13 - Intro to Neoplasia

Question 1

Neoplasm

Answer 1

A disorder of cell growth that is triggered by a series of acquired mutations affecting a single cell and its clonal progeny.

Question 2

Oncology

Answer 2

Study of neoplasms

Question 3

Two components of all tumours

Answer 3

Parenchyma cells and Stroma cells

Question 4

Parenchyma cells

Answer 4

• The neoplastic cells that make up the tumour itself
• Classification based on this component
• Determines biological behaviour

Question 5

Stroma cells

Answer 5

• Connective tissue, vessels, inflammatory cells
• Influences the growth and spread

Question 6

Desmoplastic

Answer 6

Abundant collagenous stroma

Question 7

Benign tumours

Answer 7

• Will remain localised
• May be surgically removed
• Most patients survive
• Can cause morbidity and even death in some circumstances

Question 8

Nomenclature of mesenchymal neoplasms

Answer 8

Attach suffix ‘-oma’ to cell type of origin (e.g fibroma, chondroma)

Question 9

Adenoma

Answer 9

Benign epithelial neoplasm derived from glands

Question 10

Papilloma

Answer 10

Benign epithelial neoplasm comprised of finger-like projections

Question 11

Cystadenoma

Answer 11

Lesions that form cystic masses

Question 12

Polyp

Answer 12

macroscopically visible projection above a mucosal surface

Question 13

Malignant tumours

Answer 13

• Can invade and destroy adjacent structures, as well as spread to distant sites (metastasis).
• May lead to death

Question 14

Carcinomas

Answer 14

Malignant tumours arising from epithelial cells

Question 15

Adenocarcinoma

Answer 15

Malignant tumour arising from glandular tissue

Question 16

Squamous cell carcinoma

Answer 16

Malignant tumour arising from squamous epithelium

Question 17

Sarcomas

Answer 17

Malignant tumours arising from mesenchymal cells

Question 18

Leukaemia or lymphomas

Answer 18

Malignant tumours arising from blood forming cells

Question 19

Teratoma

Answer 19

• Contain mature cells from more than one germ layer
• Derives from totipotent germ cells in the gonads, or
  occasionally from embryonic rests in midline structures

Question 20

Macroscopic features of benign tumours

Answer 20

• Well circumscribed
• Even cut surface
• No necrosis or haemorrhage
• May compress surrounding
  structures, but no infiltration
• May have a capsule

Question 21

Microscopic features of benign tumours

Answer 21

• Well organised
• Similar appearance to normal tissue
• No cytological features of malignancy

Question 22

Macroscopic features of malignant tumours

Answer 22

• Irregular, infiltrative outline
• Necrosis and haemorrhage
• May invade adjacent structures

Question 23

Microscopic features of malignant tumours

Answer 23

• Disorganised architecture
• Nuclear pleomorphism (variation in size and shape)
• Increased nucleus to cytoplasm ratio
• Hyperchromasia (darkly staining)
• Mitosis
• Disorder, loss of polarity

Question 24

Dysplasia

Answer 24

• Disordered growth
• Typically encountered in epithelia
• Loss of differentiation
• Nuclear enlargement, hyperchromasia, pleomorphism

Question 25

Carcinoma in citu

Answer 25

- When the dysplastic changes are marked and involve the full thickness of the epithelium (without penetration of the basement membrane). - Considered to be a pre invasive neoplasm

Question 26

Invasive

Answer 26

Once the tumour cells breach the basement membrane

Question 27

Local invasion

Answer 27

- Growth of malignant tumours is accompanied by progressive infiltration, invasion and destruction of the surrounding tissue - They do not recognise anatomical boundaries, and may penetrate the wall of a visceral organ, or fungate through the surface of the skin

Question 28

Lymphatic spread

Answer 28

- Most common pathway for the initial metastasis - Sentinel lymph node analysis can be used to determine whether there is any lymphatic spread

Question 29

Sentinel lymph node

Answer 29

First node in a regional lymphatic basin that receives lymph flow from the primary tumour

Question 30

Haematogenous

Answer 30

- Spread of tumours via blood vessels - Liver and lungs are frequent sites for these deposits

Question 31

Seeding of body cavities and surfaces

Answer 31

- Peritoneal - Pleural - Pericardial - Subarachnoid

Question 32

Cancer grading

Answer 32

Describes the extent to which tumour cells resemble (or fail to resemble) their normal counterparts. Done under microscope by pathologist

Question 33

Cancer staging

Answer 33

Assessment of clinical gravity of disease. TNM staging

Question 34

TNM staging

Answer 34

- T: Tumour size and extent of spread - N: Nodal status (number, groups, size) - M: Metastasis

Question 35

Aetiology of neoplasms

Answer 35

- Genetic - Chemical - Hormonal - Irradiation - Ultraviolet light - Microbial organisms - Chronic diseases and ulcers - Immune system disorders

Question 36

How can geographical patterns effect neoplasias

Answer 36

Related to carcinogens (chemicals, viruses, alcohol, smoking, radiation, asbestos)