Tumour Pathology Flashcards
what are the supporting structures of tumour cells?
+ neoplastic cells
+ stroma (connective tissue, blood vessels, inflammatory cell)
what is meant by autonomous?
response to physiological stimuli is lost or abnormal, allowing unregulated growth
what cancer has the highest incidence, and the lowest in males in the uk?
prostate and kidney
what cancer has the highest incidence, and the lowest in females in the uk?
breast and melanoma
what are key features of cancerous cells?
\+ self-sifficiency in growth signals \+ insensitivity to anti-growth signals \+ evading apoptosis \+ sustained angiogenesis \+ tissue invasion and metastasis \+ limitless replicative potential
what is the timeline of cancer?
- initiation/promotion
- growth
- diagnosis + excision
- cure/relapse/metastasis/death
what are the features of a benign tumour?
\+ well circumscribed \+ slow growth \+ no necrosis \+ non-invasive \+ no metastasis
what are the features of a malignant tumour?
\+ poorly circumscribed \+ rapid growth \+ often necrotic \+ invasive \+ metastasis
what is the clinical relevance of a benign tumour?
+ does not invade
+ does not metastasise
what is the clinical relevance of a malignant tumour?
+ invades
+ metastisises
what are clinical effects of benign tumours?
+ do not invade or metastasise
+ not always clinically benign
what are ways benign tumours are not always clinically benign?
+ space occupying effects
+ haemorrhage
+ hormone production
what can be caused by space occupying effects?
+ obstruction
+ epilepsy
+ conduction abnormalities
what is a malignant tumour?
a colony of malignant cells established at a point distant from the original tumour
how do malignant tumours spread?
+ directly invade locally
+ via lymphatics
+ via bloodstream (haematological)
+ through body cavities (transcoelomic)
where do prostate tumours metastasise to?
bone
where do lung tumours metastasise to?
brain, adrenals
where do breast tumours metastasise to?
lung, liver, bone, brain
where do ovarian tumours metastasise to?
peritoneal cavity
what are macroscopic features of benign tumours?
+ intacts surface
+ exophytic growth
+ homogeneous cut surface
+ circumscribed or encapsulated edge
what are macroscopic features of malignant tumours?
\+ heterogeneous cut surface due to necrosis \+ ulcerated surface \+ endophytic growth \+ vascular permeation \+ irregular infiltrative edge
what are microscopic features of benign tumours?
\+ resemble tissue of origin \+ well circumscribed \+ well differentiated \+ minimal nuclear pleomorphism \+ mitotic figures normal \+ no necrosis
what are features of microscopic features of malignant tumours?
\+ variable resemblance \+ poorly circumscribed \+ variable differentiation \+ variable pleomorphism may be anaplastic \+ mitotic figures abnormal \+ necrotic
what are cytological features of malignancy?
\+ high nucleo-cytoplasmic ratio \+ nuclear hyperchromasia \+ nuclear pleomorphism \+ abnormal chromatin structure \+ abnormal mitotic figures
what is histogenic classification?
grading based on degree of resemblance of tissue to origin (differentiation)
what does grade broadly correlate with?
clinical behaviour of tumour
what is the definition of a grade I malignant neoplasm?
well differentiated
what is the definition of a grade II malignant neoplasm?
moderately differentiated
what is the definition of a grade III malignant neoplasm?
poorly differentiated
what is the definition of a grade IV malignant neoplasm?
nearly anaplastic
what are the stages of bone metastases mechanism?
> 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
where do tumours of the bowel spread to?
liver, lymph nodes, peritoneum
what are the different shapes/formations of tumours?
\+ sessile \+ pedunculated polyp \+ papillary \+ fungating \+ ulcerated \+ annular
what are sessile tumours like?
attached directly by a broad base
what are pedunculated polyp tumours like?
polyp: abnormal growth of tissue projecting from a mucous membrane
pedunculated: if attached to surface by narrow elongated stalk
what are papillary tumours like?
finger-like projections
what are fungating tumours like?
fungus like in appearance and growth rate
what are ulcerated tumours like?
eroding away the skin or mucous membrane
what are annular tumours like?
ring-like in structure
