Tumour Pathology

Question 1

classification of tumours depends on …

Answer 1

tissue of origin

benign or malignant

Question 2

epithelial tumours

Answer 2

glandular- benign = adenoma
malignant = adeno-carcinoma

squamous - benign = squamous papilloma
malignant = squamous carcinoma

Question 3

bone tumours

Answer 3

benign = osteoma
malignant = osteosarcoma

Question 4

fat tumours

Answer 4

benign = lipoma
malignant = liposarcoma

Question 5

fibrous tissue tumours

Answer 5

benign = fibroma
malignant = fibrosarcoma

Question 6

white blood cell tumour

Answer 6

malignant = leukaemia

Question 7

lymphoid tissue tumour

Answer 7

malignant = lymphoma

Question 8

germ cell tumours

Answer 8

teratomas

ovarian = benign
testes = malignant

Question 9

benign tumour features

Answer 9

non-invasive growth pattern
usually encapsulated
no evidence of invasion
no metastases
cells similar to normal and function similar to normal tissue
rarely cause death

Question 10

malignant tumour features

Answer 10

invasive growth patterns
no capsule, or capsule breached by tumour cells
cells abnormal
poorly differentiated
loss of normal function
often evidence of spread
often cause death

Question 11

properties of cancer cells

Answer 11

altered genetics - loss of tumour-suppressor genes, gain of function of oncogenes

altered cellular function - tumour related proteins

abnormal structure

cells capable of independent growth

Question 12

spread of cancer and its mechanisms

Answer 12

local spread - surrounding connective tissue

lymphatic spread

blood spread

trans-coelomic spread - across body cavities

Question 13

common sites of cancer spread

Answer 13

liver, lung, brain, bone, adrenal glands

Question 14

local effects of cancer

Answer 14

pressure

obstruction

malignant - tissue destruction, bleeding, pain, effects of treatment

Question 15

systemic effects of cancer

Answer 15

secretion of hormones- normal hormones ( abnormal control of production/secretion), abnormal hormones ( in an organ that doesn’t usually produce that hormone)

weight loss

effects of treatment

Question 16

concepts of dysplasia and intra-epithelial neoplasia

Answer 16

dysplasia = pre-malignant change

used to indicate the tumour is becoming malignant

identified in epithelium without invasion

neoplasm can become cancerous if left unchecked or untreated

disorganisation of cells

no invasion

Question 17

early detection of cancer

Answer 17

sensitive/specific testing

acceptable

eg. cervical screening

Question 18

cell cycle of normal cells

Answer 18

the cell cycle is the interval between mitotic divisions

Question 19

process of carcinogenesis

Answer 19

production of cancer cells caused by the mutation of genetic material

disrupts cyclin pRB pathway- pRB acts as the cycle brakes, slowing down growth and proliferation, therefore mutation releases the brakes allowing uncontrolled proliferation

P53 pathway- normally maintains genomic integrity stopping cycle when DNA is damaged for repair or apoptosis, mutations prevent cycle from stopping so cell continues despite damage and so mutations occur leading to cancer

Question 20

major aetiological agents of cancer

Answer 20

heredity/inherited disposition

proto-oncogenes -> oncogene mutations

viruses

chemicals

Question 21

scientific basis of MRI

Answer 21

magnetic fields make the protons in the body all spin in the same direction

a radio-frequency pulse then distorts the protons and takes pictures by displaying the protons “relaxing” back to their original position

Question 22

advantages of MRI-specific contrast agents

Answer 22

excellent bone/soft tissue detail

vessels can be demonstrated

cardiac imaging

brain, spine and musculoskeletal system

Question 23

disadvantages of MRI-specific contrast agents

Answer 23

claustrophobic and noisy

cannot image patient with pacemakers or metal prosthetics/fillings

Question 24

what is a contrast agents

Answer 24

galdolinium DPTA is an IV medium that causes changed in the magnetic field, altering the tissue signals

vascular lesions and some tumours can be seen ver clearly

very safe agent

Question 25

principles of staging in cancer

Answer 25

position of tumour

depth on penetration of tumour

relationship to adjacent structures

involvement of regional lymph nodes

presence of distant metastases

Question 26

classes of anti-cancer therapeutics

Answer 26

alkylating agents

antimetabolites

vinca alkaloids

taxanes

antimitotic antibiotics