a result will cause a cell to appear more like a mesenchymal cell than an epithelial cell.

Question 4

What material alters adhesion between malignant cells?

Answer 4

E-cadherins

Question 5

What substance alters adhesion between malignant cells and stromal proteins?

Answer 5

Integrin expression

Question 6

How do invasive neoplasms increase their proteolytic activity?

Answer 6

Altered expression of proteases in the cell - namely matrix metalloproteases

Question 7

What is the relevance of proteins from the RHO family?

Answer 7

They are involved in integrin signalling which involves cellular adhesion.

Question 8

What are the three methods by which neoplasms can spread throughout the body?

Answer 8

1. blood
2. lymphatics
3. transcoelomic - through fluids of the body such as the pleura, peritoneal, ventricles, etc)

Question 9

what causes a relapse of a malignant neoplasm?

Answer 9

micrometastases undergoing random colonisation - one or more grow into a tumour.

Question 10

what is the seed and soil phenomenon?

Answer 10

This is an explanation of the unpredictable metastatic location of neoplasms. It is said that the secondary location of a neoplasm depends on the interactions between cells and the local tumour environment.

Question 11

How do carcinomas tend to spread?

Answer 11

Via the lymphatics

Question 12

How do sarcomas tend to spread around the body?

Answer 12

Via the blood.

Question 13

what is a blood borne metastasis?

Answer 13

a metastasis that has travelled through the blood.

Question 14

What are the common site of blood borne metastasis?

Answer 14

• Lung
• Liver
• Bone
• Brain

Question 15

The neoplasms that most frequently spread to bone are:

Answer 15

Thyroid

Bronchi

Breast

Kidney

Prostate

Question 16

List some local effects of neoplasms?

Answer 16

• Ulceration leading to bleeding
• Compression of adjacent structures
• Direct invasion and destruction of normal tissue
• Blocking of tubes and orifices

Question 17

What hormones can a bronchial small cell carcinoma produce?

Answer 17

ACTH or ADH

Question 18

What hormones can a bronchial squamous cell carcinoma produce?

Answer 18

PTH

Question 19

What are some examples of systemic effects that cancer can have on the body?

Answer 19

• Hormonal secretion - eg. ACTH or ADH secretion from a bronchial small cell carcinoma
• Thrombosis
• Tumour burden
• Cachexia
• Malaise

Question 20

What is leukemia?

Answer 20

A malignant neoplasm of blood forming cells arising in the bone marrow. Results in the production of immature or abnormal leucocytes and as a result suppress the synthesis of other cells such as erythrocytes for an example.

Question 21

What is lymphoma?

Answer 21

Malignant neoplasm of the lymphocytes which primarily affects the lymph nodes. You also get lymphoid tissue in peyers patches, cold sores, etc.

Question 22

A carcinoid tumour is an old term that was used, what is that tumour called now?

Answer 22

A neuroendocrine tumour.