Week 4 - Neoplasia Flashcards
Pathology
Science of disease
What is the mnemonic for the surgical sieve
VITAMIN CDEF (different types of pathology)
vascular
inflammation
trauma
autoimmune
metabolic
iatrogenic
neoplastic
congenital
degenerative
endocrine
functional
3 types of pathology specific investigations
Cytology sampling (study of individual cells) - fluid sampling, fine needle aspiration
Tissue sampling - biopsy or resection
Immunohistochemistry/genetic profiling
What is neoplasia
An excessive, irreversible and uncontrolled growth which persists even after withdrawal of the stimuli that caused it
What happens when cells are under stress
They undergo changes to help respond to this stress
What is hyperplasia
Increase in cell number
What is hypertrophy
Increase in cell size
What is atrophy
Reduction in cell size
What is metaplasia
Change from one cell type to another
What is the name for programmed cell death
apoptosis
What is the name for uncontrolled cell death
Necrosis
When is inflammation initiated
They ‘clean up’ after cell death
7 features of benign disease
Not invasive
Slow growing
Damage at local level
Few cell division
Regular nuclei
Resemble the tissue of origin
Well encapsulated
How can be identify cancerous cells in terms of h&e colours
Cancerous = very purple since chromosome condenses
What is dysplasia
Abnormal structure due to a failure of differentiation contributing to:
Disordered architecture of tissue
Disordered cellular features - PLEOMORPHISM (able to assume different shapes and sizes) nuclei e.g cells with massive nuclei
Mitotic figures (able to see irregular mitotic division is happening) e.g spindle fibres coming from 3 poles
6 features of malignant cancer
Invasive
Grows fast
Shows features of dysplasia
Can metastasise
Damage at local OR distant sites
Does NOT resemble site of origin
3 ways in which cancer can metastasise
Lymphatics
Through blood
Transcoelomic
What do we call cancer that have metastasised so we cannot easily identify the site the cancer originated in
Cancer of unknown primary
What is the ending of benign epithelial neoplasms
-oma
What is the ending of a malignant epithelial neoplasm
-carcinoma
What is the ending of benign connective tissue neoplasms
-oma
What is the ending of malignant connective tissue
-sarcoma
How are HER2 breast cancers tested
Using immunohistochemistry
Microsatellite instability
MSI occurs when there is a failure to repair damaged DNA in the cell cycle
How are neoplasms graded
how closely the neoplasm corresponds with the normal cells for that tissue - the more dysplastic the cells are, the higher the grade
How are neoplasms given ‘stages’
Based on how far the neoplasm has spread through the body
TNM classification of staging
Tumour - measures local invasion
Node - measures spread to the lymph node
Metastasis - measures spread to distant tissues
Example of cellular atrophy
Reduction in brain size - brain becomes shrunken (membrane lines more visible, with fewer material in between)
Example of cellular hyperplasia
Endometrium can become too thick
Example of cellular hypertrophy
Skeletal muscle hypertrophy following exercise
Example of cellular metaplasia
Barrett’s oesophagus stratified squamous epithelium becomes like cells found in the intestine
Pleomorphism
cells with disrupted structures e.g massive nucleus
What is anaplasia
Poorly differentiated cells so can’t trace the cancerous cells to their origin
Mitotic figures
Atypical mitosis e.g spindle fibres coming from 3 poles
Which type of cancer will less likely become dysplastic or metastasise
Benign cancer
Difference between invasion and metastasis
Invasion is spread within the region of the original site whereas metastasis is when cancer spreads to a distinctly different site
Example of symptoms due to metastasis
Lung cancer causing deposits in the liver, causing abdomen pain
Example of a systemic symptom of cancer
Weight loss
Explain how a failure of p53 could cause cancer
If p53 can’t arrest the cell cycle to check for DNA damage, cells with mutated DNA will be able to replicate uncontrolled
These mutations confer a higher risk of dysplastic cells and then malignancy secondary to uncontrolled and unregulated cell division
