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Medicine Year 1 - Semester 2 - Part 2 > Tumour Pathology > Flashcards

Tumour Pathology Flashcards

1
Q

What is a tumour ?

A

Neoplasm - new growth

Usually one cell type with supporting tissue structures.
(neoplastic cells and stroma)

Autonomous

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2
Q

Stroma

A

Connective tissue
Fibroblasts
Blood vessels
Immune cells

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3
Q

What does autonomous mean ?

A

Response to physiological stimuli lost or abnormal, allowing unregulated growth.

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4
Q

State a key risk factor for cancer

A

Age related incidence of cancer

There is a significant increase in the number of new cases, as the age at diagnosis increases.

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5
Q

State the most common cancer

A

Breast cancer
- much higher incidence in females

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6
Q

List the most common cancers

A

Breast
Prostate
Lung
Bowel

(all of these are organs with epithelial cells)

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7
Q

Feature of most common cancers

A

The most common cancers arise from tissue compartments or epithelial cells

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8
Q

State the 6 hallmarks of cancer

A
  • Self sufficiency in growth signals
  • Insensitivity to anti-growth signals
  • Tissue invasion and metastasis
  • Limitless replicative potential
  • Sustained angiogenesis
  • Evading apoptosis
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9
Q

Self sufficiency in growth signals

A

Doesn’t require signalling from the outside environment.

It can grow itself.

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10
Q

Insensitivity to growth signals

A

Provides its own proliferation signals and ignores anything else going on.

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11
Q

Tissue invasion and metastasis

A

Moves to other parts of the body

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12
Q

Limitless replicative potenital

A

Ability to keep growing.

Telomerase doesn’t degrade.

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13
Q

Sustained angiogenesis

A

Methods to get in blood supply for nutrients and oxygen.

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14
Q

State some features of benign tumour

A

Well circumscribed (rounded boundary)
Slow growth

No necrosis
Non-invasive
No metastasis

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15
Q

State some features of malignant tumour

A

Poorly circumscribed (poor boundary)
Rapid growth

Often necrotic
Invasive
Metastasis

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16
Q

Why is malignant cancer often necrotic ?

A

As malignant cells are fast growing and moving, they have used up oxygen and nutrients.

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17
Q

Clinical relevance of benign tumours

A

Does not invade surrounding structures
Does not metastasise

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18
Q

Clinical relevance of malignant tumours

A

Invades
Metastasises

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19
Q

State some clinical effects of benign tumours

A
  • Space occupying
  • Haemorrhage
  • Hormone production
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20
Q

Describe the clinical effects of benign tumours

A

Space occupying
- Obstruction
- Epilepsy
- Conduction abnormalities (nerves)

Haemorrhage
- Pulmonary
- Gastrointestinal

Hormone production
- Pituitary
- Adrenal
- Endocrine pancreas

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21
Q

Describe malignant tumours

A

A colony of malignant cells established at a point distant from the original tumour.

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22
Q

How do malignant tumours spread ?

A

Directly invade locally
Via the lymphatics
Via the bloodstream (haematological)
Through body cavities (transcoelomic)

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23
Q

State some common secondary sites of spread

A

Prostate —> Bone
Lung —> Brain, Adrenals
Breast —> Lung, Liver, Bone, Brain
Ovary —> Peritoneal cavity

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24
Q

Secondary site for prostate cancer

A

Bone

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25
Q

Secondary site for lung cancer

A

Brain
Adrenals

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26
Q

Secondary site for breast cancer

A

Lung
Liver
Bone
Brain

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27
Q

Secondary site for ovarian cancer

A

Peritoneal cavity

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28
Q

State some names for tumour cells growing on the surface

A

Sessile - skin cancer
Pedunculated polyp - GI tract cancer
Papillary

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29
Q

State some names for tumour cells that move to surrounding tissue

A

Fungating
Ulcerated

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30
Q

State some names for tumour cells that grow in vessels

A

Annular

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31
Q

State some macroscopic features of benign tumours

A

Intact surface
Exophytic growth - grow on the outside

Homogenous cut surface
Circumscribed or encapsulated edge

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32
Q

State some macroscopic features of malignant tumours

A

Heterogenous cut surface due to necrosis

Ulcerated surface

Endophytic growth
Vascular permeation

Irregular infiltrative edge

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33
Q

Microscopic features of benign tumours

A

Resemble tissue of origin

Well circumscribed
Well differentiated

Minimal nuclear pleomorphism

Mitotic figures normal
NO necrosis

34
Q

Microscopic features of malignant tumours

A

Variable resemblance
Poorly circumscribed

Variable differentiation
Variable pleomorphism may be anaplastic

Mitotic figures abnormal
Necrotic

35
Q

Cytological features of malignancy

A

High nuclei-cytoplasmic ratio

Nuclear hyperchromasia
Nuclear pleomorphism

Abnormal chromatin structure
Abnormal mitotic figures

36
Q

Differentiation

A

Resemblance to tissue of origin

Degree of differentiation allows GRADING - determined histologically

37
Q

How is histological classification - grading - carried out ?

A

Degree of resemblance of tissue of origin allows grading.

Grade correlated broadly with clinical behaviour.

Precise classification important for planning treatment.

38
Q

State the grading scale for malignant neoplasms

A

Grade:

1 - well differentiated
2 - moderately differentiated
3 - poorly differentiated
4 - nearly neoplastic

39
Q

Classification of spread

A

Stage
- TNM staging

40
Q

TNM staging system

A

T - tumour (1-4)

N - degree of lymph node involvement (0-2)

M - extent of distant metastases (0-2)

41
Q

What staging system is used for colorectal cancer ?

A

Dukes’ Staging System for colorectal cancer

42
Q

Describe Dukes’ Staging System for colorectal cancer

A

A - confined to bowel wall
B - through bowel wall but no lymph node involvement

C - lymph nodes involved
D - distant spread

43
Q

Describe the nomenclature for benign tumours

A

Benign epithelial tumours can be:
- Papillomas
- Adenomas

Benign connective tissue tumours begin with the term denoting the cell of origin e.g. lipoma

44
Q

Describe the nomenclature for malignant tumours

A

Malignant epithelial tumours are carcinomas

Malignant connective tissue tumours are sarcomas

45
Q

State the major tumour categories

A

Epithelial origin

Connective tissue origin (mesenchymal)

Lymphoid/ haematopoetic origin

46
Q

Benign squamous cell - nomenclature

A

Squamous cell papilloma

47
Q

Benign transitional - nomenclature

A

Transitional cell papilloma

48
Q

Benign basal cell - nomenclature

A

Basal cell papilloma

49
Q

Benign glandular - nomenclature

A

Adenoma

50
Q

Malignant squamous cell - nomenclature

A

Squamous cell carcinoma

51
Q

Malignant transitional epithelia - nomenclature

A

Transitional cell carcinoma

52
Q

Malignant basal cell - nomenclature

A

Basal cell carcinoma

53
Q

Malignant squamous glandular - nomenclature

A

Adenocarcinoma

54
Q

Benign smooth muscle - nomenclature

A

Leiomyoma

55
Q

Benign striated muscle - nomenclature

A

Rhabdomyoma

56
Q

Benign adipose tissue - nomenclature

A

Lipoma

57
Q

Benign blood vessels - nomenclature

A

Angioma

58
Q

Benign bone - nomenclature

A

Osteoma

59
Q

Benign cartilage - nomenclature

A

Chondroma

60
Q

Benign mesothelium - nomenclature

A

Benign mesothelioma

61
Q

Benign synovium - nomenclature

A

Synovioma

62
Q

Malignant smooth muscle - nomenclature

A

Leiomyosarcoma

63
Q

Malignant striated muscle - nomenclature

A

Rhabdomyosarcoma

64
Q

Malignant adipose tissue - nomenclature

A

Liposarcoma

65
Q

Malignant blood vessels - nomenclature

A

Angiosarcoma

66
Q

Malignant bone - nomenclature

A

Osteosarcoma

67
Q

Malignant cartilage - nomenclature

A

Chondrosarcoma

68
Q

Malignant mesothelium - nomenclature

A

Malignant mesothelioma

69
Q

Malignant synovium - nomenclature

A

Synovial sarcoma

70
Q

State some benign epithelial tumours

A

Papilloma (squamous, transitional)
Adenoma

71
Q

State some malignant epithelial tumours

A

Squamous cell carcinoma
Transitional cell carcinoma
Adenocarcinoma

72
Q

What can epithelial tumours be associated with ?

A

Non-invasive precursors

  • Carcinoma in situ
  • Intraepithelial neoplasia
73
Q

State some benign mesenchymal tumours

A

Lipoma
Haemangioma

74
Q

State some mesenchymal malignant tumours

A

Liposarcoma
Haemangiosarcoma

75
Q

State some miscellaneous tumours

A

Melanoma
Lymphoma
Teratoma
Embryonal tumours - blastoma
Carcinoid tumours
Cysts

76
Q

Describe teratoma

A

Contains elements of all 3 embryonic germ cell layers

  • Of germ cell origin
  • Benign and malignant forms
  • Ovarian - almost always benign
  • Testicular - more often malignant
77
Q

Key feature of most tumours

A

Tumours have a clonal origin - they are derived from 1 abhorrent cellular change

Not all tumour cells are equal

78
Q

Aide memoire for tumours

A

Incidence
Age
Sex
Geographical distribution
Predisposing factors
Macroscopic factors
Microscopic features
Spread
Prognosis

In a surgeons gown, physicians may make some progress

78
Q

Describe how the concept of tumours having a clonal origin came about

A

Gene coded for by X chromosome

  • Enzyme marker
  • Lyon inactivation hypothesis
  • Only 1 X chromosome in female cells is active
  • One X chromosome is randomly switched off
79
Q

Clonal origin

A

If the tumour arises from a single cell, if the tumour is from a clonal origin, then all the tumour cells will have the same enzyme marker.

80
Q

CD24+

A

Non-tumorigenic

81
Q

CD24-

A

Tumorigenic

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

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