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Medicine 2 Week 6 - 11 > Tumour Diagnosis and Prognosis > Flashcards

Tumour Diagnosis and Prognosis Flashcards

1
Q

Factors determining Tumour Prognosis

A

Tumour Grade
Tumour Stage
Tumour Markers

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2
Q

Melanomas

A

Tumours on skin

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3
Q

What is needed for definitive tumour diagnosis

A

Tissue Biopsy Sampling

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4
Q

What is suspicious here

A

Dark Shadow on left (reversed) t requiring more investigation

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5
Q

Tumour Markers

A

Certain tumours liberate products that can be detected in blood/urine/CSF samples

May aid diagnosis but may also be used to follow up therapy when blood levels increase, often before imaging can detect tumour recurrence

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6
Q

HCG & Tumours

A

human chorionic gonadotrophin marker released from tumours with trophoblast elements

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7
Q

AFP & Tumours

A

Alpha fetoprotein

Liver cancer, germ cell tumours

Tumour marker

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8
Q

PSA

A

Prostate Specific Antigen

It is produced by the prostate; raised levels MAY indicate prostate cancer

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9
Q

Types of Biopsy

A
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10
Q

Needle Biopsy Techniques

A

Mark, Anaesthatise Area, Prepare it with a scalpel, Insert Needle and Extract

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11
Q

Biopsy Handling

A

Fix in formalin solution for routine histology, special stains and immunohistochemistry

Fix in glutaraldehyde for electron microscopy

Send fresh for cytogenetics, tumour genetics (frozen in liquid Nitrogen)

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12
Q

Cervical Smear

A

Take a swab of the cervix with a tissue and spread the tissues out

This shows early dysplastic growth

**Form of diagnostic cytology

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13
Q

Pap Smear

A

Cervical Smear

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14
Q

How Histology of Neoplasms allows prediction of Behaviour

A
  • Analysis of the degree of differentiation and growth pattern of the tumour.
  • Evaluation of how far a tumour has spread

**Special techniques may be used to obtain further prognostic information

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15
Q

Grade of Tumour

A

The degree of differentiation of tumour cells relative to normal tissue of origin

Determined by:

  • Variation in size and shape of constituent cells of the tumour (pleomorphism)
  • The proportion of cells containing mitotic figures (mitotic index)
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16
Q

General rule of low grade and high grade tumour prognosis

A

Low grade tumours are slow growing and have a good prognosis

High grade tumours are fast growing and have a poor prognosis

***These are very general rules that have to be considered with all other clinical aspects

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17
Q

Nottingham histologic score

A

Assessment of the degree of differentiation of a carcinoma from semi-quantitative analysis of its morphological characteristics

  • Tubule formation
  • Nuclear pleomorphism
  • Mitotic counts
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18
Q

Tubule formation

A

Are the tumours forming ducts?

If the majority of the tumour is undergoing tubule formation, this is betterI think??

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19
Q

Breast Cancer Tumour Grade

A
20
Q

Prognosis of Grade 1, 2 & 3 Breast Cancer Tumour

A
21
Q

Factors determining Tumour Stage

A
  • The size of a primary tumour
  • The degree to which it has locally invaded
  • The extent to which it has spread by distant metastasis
22
Q

Tumour Grade vs Stage

A

Grade - Histological & Cytological Features of a tumour

Stage - The time dependent factors of a tumour that indicate how badly its grown

23
Q

TNM System

A

Staging system for most tumour types
Tumour, Node, Metastatic Site (Think of it chronologically)

Based upon local tumour spread, Regional lymph node involvement and presence of distant metastases

Can be applied to many different tumour types, but each tumour site has different specific criteria

24
Q

Discuss the T of the TNM System

A

Size of tumour

25
Q

Discuss the N of the TNM System

A

Refers to he number of lymph nodes that the cancer has spread to or a tumour’s enlargement into tumours

26
Q

Discuss the M of the TNM System

A
27
Q

TX (TNM)

A

Primary tumour cannot be assessed

28
Q

T0 (TNM)

A

No evidence of primary tumour

29
Q

Tis (TNM)

A

Carcinoma in-situ (Group of abnormal neoplastic cells that are pre-cancerous)

30
Q

T4 (TNM)

A

Tumour of any size growing into chest wall or skin, including inflammatory breast cancer

31
Q

Differences between T1, T2 & T3 (TNM)

A

Specific size in cm

32
Q

NX (TNM)

A

Nearby lymph nodes cannot be assessed (e.g. previously removed)

33
Q

N0 (TNM)

A

Cancer has not spread to nearby lymph nodes

34
Q

Differences between N1, N2, N3

A

Number of lymph nodes to which a tumour has spread

35
Q

MX (TNM)

A

Metastasis cannot be assessed

36
Q

What prognostic stage would T2N1M0 be

A

IIB

37
Q

Stages of Breast Cancer Tumour

A
38
Q

Dukes Staging for Colorectal Carcinoma

A

Not massively used as TNM has gained prominence

39
Q

Stage and Prognosis

A

The stage of a tumour is generally the most important indicator of likely prognosis and of appropriate therapy

Early stage tumours (localised) may be treatable by relatively conservative measures

Advanced stage tumours (extensive spread) may require aggressive treatment

40
Q

Breast Cancer Prognosis based on Stage

A
41
Q

Main modes of therapy for neoplastic disease

A

Surgery
Radiotherapy
Chemotherapy
Targeted therapy

Multimodal therapy is common

42
Q

How important is pathology in deciding appropriate tumour therapy

A

Very important lol

43
Q

Remission

A

Reduction in cancer signs and symptoms

May be partial or complete (remember breaking bad)

44
Q

Tumour with excellent prognosis

A

Thyroid Tumour

45
Q

Tumours with moderate prognosis

A

Kidney, prostate, cervix, breast

46
Q

Tumours with very poor prognosis

A

Pancreas, Brain, Oesophagus

Medicine 2 Week 6 - 11 (54 decks)

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