Tumour Pathology Flashcards
Another common name for a tumour?
neoplasm
What is cancer?
a malignant tumour
Benign glandular tumour
adenoma
Malignant glandular tumour
adenocarcinoma
Benign squamous tumour
squamous papilloma
Malignant squamous tumour
squamous carcinoma
Benign bone tumour
osteoma
Malignant bone tumour
osteosarcoma
Benign fat tumour
lipoma
Malignant fat tumour
liposarcoma
Benign Fibrous tissue tumour
fibroma
Malignant fibrous tumour
fibrosarcoma
What are tumours of the blood cells called?
leukaemia (only malignant tumours)
Lymphoid tissue tumours
lymphoma (only malignant)
CNS tissue tumour
astrocytoma
PNS tissue tumour
schwannoma
Germ cell tumours
teratomas
Features of benign tumours
- usually encapsulated
- non invasive growth pattern
- don’t usually result in death
- well differentiated
- function similar to normal tissue
- no metastases
Features of malignant tumours
- metastasise
- not encapsulated or have breached capsule
- poorly differentiated
- invasive growth pattern
- cells abnormal
- frequently cause death
- loss of normal function
Give 4 examples of differences between normal cells and cancer cells
- abnormal genetics e.g. loss of function of tumour suppressor genes, activation of oncogenes
- altered cellular functions - produce tumour related proteins
- abnormal morphology
- cells capable of independent growth
How can altered cellular function (structure) characterise the cells as being cancerous?
altered cell- cell adherence and altered cell-matrix adhesion could suggest they are more likely to metastasise
production of tumour related proteins
Tumour related proteins are better known as tumour biomarkers. Give 3 examples of tumour biomarkers.
- oncofetal proteins
- oncogene products
- growth factors and receptors
What are oncofetal proteins?
proteins that are general produced during foetal development but are also found in adults with certain types of cancers
Give 2 examples of oncofetal proteins that can be identified as tumour biomarkers and the cancers they are indicative of.
- alphafetoprotein - hepatocellular carcinoma, testicular teritoma
- carcino-embryonic antigen - colon cancer
Give 3 examples of growth factors and receptors acting as tumour biomarkers and identify the cancers they are indicative of.
- Her2 - have these receptors normally on breast tissue. Abnormality when there are more than normal as when activated can promote growth of cancer cells. Breast cancer.
- oestrogen receptors - normal in females but at elevated levels can promote the growth and development of cancers. Breast cancer
- Prostate specific antigen - higher levels than normal can indicate prostate cancer
What abnormalities in appearance of cancer cells might you expect to find?
- cellular and nuclear pleomorphism- marked variation in shape and size
- mitoses present and often abnormal
What two factors balance tumour growth?
apoptosis and angiogenesis
How does angiogenesis contribute to growth of tumours?
more blood vessels to provide nutrients to tumour cells for growth
Why does greater angiogenesis in tumours lead to a poorer prognosis for the patient?
more routes for metastasis
How does apoptosis help balance tumour growth?
involved in response to chemo/radiotherapy
if tumour grows too quickly and not at the same rate as angiogenesis then there will not be enough nutrients for tumour growth to continue
What factors can contribute to a cell metastasising?
increased matrix degradation by proteolytic enzymes
altered cell- cell and cell- matrix adhesion
What are the 4 modes of spread of cancer?
trans-coelemic
blood
lymphatic
local
What is the general progression of tumour invasion?
maligant tumour—- invasion into connective tissue—- invasion into lymph/ blood vessels
Tumour metastasis via lymphatics
malignant tumour—-adherence of tumour cells to lymph vessels—invasion from lymphatics—invasion into lymph node— formation of metastasis in lymph node—- clinical evidence of metastasis
Tumour metastasis via blood
malignant tumour—adherence of tumour cells to blood vessels—- invasion of blood vessel— invasion into tissue— formation of metastasis–clinical evidence of metastasis
Transcoelemic spread
spread across body cavities
What organs commonly show transcoelemic spread?
tumours of: colon lung stomach ovary COLS
What are 4 common sites of metastasis?
bone
lung
liver
adrenal cortex
Where are 4 uncommon sites of metastasis?
spleen
kidney
heart
skeletal muscle
Where do breast tumours commonly metastasise to?
bone
lung
Where do tumours of the prostate commonly metastasise to?
bone (Peanut Butter)
Where do tumours of the colon commonly metastasise to?
liver (think Clever)
What are the local effects of benign tumours?
pressure and obstruction
What are 6 local effects of malignant tumours?
pressure
obstruction
effects of treatment
pain - as a result of pressure on nerves etc
bleeding - anaemia from destruction of small vessels, haemorrhage from destruction of large vessels
tissue destruction - ulceration/infection
What are 4 systemic effects of malignant tumours?
effects of treatment
secretion of hormones - normal or abnormal
weight loss - cachexia
paraneoplastic syndromes
What is a paraneoplastic syndrome?
rare disorder triggered by an altered immune response to an abnormal growth like a tumour
What is ‘normal’ hormone production by tumours?
tumour produces hormone expected of organ tumour is on but has abnormal production/secretion
‘Abnormal’ hormone production by tumours?
organ that does not normally produce that hormone is making it
2 examples of inappropriate hormone secretions that are associated with lung cancer
ADH
ACTH
What is one way you can detect cancer at a pre-invasive stage?
identification of dysplasia in epithelium
What is dysplasia?
premalignant change in cells - no invasion
