Tumour Pathology Flashcards
1
Q
What is a tumour?
A
Is an abnormal growing mass of tissue
2
Q
What is another name for a tumour?
A
A neoplasm
3
Q
Is tumour growth a reversible change?
A
No
4
Q
What are the two types of tumours?
A
Benign
Malignant
5
Q
Which tumour benign or malignant is cancerous?
A
Malignant
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
7
Q
What other factors are important in cancer causation?
A
Genetic and environmental factors
8
Q
What is the most common cancer in males?
A
Prostate
9
Q
What is the most common cancer in females?
A
Breast
10
Q
What is the most common cancer overall?
A
Breast
11
Q
Which cancer has the highest survival rate?
A
Melanoma
12
Q
Which cancer has the lowest survival rate?
A
Lung
13
Q
Why is tumour classification important?
A
For understanding tumour behaviour
For determining the outcome (prognosis) and selecting suitable therapy
14
Q
Epithelium Glandular benign tumour are known as what?
A
Adenoma
15
Q
Epithelium Glandular malignant tumours are known as what?
A
Adeno-carcinoma
16
Q
Epithelium squamous benign tumours are known as what?
A
Squamous Papilloma
17
Q
Epithelium squamous malignant tumours are known as what?
A
Squamous carcinoma
18
Q
Benign tumours of the bones are known as what?
A
Osteoma
19
Q
Malignant tumours of the bone are known as what?
A
Osteo-sarcoma
20
Q
Benign tumours of fat are known as what?
A
Lipoma
21
Q
Malignant tumours of fat are known as what?
A
Lipo-sarcoma
22
Q
Benign fibrous tissue tumours are known as what?
A
Fibroma
23
Q
Malignant tumours of fibrous tissue are known as what?
A
Fibro-sarcoma
24
Q
What is a sarcoma?
A
Any malignant tumour of connective tissue
25
What is a carcinoma?
Any malignant tumour of epithelium tissue
26
What are malignant tumours of WBC known as?
Leukaemia
27
What are more common carcinomas or sarcomas?
Carcinomas
28
What are malignant tumours of lymphoid tissue known as?
Lymphoma
29
What is a malignant tumour of the CNS?
Astrocytoma
30
What is a malignant tumour of the peripheral NS?
Schwannoma
31
What is a malignant tumour of a germ cell known as?
Teratomas
32
Are ovarian teratomas usually benign or malignant?
Benign
33
Are testicular teratomas usually benign or malignant?
Malignant
34
Are benign tumours encapsulated?
Yes usually
35
Are benign tumours invasive or not?
Non- invasive growth pattern
36
Is metastases present in benign tumours?
No
37
What are the cells in benign tumours like?
Similar to normal
38
In terms of differentiation what are benign tumours cells like?
Well-differentiated
39
Do benign tumours function similarly to normal tissue?
Yes
40
How often do benign tumours cause death?
Rarely
41
What is the growth patter in malignant tumours like?
Invasive growth pattern
42
Are malignant tumours capsulated?
No
43
What are the cells in malignant tumours like?
Abnormal
44
In terms of differentiation what are malignant tumours cells like?
Poorly differentiated
45
Do malignant tumour cells lot normal function?
Yes
46
How often do malignant tumours cause death?
Frequently
47
In cancer cells what is there a loss of?
Tumour suppressor genes
48
In cancer cells what is there a gain in function of?
Oncogenes
49
Is there a single feature unique to cancer cells?
No
50
Why is cancer difficult to diagnose and treat?
Because there is no single feature that is unique to cancer cells
51
What is another name of tumour-related proteins?
Tumour biomarkers
52
In cancer cells is there a loss of cell to cell adhesion?
Yes
53
In cancer cells is there an altered cell to matrix adhesion?
Yes
54
What are some examples of tumour related proteins?
Onco-fetal proteins
Oncogenes
Growth factors and receptors
55
What are onco-fetal proteins?
Proteins that are found in early foetuses but should not be found in adults
56
What is an onco-gene?
A gene which under certain circumstances can turn into cancer cells
57
What are screening programmes for?
To screen people that are asymptomatic to check for early signs of cancer
58
What is a diagnosis in cancer?
Wether the person has cancer or not
59
What is a prognosis in cancer?
Identifying certain outcomes for patients
60
What is Braf a biomarker for?
Melanoma
61
What is EGFR a biomarker for?
Lung cancer
62
What is Kras a biomarker for?
colorectal cancer
63
What is Her2 a biomarker for?
Breast and gastric cancer
64
What is alpha-fetoprotein a biomarker for?
Teratoma of testis
| Hepatocellular carcinoma
65
What is oestrogen receptor a biomarker for?
Breast cancer
66
What is prostate specific antigen a biomarker of?
Prostate cancer
67
In cancer cells what is mitosis like?
Present and often abnormal
68
What is the appearance of cancer cells?
Marked variation in size and shape
69
What is tumour growth a balance of?
Cell growth and cell death
70
What is tumour angiogenesis?
New blood vessel formation by tumours, required to sustain tumour growth
71
Why is tumour angiogenesis bad?
It provides a route for the release of tumour cells in circulation
72
What is apoptosis?
Mechanism of programmed single cell death
73
Is apoptosis an active cell process?
Yes
74
What does apoptosis do?
Regulates tumour growth
75
What is a major clinical problem of cancer?
The formation of metastatic (secondary) tumours
76
Why does detecting a tumour early have a better chance of a better prognosis?
Is likely to have spread less?
77
How do tumours get through the matrix?
By proteolytic enzymes
78
In metastasis what is altered
cell to cell adhesion
| Cell to matrix adhesion
79
What are the modes of spread of cancer?
Local spread
Lymphatic spread
Blood spread
Trans-coelomic spread
80
Via lymphatics were do metastasis form?
In the lymph nodes
81
Via lymphatics where do tumour cells adhere to?
Lymph vessels
82
Via the blood how does metastasis occur?
Adherence of tumour cells to blood vessels
Invasion from blood vessels
Invasion into tissue
Formation of metastasis
83
What is trans-coelomic spread? (cancer)
Spread of tumour cells across body cavities
84
Tumours of which organs show trans-coelomic spread?
Lung, Stomach, Colon, Ovary
85
Where are common sites of metastasis?
Liver, Lung, Brain, Bone (of the axial skeleton), Adrenal Gland
86
Where are uncommon sites of metastasis?
Spleen, Kidney, Skeletal muscle, Heart
87
Tumours of the breast often metastasis to where?
Bone (axial skeleton)
88
Tumours of the prostate often spread to?
Bone (axial skeleton)
89
Tumours of the colorectal often metastasise to where?
Liver
90
What are the local effects of benign tumours?
Pressure
| Obstruction
91
What are the local effects of malignant tumours?
Pressure
Obstruction
Tissue destruction
Bleeding
92
What are the two types of bleeding in malignant tumours?
Anaemia
| Haemorrhage
93
What is ulceration?
The breakdown of tissues
94
What does anaemia bleeding mean?
Slow chronic loss of blood
95
What does haemorrhage bleeding mean?
Larger vessel damaged leading to major loss of blood
96
What is pain in tumours caused by?
Tumour pressure on nerves
97
What is perineural infiltration?
When cancer grows along the nerve fibres
98
What kind of weight change do malignant tumours induce?
Weight loss and not good weight loss
99
What is 'normal' hormone production?
When hormones are produced by tumours of the normal endocrine organs
However there is an abnormal control of hormone production and secretion
100
What is abnormal hormone production in tumours?
When hormones are produced by tumours of organs that do not normally produce hormones
101
What are the 2 abnormal secretion of hormones that can indicate cancer of the lung?
ACTH and ADH
102
Why is it important to detect cancer at an early stage?
To reduce/prevent morbidity and mortaility
103
What is morbidity?
Signs and symptoms of the cancer
104
What is dysplasia?
Pre-malignant change
105
What is the earliest change in the process of malignancy that can be visualised?
Dysplasia
106
Where is dysplasia identifies?
Epithelium tissue
107
Can dysplasia progress into cancer?
Yes
108
What are the cells like in dysplasia?
Increased nuclear size
Increased mitotic activity
Abnormal mitoses
109
Can dysplasia occur anywhere in the body?
NO - dysplasia can only occur in certain parts of the body
110
What are the 3 screenings available to check for dysplasia?
Breast
Bowel
Cervical
111
What are the 2 frequently disturbed pathways in the cell cycle that lead to cancer?
Cyclin pRb pathway
| p53 pathway
112
What is G1 of the cell cycle?
The first growth phase
113
What is G2 of the cel cycle?
The second growth phase
114
What occurs at the S phase of the cell cycle?
DNA replication
115
What occurs at the M phase of the cell cycle?
Mitosis and Cytokinesis
116
What is the normal function of p53?
To maintain genomic integrity and to stop the cell cycle to repair or kill damage DNA cells
117
Where are common sites of cancer spread?
```
Liver
Lung
Brain
Bone
Adrenal glands
```
118
What is carcinogenesis?
The production of cancer cells caused by the mutation of genetic material
119
What are the 2 pathways frequently disrupted in the formation of cancer?
Cyclin pRb pathway
| p53 pathway
120
What are the major aetiology agents of cancer?
Heredity
Proto-oncogene> oncogene mutations
Viruses
Chemicals
121
What are the principles to consider in the staging of cancer?
```
Position of the tumour
Depth of penetration of the tumour
Relationship to adjacent structures
Involvement of regional lymph nodes
Presence of distant metastases
```
122
What do taxanes do?
Promote spindles and freeze the cell at that stage of replication
123
What do vinca alkaloids do?
Prevent metaphase by preventing spindle formation
124
What do alkylating agents do?
Attatch the guanine between DNA strands during replication preventing it from taking place
125
What do antimetabolites do?
Can integrate themselves into the nuclear material or bind irreversibly with vital enzymes to prevent division
126
What do antimitotic antibiotics do?
Intercalate to prevent DNA and RNA synthesis
127
What is the cell cycle?
The time interval between mitotic divisions
128
What does the quality control of the cell cycle do?
Ensures each cell receives the full chromosome complement
| Ensures mutations in DNA do not pass on
129
If the cell size is inadequate what check point is arrested?
G1 or G2
130
If an essential external stimulus is lacking what check point is arrested?
G1
131
If the DNA is not replicated what check point is arrested?
S arrest
132
If DNA damage is detected what is arrested?
G1 or G2
133
If the chromosomes are misaligned what is arrested?
M phase arrest
134
What are the catalytic subunits of the cell cycle called?
CDKS
135
What are the regulatory subunits of the cell cycle called?
Cyclins
136
What is the active enzyme complex of the cell cycle called?
CDK/cyclin complex
137
Where is the retinoblastoma gene expressed?
Almost every cell of the human body
138
Is rB phosphorylated or hypophosphorylated?
Hypo
139
As the cell cycle progresses what happens to pRB?
It becomes phosphorylated
140
What does hypo pRB do to E2F?
Inactivates it
141
What does phosphorylated pRB do to E2F?
Frees the E2F
142
What is E2F?
A transcription factor
143
What environmental agents can cause carcinogenesis?
Chemicals
Radiation
Oncogenic Viruses
144
What 2 bases in DNA are critically damaged by various chemicals?
Purine
| Pyrimidine
145
What does chemical carcinogenesis cause the formation of?
Adducts
146
What bases are critical cellular targets for radiation damage?
Purine
| Pyrimidine
147
What type of radiation can cause cancer?
UV
X-rays
Gamma radiation
148
Where are virtually all cancers dysregulated?
G1-S
149
What does p53 do?
Maintains genomic integrity
150
Levels of what increase in damaged cells?
p53
151
If p53 is missing what happens to a damaged cell?
Cells do not G1 arrest
| Or repair damaged DNA
152
Where do tumours invade?
Through the basement membrane
153
Why can the immune system not recognise some foreign cells?
Because the cancer cells can hide from the immune system
154
How do cancer cells evade the immune system?
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
What does mitotic division generate?
Two genetically identical daughter cells
156
What external factors control the cell cycle?
Hormones
Growth factors
Cytokines
Stroma
157
What o active CDK/cyclin complexes do?
Phosphorylate target proteins
158
What does carcinogenesis upset the balance between?
Proliferation and apoptosis
159
What does adduct formation at particular chromosome sites cause?
Cancer
160
What number of cells does there have to be before cancer can be clinically detected?
10 to the 9
161
At how many cells do the cancer cells cause death?
10 to the 13
162
What can retroviruses lead to?
Leukaemia
| Lymphoma
163
What can the herpes virus lead to?
Burkitts lymphoma
164
What can the Hep B virus lead to?
Liver cancer
165
What can the papillomavirus lead to?
Cervical cancer
166
What is VEGF?
A growth factor
167
What does VEGF do?
Binds to epithelium on existing blood vessels
| Stimulates the growth of new blood vessels to the tumour
168
What does Anti-VEGF do?
Binds to VEGF receptors o the surface of endothelial cells
| Prevents anigogenesis
169
What do Anti-VEGFs prevent?
The interaction of VEGF with its receptors
| The activation of downstream signalling pathways
170
Why is anti-VEFG good for tumour treatment?
Helps combat the metasises of tumours
