18 Characteristics of tumours

Question 1

Define cancer:

Answer 1

Uncontrolled growth of cells which invade and spread to distant sites of the body.

Question 2

Define tumour/neoplasia:

Answer 2

Lesion resulting from autonomous growth of cells that persists in the absence of an initiating stimulus.

Question 3

Define histogenesis:

Answer 3

The differentiation of cells into specialised tissue and organs during growth from undifferentiated cells.

Question 4

From most to least, which cancers are most common in men? (3).

Answer 4

Prostate.
Lung.
Colon and rectum.

Question 5

From most to least, which cancers are most common in women? (3).

Answer 5

Breast.
Lung.
Colon and rectum.

Question 6

From most to least, which cancers are most fatal in women? (3).

Answer 6

Lung.
Breast.
Colon and rectum.

Question 7

From most to least, which cancers are most fatal in men? (3).

Answer 7

Lung.
Prostate.
Colon and rectum.

Question 8

How are tumours characterised? (4).

Answer 8

Differentiation.
Rate of growth.
Local invasion.
Metastasis.

Question 9

Define differentiation.

Answer 9

The extent t neoplastic cells resemble the normal parenchymal cells, morphologically and functionally.

Question 10

Define anaplasia:

Answer 10

Neoplasm that consists of poorly differentiated cells - hallmark of malignancy.

Question 11

What morphological changes are seen in malignancy? (4).

Answer 11

Pleomorphism.
Abnormal nuclear morphology.
Mitoses.
Loss of polarity.

Question 12

Define pleomorphism:

Answer 12

Variation in size and shape.

Question 13

Give examples of abnormal nuclear morphology: (5).

Answer 13

High nucleus:cytoplasm ration.
Variability in nuclear shape.
Chromatin distribution: clumped/lining outside.
Hyperchromatism.
Large nucleoli.

Question 14

Name three atypical mitotic figures seen in malignancy.

Answer 14

Tripolar.
Quadripolar.
Multipolar spindles.

Question 15

What does the grade of a tumour measure?

Answer 15

Level of differentiation.

Well diff = low grade.

Question 16

Name four hormones produced by bronchogenic carcinoma:

Answer 16

Corticotrophin.
Parathyroid-like hormone.
Insulin.
Glucagon.

Question 17

Why can benign tumours not invade to neighbouring tissue?

Answer 17

Encapsulated by fibrous tissue.

Rim of extracellular matrix deposited by stroll cells in response to hypoxia from tissue pressure.

Question 18

What is pseudo encapsulation?

Answer 18

Malignant tumours that look encapsulated. Microscopic exam shows infiltration.

Question 19

Define metasasis:

Answer 19

Spread of tumour to sites physically discontinuous with primary tumour.

Question 20

What is metastasis generally correlated with? (4).

Answer 20

Lack of differentiation.
Local invasion.
Rapid growth.
Large size.

Question 21

Define direct seeding:

Answer 21

Tumour penetrates natural open field.

Question 22

What is the most common way for tumours to spread?

Answer 22

Via lymphatic system.

Question 23

What is the pattern of breast carcinoma spread?

Answer 23

Presents in upper outer quadrant.

Disseminates to axillary, then infraclavicular, then supraclavicular lymph nodes.

Question 24

Define sentinel node:

Answer 24

The first node in a regional lymphatic basin that receives lymph flow from the primary tumour.

Question 25

Why does cancer cause reactive change in sentinel lymph nodes?

Answer 25

Drainage of tumour cell debris and tumour antigens.

Question 26

What is haematogenous spread typically seen in?

Answer 26

Sarcomas (also seen in carcinoma).

Question 27

Define stroma:

Answer 27

Connective tissue network that neoplastic cells are embedded in.

Question 28

What is a desmoplastic reaction?

Answer 28

Tumour cell derived growth factors induce connective tissue fibroblast proliferation. Causes formation of fibrous stroma.

Question 29

What are the local complications of a tumour?

Answer 29

Compression.

Destruction due to invasion.

Question 30

What are the metabolic complications of tumours? (5).

Answer 30

Cachexia.
Warburg effect.
Neuropathies.
Myopathies.
Venous thrombosis.

Question 31

What is cachexia and why does it occur in cancer?

Answer 31

Profound weight loss despite seemingly adequate nutrition.

Tumour derived humour effects that affect protein metabolism.

Question 32

What is the Warburg effect?

Clinical usage?

Answer 32

Tumours produced high rate of energy by glycolysis and fermentation of lactic acid.
Used in PET scans with FDG uptake.