Tumour Pathology

Question 1

Another common name for a tumour?

Answer 1

neoplasm

Question 2

What is cancer?

Answer 2

a malignant tumour

Question 3

Benign glandular tumour

Answer 3

adenoma

Question 4

Malignant glandular tumour

Answer 4

adenocarcinoma

Question 5

Benign squamous tumour

Answer 5

squamous papilloma

Question 6

Malignant squamous tumour

Answer 6

squamous carcinoma

Question 7

Benign bone tumour

Answer 7

osteoma

Question 8

Malignant bone tumour

Answer 8

osteosarcoma

Question 9

Benign fat tumour

Answer 9

lipoma

Question 10

Malignant fat tumour

Answer 10

liposarcoma

Question 11

Benign Fibrous tissue tumour

Answer 11

fibroma

Question 12

Malignant fibrous tumour

Answer 12

fibrosarcoma

Question 13

What are tumours of the blood cells called?

Answer 13

leukaemia (only malignant tumours)

Question 14

Lymphoid tissue tumours

Answer 14

lymphoma (only malignant)

Question 15

CNS tissue tumour

Answer 15

astrocytoma

Question 16

PNS tissue tumour

Answer 16

schwannoma

Question 17

Germ cell tumours

Answer 17

teratomas

Question 18

Features of benign tumours

Answer 18

1. usually encapsulated
2. non invasive growth pattern
3. don’t usually result in death
4. well differentiated
5. function similar to normal tissue
6. no metastases

Question 19

Features of malignant tumours

Answer 19

1. metastasise
2. not encapsulated or have breached capsule
3. poorly differentiated
4. invasive growth pattern
5. cells abnormal
6. frequently cause death
7. loss of normal function

Question 20

Give 4 examples of differences between normal cells and cancer cells

Answer 20

1. abnormal genetics e.g. loss of function of tumour suppressor genes, activation of oncogenes
2. altered cellular functions - produce tumour related proteins
3. abnormal morphology
4. cells capable of independent growth

Question 21

How can altered cellular function (structure) characterise the cells as being cancerous?

Answer 21

altered cell- cell adherence and altered cell-matrix adhesion could suggest they are more likely to metastasise
production of tumour related proteins

Question 22

Tumour related proteins are better known as tumour biomarkers. Give 3 examples of tumour biomarkers.

Answer 22

1. oncofetal proteins
2. oncogene products
3. growth factors and receptors

Question 23

What are oncofetal proteins?

Answer 23

proteins that are general produced during foetal development but are also found in adults with certain types of cancers

Question 24

Give 2 examples of oncofetal proteins that can be identified as tumour biomarkers and the cancers they are indicative of.

Answer 24

1. alphafetoprotein - hepatocellular carcinoma, testicular teritoma
2. carcino-embryonic antigen - colon cancer

Question 25

Give 3 examples of growth factors and receptors acting as tumour biomarkers and identify the cancers they are indicative of.

Answer 25

1. 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. 2. oestrogen receptors - normal in females but at elevated levels can promote the growth and development of cancers. Breast cancer 3. Prostate specific antigen - higher levels than normal can indicate prostate cancer

Question 26

What abnormalities in appearance of cancer cells might you expect to find?

Answer 26

1. cellular and nuclear pleomorphism- marked variation in shape and size 2. mitoses present and often abnormal

Question 27

What two factors balance tumour growth?

Answer 27

apoptosis and angiogenesis

Question 28

How does angiogenesis contribute to growth of tumours?

Answer 28

more blood vessels to provide nutrients to tumour cells for growth

Question 29

Why does greater angiogenesis in tumours lead to a poorer prognosis for the patient?

Answer 29

more routes for metastasis

Question 30

How does apoptosis help balance tumour growth?

Answer 30

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

Question 31

What factors can contribute to a cell metastasising?

Answer 31

increased matrix degradation by proteolytic enzymes | altered cell- cell and cell- matrix adhesion

Question 32

What are the 4 modes of spread of cancer?

Answer 32

trans-coelemic blood lymphatic local

Question 33

What is the general progression of tumour invasion?

Answer 33

maligant tumour---- invasion into connective tissue---- invasion into lymph/ blood vessels

Question 34

Tumour metastasis via lymphatics

Answer 34

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

Question 35

Tumour metastasis via blood

Answer 35

malignant tumour---adherence of tumour cells to blood vessels---- invasion of blood vessel--- invasion into tissue--- formation of metastasis--clinical evidence of metastasis

Question 36

Transcoelemic spread

Answer 36

spread across body cavities

Question 37

What organs commonly show transcoelemic spread?

Answer 37

``` tumours of: colon lung stomach ovary COLS ```

Question 38

What are 4 common sites of metastasis?

Answer 38

bone lung liver adrenal cortex

Question 39

Where are 4 uncommon sites of metastasis?

Answer 39

spleen kidney heart skeletal muscle

Question 40

Where do breast tumours commonly metastasise to?

Answer 40

bone | lung

Question 41

Where do tumours of the prostate commonly metastasise to?

Answer 41

bone (Peanut Butter)

Question 42

Where do tumours of the colon commonly metastasise to?

Answer 42

liver (think Clever)

Question 43

What are the local effects of benign tumours?

Answer 43

pressure and obstruction

Question 44

What are 6 local effects of malignant tumours?

Answer 44

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

Question 45

What are 4 systemic effects of malignant tumours?

Answer 45

effects of treatment secretion of hormones - normal or abnormal weight loss - cachexia paraneoplastic syndromes

Question 46

What is a paraneoplastic syndrome?

Answer 46

rare disorder triggered by an altered immune response to an abnormal growth like a tumour

Question 47

What is 'normal' hormone production by tumours?

Answer 47

tumour produces hormone expected of organ tumour is on but has abnormal production/secretion

Question 48

'Abnormal' hormone production by tumours?

Answer 48

organ that does not normally produce that hormone is making it

Question 49

2 examples of inappropriate hormone secretions that are associated with lung cancer

Answer 49

ADH | ACTH

Question 50

What is one way you can detect cancer at a pre-invasive stage?

Answer 50

identification of dysplasia in epithelium

Question 51

What is dysplasia?

Answer 51

premalignant change in cells - no invasion