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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
Secondary site for lung cancer
Brain Adrenals
26
Secondary site for breast cancer
Lung Liver Bone Brain
27
Secondary site for ovarian cancer
Peritoneal cavity
28
State some names for tumour cells growing on the surface
Sessile - skin cancer Pedunculated polyp - GI tract cancer Papillary
29
State some names for tumour cells that move to surrounding tissue
Fungating Ulcerated
30
State some names for tumour cells that grow in vessels
Annular
31
State some macroscopic features of benign tumours
Intact surface Exophytic growth - grow on the outside Homogenous cut surface Circumscribed or encapsulated edge
32
State some macroscopic features of malignant tumours
Heterogenous cut surface due to necrosis Ulcerated surface Endophytic growth Vascular permeation Irregular infiltrative edge
33
Microscopic features of benign tumours
Resemble tissue of origin Well circumscribed Well differentiated Minimal nuclear pleomorphism Mitotic figures normal NO necrosis
34
Microscopic features of malignant tumours
Variable resemblance Poorly circumscribed Variable differentiation Variable pleomorphism may be anaplastic Mitotic figures abnormal Necrotic
35
Cytological features of malignancy
High nuclei-cytoplasmic ratio Nuclear hyperchromasia Nuclear pleomorphism Abnormal chromatin structure Abnormal mitotic figures
36
Differentiation
Resemblance to tissue of origin Degree of differentiation allows GRADING - determined histologically
37
How is histological classification - grading - carried out ?
Degree of resemblance of tissue of origin allows grading. Grade correlated broadly with clinical behaviour. Precise classification important for planning treatment.
38
State the grading scale for malignant neoplasms
Grade: 1 - well differentiated 2 - moderately differentiated 3 - poorly differentiated 4 - nearly neoplastic
39
Classification of spread
Stage - TNM staging
40
TNM staging system
T - tumour (1-4) N - degree of lymph node involvement (0-2) M - extent of distant metastases (0-2)
41
What staging system is used for colorectal cancer ?
Dukes' Staging System for colorectal cancer
42
Describe Dukes' Staging System for colorectal cancer
A - confined to bowel wall B - through bowel wall but no lymph node involvement C - lymph nodes involved D - distant spread
43
Describe the nomenclature for benign tumours
Benign epithelial tumours can be: - Papillomas - Adenomas Benign connective tissue tumours begin with the term denoting the cell of origin e.g. lipoma
44
Describe the nomenclature for malignant tumours
Malignant epithelial tumours are carcinomas Malignant connective tissue tumours are sarcomas
45
State the major tumour categories
Epithelial origin Connective tissue origin (mesenchymal) Lymphoid/ haematopoetic origin
46
Benign squamous cell - nomenclature
Squamous cell papilloma
47
Benign transitional - nomenclature
Transitional cell papilloma
48
Benign basal cell - nomenclature
Basal cell papilloma
49
Benign glandular - nomenclature
Adenoma
50
Malignant squamous cell - nomenclature
Squamous cell carcinoma
51
Malignant transitional epithelia - nomenclature
Transitional cell carcinoma
52
Malignant basal cell - nomenclature
Basal cell carcinoma
53
Malignant squamous glandular - nomenclature
Adenocarcinoma
54
Benign smooth muscle - nomenclature
Leiomyoma
55
Benign striated muscle - nomenclature
Rhabdomyoma
56
Benign adipose tissue - nomenclature
Lipoma
57
Benign blood vessels - nomenclature
Angioma
58
Benign bone - nomenclature
Osteoma
59
Benign cartilage - nomenclature
Chondroma
60
Benign mesothelium - nomenclature
Benign mesothelioma
61
Benign synovium - nomenclature
Synovioma
62
Malignant smooth muscle - nomenclature
Leiomyosarcoma
63
Malignant striated muscle - nomenclature
Rhabdomyosarcoma
64
Malignant adipose tissue - nomenclature
Liposarcoma
65
Malignant blood vessels - nomenclature
Angiosarcoma
66
Malignant bone - nomenclature
Osteosarcoma
67
Malignant cartilage - nomenclature
Chondrosarcoma
68
Malignant mesothelium - nomenclature
Malignant mesothelioma
69
Malignant synovium - nomenclature
Synovial sarcoma
70
State some benign epithelial tumours
Papilloma (squamous, transitional) Adenoma
71
State some malignant epithelial tumours
Squamous cell carcinoma Transitional cell carcinoma Adenocarcinoma
72
What can epithelial tumours be associated with ?
Non-invasive precursors - Carcinoma in situ - Intraepithelial neoplasia
73
State some benign mesenchymal tumours
Lipoma Haemangioma
74
State some mesenchymal malignant tumours
Liposarcoma Haemangiosarcoma
75
State some miscellaneous tumours
Melanoma Lymphoma Teratoma Embryonal tumours - blastoma Carcinoid tumours Cysts
76
Describe teratoma
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
Key feature of most tumours
Tumours have a clonal origin - they are derived from 1 abhorrent cellular change Not all tumour cells are equal
78
Aide memoire for tumours
Incidence Age Sex Geographical distribution Predisposing factors Macroscopic factors Microscopic features Spread Prognosis In a surgeons gown, physicians may make some progress
78
Describe how the concept of tumours having a clonal origin came about
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
Clonal origin
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
CD24+
Non-tumorigenic
81
CD24-
Tumorigenic

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

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