Tumour Pathology Flashcards
what is a tumour?
- neoplasm (“new growth”)
- usually one cell type with supporting tissue structures (neoplastic cells and stroma)
- autonomous (response to physiological stimuli lost or abnormal, allowing unregulated growth)
what are features of benign tumours?
- well circumscribed
- slow growth
- no necrosis
- non-invasive
- no metastasis
what are features of malignant tumours?
- poorly circumscribed
- rapid growth
- often necrotic
- invasive
- metastasis
what are the clinical effects of benign tumours?
- dont invade or metastasise
- not always clinically benign
space occupying effects:
- obstruction
- epilepsy
- conduction abnormalities
haemorrhage:
- pulmonary
- GI
hormone production:
- pituitary
- adrenal
- endocrine pancreas
how can tumours spread?
- directly invade locally
- via lymphatics
- via bloodstream (haematological)
- via body cavities (transcoelomic)
where do prostate tumours generally metastasise to?
bone
where do lung tumours generally metastasise to?
- brain
- adrenals
where do breast tumours generally metastasise to?
- lung
- liver
- bone
- brain
where do ovarian tumours generally metastasise to?
- peritoneal cavity
what are macroscopic features of benign tumours?
- intact surfaces
- 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 polymorphism
- mitotic figures normal
- no necrosis
what are 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
how are stages of tumours classified?
T - tumour size
N - degree of lymph node involvement
M - extent of distant metastases
what is Tis stage of malignant neoplasms?
in situ, non-invasive (confined to epithelium)
what is T1 stage of malignant neoplasms?
small, minimally invasive within primary organ site
what is T2 stage of malignant neoplasms?
larger, more invasive within primary organ site
what is T3 stage of malignant neoplasms?
larger and.or more invasive beyond margins of primary organ site
what is T4 stage of malignant neoplasms?
very large and/or very invasive, spread to adjacent organs
what is N0 stage of malignant neoplasms?
no lymph node involvement
what is N1 stage of malignant neoplasms?
nearby lymph node involvement
what is N2 stage of malignant neoplasms?
regional lymph node involvement
what is N3 stage of malignant neoplasms?
more distant lymph node involvement
what is M0 stage of malignant neoplasms?
no distant metastases
what is M1 stage of malignant neoplasms?
distant metastases present
what are the stages of dukes’ staging system for colorectal cancer?
A - confined to bowel
B - through bowel wall but no lymph node involvement
C - lymph nodes involved
D - distant spread
what types of tumours are benign epithelial tumours?
papillomas or adenomas
what type of tumours are malignant epithelial tumours?
carcinomas, adenocarcinomas
what type of tumours are malignant connective tissue tumours?
sarcomas
what are sarcomas?
malignant connective tissue tumours
what are carcinomas?
malignant epithelial tumours
what are papillomas or adenomas?
benign epithelial tumours
how are names of benign connective tissue tumours decided?
begin with term denoting cell of origin e.g. lipoma
what type of teratoma is almost always benign?
ovarian
what type of teratoma is more often malignant?
testicular
what are hallmarks of cancer?
- self-sufficiency in growth signals
- insensitivity to anti-growth signals
- tissue invasion & metastasis
- limitless replicative potential
- sustained angiogenesis
- evading apoptosis
what are features of a teratoma?
- contains elements of all 3 embryonic germ cell layers
- of germ cell origin
- benign and malignant forms
What is the aide memoire for tumours?
In - incidence
A - age
Surgeons - sex
Gown - geographical distrubution
Physicians - predisposing factors
May - macroscopic features
Make - microscopic features
Some - spread
Progress - prognosis
what are the names of benign and malignant tumours of squamous cell origin?
B - squamous cell papilloma
M - squamous cell carcinoma
what are the names of benign and malignant tumours of transitional cell origin?
B - transitional cell papilloma
M - transitional cell carcinoma
what are the names of benign and malignant tumours of basal cell origin?
B - basal cell papilloma
M - basal cell carcinoma
what are the names of benign and malignant tumours of glandular cell origin?
B - adenoma
M - adenocarcinoma
what are the names of benign and malignant tumours of smooth muscle origin?
B - leiomyoma
M - leiomyosarcoma
what are the names of benign and malignant tumours of striated muscle origin?
B - rhabdomyoma
M - rhabdomyosarcoma
what are the names of benign and malignant tumours of adipose tissue origin?
B - lipoma
M - liposarcoma
what are the names of benign and malignant tumours of blood vessel origin?
B - angioma
M - angiosarcoma
what are the names of benign and malignant tumours of bone origin?
B - osteoma
M - osteosarcoma
what are the names of benign and malignant tumours of cartilaginous origin?
B - chondroma
M - chondrosarcoma
what are the names of benign and malignant tumours of mesothelial origin?
B - benign mesothelioma
M - malignant mesothelioma
what are the names of benign and malignant tumours of synovial origin?
B - synovioma
M - synovial sarcoma
how many tumour cells can repopulate a tumour?
1 in 10^3 –10^4 cells
