Tumour Pathology 3

Question 1

What are the local effects of a benign tumour? (2)

Answer 1

• pressure

- obstruction

Question 2

What are the local effects of a malignant tumour? (6)

Answer 2

• pressure
• obstruction
• tissue destruction including ulceration and infection
• bleeding including anaemia and haemorrhage
• pain from pressure on nerves, perineural (tumours growing along the nerve fibres)infiltration and bone pain from pathological fractures
• effects of treatment

Question 3

What are the systemic effects of a malignant tumours? (4)

Answer 3

• secretion of hormones
• weight loss
• paraneoplastic syndromes
• effects of treatment

Question 4

What is considered normal hormone production by tumours?

Answer 4

• Produced by tumours of the endocrine organ

- there is abnormal control of hormone production/secretion

Question 5

What is considered abnormal or inappropriate hormone production by tumours?

Answer 5

-produced by tumour from an organ that does not normally produce hormone

Question 6

What are 2 examples of inappropriate hormone secretion

Answer 6

• ACTH stimulates the adrenal gland to produce steroid hormones in lung cancer
• ADH in lung cancer

Question 7

What is a paraneoplastic syndrome?

Answer 7

It cannot be explained by local metastatic effects of tumours e.g. neuropathy or myopathy

• Patients can present with these signs and symptoms rather than the classic symptoms associated with a specific cancer
• Possibly caused by immune mechanism or the production of hormone/growth factor

Question 8

Why is it important to detect cancer at an early stage?

Answer 8

• to reduce/prevent morbidity/mortality

- detection at pre-invasive stage allows for identification of dysplasia/intraepithelial neoplasia

Question 9

What is dysplasia?

Answer 9

• It is a pre-malignant change
• It is the earliest change in the process of malignancy that can be visualised
• It can progress to cancer

Question 10

How is dysplasia characterised?

Answer 10

• Identified in epithelium

- There is no invasion

Question 11

What is the only difference between dysplasia and malignancy?

Answer 11

-The presence of invasion in malignancy

Question 12

What are 3 features of dysplasia?

Answer 12

• disorganisation of cell including increased nuclear size and mitotic activity and abnormal mitosis
• Grading of dysplasia including high and low grades
• no invasion

Question 13

What does early detection of cancer require

Answer 13

• an effective test that is sensitive/specific and acceptable
• for example, cervical cancer screening

Question 14

What is the aim of the NHS’s cervical cancer screening?

Answer 14

-to reduce incidence of squamous carcinoma of cervix by detection of dysplastic cells from squamous epithelium of cervix