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Principles of Disease > Tumour Pathology > Flashcards

Tumour Pathology Flashcards

1
Q

What is a tumour?

A

Is an abnormal growing mass of tissue

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2
Q

What is another name for a tumour?

A

A neoplasm

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3
Q

Is tumour growth a reversible change?

A

No

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4
Q

What are the two types of tumours?

A

Benign

Malignant

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5
Q

Which tumour benign or malignant is cancerous?

A

Malignant

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6
Q

What is a fundamental property of cancer?

A

It ability to invade into adjacent tissue and to spread to other site within the body

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7
Q

What other factors are important in cancer causation?

A

Genetic and environmental factors

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8
Q

What is the most common cancer in males?

A

Prostate

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9
Q

What is the most common cancer in females?

A

Breast

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10
Q

What is the most common cancer overall?

A

Breast

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11
Q

Which cancer has the highest survival rate?

A

Melanoma

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12
Q

Which cancer has the lowest survival rate?

A

Lung

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13
Q

Why is tumour classification important?

A

For understanding tumour behaviour

For determining the outcome (prognosis) and selecting suitable therapy

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14
Q

Epithelium Glandular benign tumour are known as what?

A

Adenoma

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15
Q

Epithelium Glandular malignant tumours are known as what?

A

Adeno-carcinoma

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16
Q

Epithelium squamous benign tumours are known as what?

A

Squamous Papilloma

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17
Q

Epithelium squamous malignant tumours are known as what?

A

Squamous carcinoma

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18
Q

Benign tumours of the bones are known as what?

A

Osteoma

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19
Q

Malignant tumours of the bone are known as what?

A

Osteo-sarcoma

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20
Q

Benign tumours of fat are known as what?

A

Lipoma

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21
Q

Malignant tumours of fat are known as what?

A

Lipo-sarcoma

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22
Q

Benign fibrous tissue tumours are known as what?

A

Fibroma

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23
Q

Malignant tumours of fibrous tissue are known as what?

A

Fibro-sarcoma

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24
Q

What is a sarcoma?

A

Any malignant tumour of connective tissue

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25
Q

What is a carcinoma?

A

Any malignant tumour of epithelium tissue

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26
Q

What are malignant tumours of WBC known as?

A

Leukaemia

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27
Q

What are more common carcinomas or sarcomas?

A

Carcinomas

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28
Q

What are malignant tumours of lymphoid tissue known as?

A

Lymphoma

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29
Q

What is a malignant tumour of the CNS?

A

Astrocytoma

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30
Q

What is a malignant tumour of the peripheral NS?

A

Schwannoma

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31
Q

What is a malignant tumour of a germ cell known as?

A

Teratomas

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32
Q

Are ovarian teratomas usually benign or malignant?

A

Benign

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33
Q

Are testicular teratomas usually benign or malignant?

A

Malignant

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34
Q

Are benign tumours encapsulated?

A

Yes usually

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35
Q

Are benign tumours invasive or not?

A

Non- invasive growth pattern

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36
Q

Is metastases present in benign tumours?

A

No

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37
Q

What are the cells in benign tumours like?

A

Similar to normal

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38
Q

In terms of differentiation what are benign tumours cells like?

A

Well-differentiated

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39
Q

Do benign tumours function similarly to normal tissue?

A

Yes

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40
Q

How often do benign tumours cause death?

A

Rarely

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41
Q

What is the growth patter in malignant tumours like?

A

Invasive growth pattern

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42
Q

Are malignant tumours capsulated?

A

No

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43
Q

What are the cells in malignant tumours like?

A

Abnormal

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44
Q

In terms of differentiation what are malignant tumours cells like?

A

Poorly differentiated

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45
Q

Do malignant tumour cells lot normal function?

A

Yes

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46
Q

How often do malignant tumours cause death?

A

Frequently

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47
Q

In cancer cells what is there a loss of?

A

Tumour suppressor genes

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48
Q

In cancer cells what is there a gain in function of?

A

Oncogenes

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49
Q

Is there a single feature unique to cancer cells?

A

No

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50
Q

Why is cancer difficult to diagnose and treat?

A

Because there is no single feature that is unique to cancer cells

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51
Q

What is another name of tumour-related proteins?

A

Tumour biomarkers

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52
Q

In cancer cells is there a loss of cell to cell adhesion?

A

Yes

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53
Q

In cancer cells is there an altered cell to matrix adhesion?

A

Yes

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54
Q

What are some examples of tumour related proteins?

A

Onco-fetal proteins
Oncogenes
Growth factors and receptors

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55
Q

What are onco-fetal proteins?

A

Proteins that are found in early foetuses but should not be found in adults

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56
Q

What is an onco-gene?

A

A gene which under certain circumstances can turn into cancer cells

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57
Q

What are screening programmes for?

A

To screen people that are asymptomatic to check for early signs of cancer

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58
Q

What is a diagnosis in cancer?

A

Wether the person has cancer or not

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59
Q

What is a prognosis in cancer?

A

Identifying certain outcomes for patients

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60
Q

What is Braf a biomarker for?

A

Melanoma

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61
Q

What is EGFR a biomarker for?

A

Lung cancer

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62
Q

What is Kras a biomarker for?

A

colorectal cancer

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63
Q

What is Her2 a biomarker for?

A

Breast and gastric cancer

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64
Q

What is alpha-fetoprotein a biomarker for?

A

Teratoma of testis

Hepatocellular carcinoma

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65
Q

What is oestrogen receptor a biomarker for?

A

Breast cancer

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66
Q

What is prostate specific antigen a biomarker of?

A

Prostate cancer

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67
Q

In cancer cells what is mitosis like?

A

Present and often abnormal

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68
Q

What is the appearance of cancer cells?

A

Marked variation in size and shape

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69
Q

What is tumour growth a balance of?

A

Cell growth and cell death

70
Q

What is tumour angiogenesis?

A

New blood vessel formation by tumours, required to sustain tumour growth

71
Q

Why is tumour angiogenesis bad?

A

It provides a route for the release of tumour cells in circulation

72
Q

What is apoptosis?

A

Mechanism of programmed single cell death

73
Q

Is apoptosis an active cell process?

A

Yes

74
Q

What does apoptosis do?

A

Regulates tumour growth

75
Q

What is a major clinical problem of cancer?

A

The formation of metastatic (secondary) tumours

76
Q

Why does detecting a tumour early have a better chance of a better prognosis?

A

Is likely to have spread less?

77
Q

How do tumours get through the matrix?

A

By proteolytic enzymes

78
Q

In metastasis what is altered

A

cell to cell adhesion

Cell to matrix adhesion

79
Q

What are the modes of spread of cancer?

A

Local spread
Lymphatic spread
Blood spread
Trans-coelomic spread

80
Q

Via lymphatics were do metastasis form?

A

In the lymph nodes

81
Q

Via lymphatics where do tumour cells adhere to?

A

Lymph vessels

82
Q

Via the blood how does metastasis occur?

A

Adherence of tumour cells to blood vessels
Invasion from blood vessels
Invasion into tissue
Formation of metastasis

83
Q

What is trans-coelomic spread? (cancer)

A

Spread of tumour cells across body cavities

84
Q

Tumours of which organs show trans-coelomic spread?

A

Lung, Stomach, Colon, Ovary

85
Q

Where are common sites of metastasis?

A

Liver, Lung, Brain, Bone (of the axial skeleton), Adrenal Gland

86
Q

Where are uncommon sites of metastasis?

A

Spleen, Kidney, Skeletal muscle, Heart

87
Q

Tumours of the breast often metastasis to where?

A

Bone (axial skeleton)

88
Q

Tumours of the prostate often spread to?

A

Bone (axial skeleton)

89
Q

Tumours of the colorectal often metastasise to where?

A

Liver

90
Q

What are the local effects of benign tumours?

A

Pressure

Obstruction

91
Q

What are the local effects of malignant tumours?

A

Pressure
Obstruction
Tissue destruction
Bleeding

92
Q

What are the two types of bleeding in malignant tumours?

A

Anaemia

Haemorrhage

93
Q

What is ulceration?

A

The breakdown of tissues

94
Q

What does anaemia bleeding mean?

A

Slow chronic loss of blood

95
Q

What does haemorrhage bleeding mean?

A

Larger vessel damaged leading to major loss of blood

96
Q

What is pain in tumours caused by?

A

Tumour pressure on nerves

97
Q

What is perineural infiltration?

A

When cancer grows along the nerve fibres

98
Q

What kind of weight change do malignant tumours induce?

A

Weight loss and not good weight loss

99
Q

What is ‘normal’ hormone production?

A

When hormones are produced by tumours of the normal endocrine organs
However there is an abnormal control of hormone production and secretion

100
Q

What is abnormal hormone production in tumours?

A

When hormones are produced by tumours of organs that do not normally produce hormones

101
Q

What are the 2 abnormal secretion of hormones that can indicate cancer of the lung?

A

ACTH and ADH

102
Q

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

A

To reduce/prevent morbidity and mortaility

103
Q

What is morbidity?

A

Signs and symptoms of the cancer

104
Q

What is dysplasia?

A

Pre-malignant change

105
Q

What is the earliest change in the process of malignancy that can be visualised?

A

Dysplasia

106
Q

Where is dysplasia identifies?

A

Epithelium tissue

107
Q

Can dysplasia progress into cancer?

A

Yes

108
Q

What are the cells like in dysplasia?

A

Increased nuclear size
Increased mitotic activity
Abnormal mitoses

109
Q

Can dysplasia occur anywhere in the body?

A

NO - dysplasia can only occur in certain parts of the body

110
Q

What are the 3 screenings available to check for dysplasia?

A

Breast
Bowel
Cervical

111
Q

What are the 2 frequently disturbed pathways in the cell cycle that lead to cancer?

A

Cyclin pRb pathway

p53 pathway

112
Q

What is G1 of the cell cycle?

A

The first growth phase

113
Q

What is G2 of the cel cycle?

A

The second growth phase

114
Q

What occurs at the S phase of the cell cycle?

A

DNA replication

115
Q

What occurs at the M phase of the cell cycle?

A

Mitosis and Cytokinesis

116
Q

What is the normal function of p53?

A

To maintain genomic integrity and to stop the cell cycle to repair or kill damage DNA cells

117
Q

Where are common sites of cancer spread?

A 
Liver
Lung 
Brain 
Bone 
Adrenal glands
118
Q

What is carcinogenesis?

A

The production of cancer cells caused by the mutation of genetic material

119
Q

What are the 2 pathways frequently disrupted in the formation of cancer?

A

Cyclin pRb pathway

p53 pathway

120
Q

What are the major aetiology agents of cancer?

A

Heredity
Proto-oncogene> oncogene mutations
Viruses
Chemicals

121
Q

What are the principles to consider in the staging of cancer?

A 
Position of the tumour 
Depth of penetration of the tumour 
Relationship to adjacent structures
Involvement of regional lymph nodes
Presence of distant metastases
122
Q

What do taxanes do?

A

Promote spindles and freeze the cell at that stage of replication

123
Q

What do vinca alkaloids do?

A

Prevent metaphase by preventing spindle formation

124
Q

What do alkylating agents do?

A

Attatch the guanine between DNA strands during replication preventing it from taking place

125
Q

What do antimetabolites do?

A

Can integrate themselves into the nuclear material or bind irreversibly with vital enzymes to prevent division

126
Q

What do antimitotic antibiotics do?

A

Intercalate to prevent DNA and RNA synthesis

127
Q

What is the cell cycle?

A

The time interval between mitotic divisions

128
Q

What does the quality control of the cell cycle do?

A

Ensures each cell receives the full chromosome complement

Ensures mutations in DNA do not pass on

129
Q

If the cell size is inadequate what check point is arrested?

A

G1 or G2

130
Q

If an essential external stimulus is lacking what check point is arrested?

A

G1

131
Q

If the DNA is not replicated what check point is arrested?

A

S arrest

132
Q

If DNA damage is detected what is arrested?

A

G1 or G2

133
Q

If the chromosomes are misaligned what is arrested?

A

M phase arrest

134
Q

What are the catalytic subunits of the cell cycle called?

A

CDKS

135
Q

What are the regulatory subunits of the cell cycle called?

A

Cyclins

136
Q

What is the active enzyme complex of the cell cycle called?

A

CDK/cyclin complex

137
Q

Where is the retinoblastoma gene expressed?

A

Almost every cell of the human body

138
Q

Is rB phosphorylated or hypophosphorylated?

A

Hypo

139
Q

As the cell cycle progresses what happens to pRB?

A

It becomes phosphorylated

140
Q

What does hypo pRB do to E2F?

A

Inactivates it

141
Q

What does phosphorylated pRB do to E2F?

A

Frees the E2F

142
Q

What is E2F?

A

A transcription factor

143
Q

What environmental agents can cause carcinogenesis?

A

Chemicals
Radiation
Oncogenic Viruses

144
Q

What 2 bases in DNA are critically damaged by various chemicals?

A

Purine

Pyrimidine

145
Q

What does chemical carcinogenesis cause the formation of?

A

Adducts

146
Q

What bases are critical cellular targets for radiation damage?

A

Purine

Pyrimidine

147
Q

What type of radiation can cause cancer?

A

UV
X-rays
Gamma radiation

148
Q

Where are virtually all cancers dysregulated?

A

G1-S

149
Q

What does p53 do?

A

Maintains genomic integrity

150
Q

Levels of what increase in damaged cells?

A

p53

151
Q

If p53 is missing what happens to a damaged cell?

A

Cells do not G1 arrest

Or repair damaged DNA

152
Q

Where do tumours invade?

A

Through the basement membrane

153
Q

Why can the immune system not recognise some foreign cells?

A

Because the cancer cells can hide from the immune system

154
Q

How do cancer cells evade the immune system?

A

PD1 is on the T cell
PDL-1 is on the cancer cell
The interaction of the 2 suppresses the action of the T cells

155
Q

What does mitotic division generate?

A

Two genetically identical daughter cells

156
Q

What external factors control the cell cycle?

A

Hormones
Growth factors
Cytokines
Stroma

157
Q

What o active CDK/cyclin complexes do?

A

Phosphorylate target proteins

158
Q

What does carcinogenesis upset the balance between?

A

Proliferation and apoptosis

159
Q

What does adduct formation at particular chromosome sites cause?

A

Cancer

160
Q

What number of cells does there have to be before cancer can be clinically detected?

A

10 to the 9

161
Q

At how many cells do the cancer cells cause death?

A

10 to the 13

162
Q

What can retroviruses lead to?

A

Leukaemia

Lymphoma

163
Q

What can the herpes virus lead to?

A

Burkitts lymphoma

164
Q

What can the Hep B virus lead to?

A

Liver cancer

165
Q

What can the papillomavirus lead to?

A

Cervical cancer

166
Q

What is VEGF?

A

A growth factor

167
Q

What does VEGF do?

A

Binds to epithelium on existing blood vessels

Stimulates the growth of new blood vessels to the tumour

168
Q

What does Anti-VEGF do?

A

Binds to VEGF receptors o the surface of endothelial cells

Prevents anigogenesis

169
Q

What do Anti-VEGFs prevent?

A

The interaction of VEGF with its receptors

The activation of downstream signalling pathways

170
Q

Why is anti-VEFG good for tumour treatment?

A

Helps combat the metasises of tumours

Principles of Disease (14 decks)

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