Tumour Pathology 2

Question 1

What are the 2 groups of genes that cause cancer?

Answer 1

Suppresor genes

Oncogenes (promote tumour development, are normally switched of)

Question 2

What are some properties of cancers?

Answer 2

Altered cellular function

Abnormal morphology

Cells capable of independant growth

No single feature is unique to tumour cells

Tumour biomarkers

Question 3

What is the altered function in cancers?

Answer 3

Loss of cell to cell adhesion

Altered cell to matrix adhesion

Production of tumour related proteins (tumour biomarkers)

Question 4

What are tumour biomarkers?

Answer 4

Ono-fetal proteins

Oncogenes

Growth factor and receptors

Immune checkpoint inhibitors

Question 5

What are tumour biomarkers used clinically for?

Answer 5

Screening

Diagnosis

Prognostic (identifying patients with specific outcome)

Predictive (identifying patients who will response to a particular therapy)

Question 6

What is the difference between diagnosis and screening?

Answer 6

Diagnosis is once the patient is already symptomatic whereas screening is before the symptoms are apparent

Question 7

What are some examples of tumour biomarkers?

Answer 7

Alpha-fetoprotein

Carcino-embryonic antigen (CEA)

Oestrogen receptor

Prostate specific antigen

Kras

Braf

EGFR

PD-L1

Her2

Question 8

What cancer shows alpha-fetoprotein?

Answer 8

Teratoma of testis

Hepatocellular carcinoma

Question 9

What cancer shows carcino-embryonic antigen (CEA)?

Answer 9

Colorectal cancer

Question 10

What cancer shows oestrogen receptors?

Answer 10

Breast cancer

Question 11

What cancer shows prostate specific antigen?

Answer 11

Prostate cancer

Question 12

What cancer shows Kras?

Answer 12

Colorectal cancer

Question 13

What cancer shows Braf?

Answer 13

Melanoma

Question 14

What cancer shows EGFR?

Answer 14

Lung cancer

Question 15

What cancer shows PD-L1?

Answer 15

Lung cancer

Question 16

What cancer shows Her2?

Answer 16

Breast cancer

Gastric cancer

Question 17

What do you see in morphology of cancer?

Answer 17

Cellular and nuclear pleomorphism (marked variation in size and shape)

Mitosis present and often abnormal (cell division not normal as chromosomes are not structured)

Question 18

What is tumour growth a balance between?

Answer 18

Cell growth (angiogenesis) and cell death (apoptosis)

Question 19

What happens during tumour angiogenesis?

Answer 19

New blood vessels are formed by the tumours that provides a route for the release of tumour cells in circulation

Question 20

What does greater tumour angiogenesis mean?

Answer 20

Poorer prognosis (outcome)

Question 21

What is apoptosis?

Answer 21

The mechanism for programmed cell death

Question 22

What is metastasis?

Answer 22

Spread of cancer

Question 23

What are metastatic tumours?

Answer 23

Secondary tumours

Question 24

What is a major clinical problem of cancer?

Answer 24

Formation of metastatic tumours

Question 25

What is invasion and metastasis due to?

Answer 25

Increased matrix degradation by proteolytic enzymes Altered cell to cell and cell to matrix adhesion

Question 26

What is the cell to cell adhesion of tumours like throughout their lifetime?

Answer 26

At some point they need to be stuck together, and at other points they need to be seperate to spread

Question 27

What are different modes for the spread of cancer?

Answer 27

Local spread (invastion of primary tumours in adjacent structures) Lymphatic spread (to lymph nodes) Blood spread (to other tissues and organs in the body) Trans-coelomic spread (through cavities such as pleural)

Question 28

What is the process of tumour invasion?

Answer 28

1) Malignant tumour 2) Invasion into connective tissue 3) Invastion into lymph/blood vessels

Question 29

What is the process of tumour metastasis via lymphatics?

Answer 29

1) Adherance of tumour cells to lymph vessels 2) Invasion from lymphatics 3) Invastion into lymph nodes 4) Formation of metastasis in lymph node 5) Clinical evidence of metastasis

Question 30

What is the process of tumour metastasis via blood?

Answer 30

1) Adherance of tumour cells to blood vessels 2) Invasion from blood vessels 3) Invasion into tissue 4) Formation of metastasis 5) Clinical evidence of metastasis

Question 31

What is trans-coelomic spread?

Answer 31

Special form of local spread where tumour cells spread across body cavities such as pleural or peritoneal

Question 32

What kinds of tumours show trans-coelomic spread?

Answer 32

Lung Stomach Colon Ovary

Question 33

What is the site of tumour metastasis related to?

Answer 33

The tumour, not the tissue blood flow

Question 34

What are common sites of metastasis?

Answer 34

Liver Lung Brain Bone (axial skeleton) Adrenal gland Omentum/perioneum

Question 35

What are uncommon sites of metastasis?

Answer 35

Spleen Kidney Skeletal muscle Heart

Question 36

What is the spread of tumours from sites like?

Answer 36

Tumours from tissues often commonly metastasis to specific sites

Question 37

Where do breast tumours commonly metastasis to?

Answer 37

Bone

Question 38

Where do prostate tumours commonly metastasis to?

Answer 38

Bone

Question 39

Where do colorectal tumours commonly metastasis to?

Answer 39

Liver

Question 40

Where do ovary tumours commonly metastasis to?

Answer 40

Omentium/perioneum