Tumour Pathology

Question 1

what are the supporting structures of tumour cells?

Answer 1

+ neoplastic cells

+ stroma (connective tissue, blood vessels, inflammatory cell)

Question 2

what is meant by autonomous?

Answer 2

response to physiological stimuli is lost or abnormal, allowing unregulated growth

Question 3

what cancer has the highest incidence, and the lowest in males in the uk?

Answer 3

prostate and kidney

Question 4

what cancer has the highest incidence, and the lowest in females in the uk?

Answer 4

breast and melanoma

Question 5

what are key features of cancerous cells?

Answer 5

\+ self-sifficiency in growth signals
\+ insensitivity to anti-growth signals
\+ evading apoptosis
\+ sustained angiogenesis
\+ tissue invasion and metastasis
\+ limitless replicative potential

Question 6

what is the timeline of cancer?

Answer 6

1. initiation/promotion
2. growth
3. diagnosis + excision
4. cure/relapse/metastasis/death

Question 7

what are the features of a benign tumour?

Answer 7

\+ well circumscribed
\+ slow growth
\+ no necrosis
\+ non-invasive
\+ no metastasis

Question 8

what are the features of a malignant tumour?

Answer 8

\+ poorly circumscribed
\+ rapid growth
\+ often necrotic
\+ invasive
\+ metastasis

Question 9

what is the clinical relevance of a benign tumour?

Answer 9

+ does not invade

+ does not metastasise

Question 10

what is the clinical relevance of a malignant tumour?

Answer 10

+ invades

+ metastisises

Question 11

what are clinical effects of benign tumours?

Answer 11

+ do not invade or metastasise

+ not always clinically benign

Question 12

what are ways benign tumours are not always clinically benign?

Answer 12

+ space occupying effects
+ haemorrhage
+ hormone production

Question 13

what can be caused by space occupying effects?

Answer 13

+ obstruction
+ epilepsy
+ conduction abnormalities

Question 14

what is a malignant tumour?

Answer 14

a colony of malignant cells established at a point distant from the original tumour

Question 15

how do malignant tumours spread?

Answer 15

+ directly invade locally
+ via lymphatics
+ via bloodstream (haematological)
+ through body cavities (transcoelomic)

Question 16

where do prostate tumours metastasise to?

Answer 16

bone

Question 17

where do lung tumours metastasise to?

Answer 17

brain, adrenals

Question 18

where do breast tumours metastasise to?

Answer 18

lung, liver, bone, brain

Question 19

where do ovarian tumours metastasise to?

Answer 19

peritoneal cavity

Question 20

what are macroscopic features of benign tumours?

Answer 20

+ intacts surface
+ exophytic growth
+ homogeneous cut surface
+ circumscribed or encapsulated edge

Question 21

what are macroscopic features of malignant tumours?

Answer 21

\+ heterogeneous cut surface due to necrosis
\+ ulcerated surface
\+ endophytic growth
\+ vascular permeation
\+ irregular infiltrative edge

Question 22

what are microscopic features of benign tumours?

Answer 22

\+ resemble tissue of origin
\+ well circumscribed
\+ well differentiated
\+ minimal nuclear pleomorphism
\+ mitotic figures normal
\+ no necrosis

Question 23

what are features of microscopic features of malignant tumours?

Answer 23

\+ variable resemblance
\+ poorly circumscribed
\+ variable differentiation
\+ variable pleomorphism may be anaplastic
\+ mitotic figures abnormal
\+ necrotic

Question 24

what are cytological features of malignancy?

Answer 24

\+ high nucleo-cytoplasmic ratio
\+ nuclear hyperchromasia
\+ nuclear pleomorphism
\+ abnormal chromatin structure
\+ abnormal mitotic figures

Question 25

what is histogenic classification?

Answer 25

grading based on degree of resemblance of tissue to origin (differentiation)

Question 26

what does grade broadly correlate with?

Answer 26

clinical behaviour of tumour

Question 27

what is the definition of a grade I malignant neoplasm?

Answer 27

well differentiated

Question 28

what is the definition of a grade II malignant neoplasm?

Answer 28

moderately differentiated

Question 29

what is the definition of a grade III malignant neoplasm?

Answer 29

poorly differentiated

Question 30

what is the definition of a grade IV malignant neoplasm?

Answer 30

nearly anaplastic

Question 31

what are the stages of bone metastases mechanism?

Answer 31

> primary malignant neoplasm
> new vessel formation
> invasion of vessel
> embolism
> arrest in distant capillary bed in bone
> adherence
> extravasation
> response to microenvironment
> tumour cell proliferation
> bone metastases

Question 32

where do tumours of the bowel spread to?

Answer 32

liver, lymph nodes, peritoneum

Question 33

what are the different shapes/formations of tumours?

Answer 33

\+ sessile
\+ pedunculated polyp
\+ papillary
\+ fungating
\+ ulcerated
\+ annular

Question 34

what are sessile tumours like?

Answer 34

attached directly by a broad base

Question 35

what are pedunculated polyp tumours like?

Answer 35

polyp: abnormal growth of tissue projecting from a mucous membrane
pedunculated: if attached to surface by narrow elongated stalk

Question 36

what are papillary tumours like?

Answer 36

finger-like projections

Question 37

what are fungating tumours like?

Answer 37

fungus like in appearance and growth rate

Question 38

what are ulcerated tumours like?

Answer 38

eroding away the skin or mucous membrane

Question 39

what are annular tumours like?

Answer 39

ring-like in structure