18 - Characteristics of Tumours Flashcards Preview

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Flashcards in 18 - Characteristics of Tumours Deck (39):
1

Histogenic classification

Classification of the tumour by the specific cell or tissue of origin

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Epithelial cell tumours

Carcinomas

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Connective tissue tumours

Sarcomas

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Lymphoid
Haematopoietic organs

Lymphomas/leukaemias

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Characterising tumours

Differentiation
Rate of growth
Local invasion
Metastasis

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Malignant tumours vs benign tumours growth wise

malignant tumours tend to grow more rapidly than benign tumours but many exceptions to this

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differentiation definition

the extent that neoplastic cells resemble the corresponding normal parenchymal cells, morphologically and functionally

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benign tumour differentiation

usually well-differentiated and mitoses are rare

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malignant neoplasm differentiation

wide-range of parenchymal differentiation where most exhibit morphological alterations

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anaplasia

neoplasms comprised of poorly-differentiated cells are described as anaplastic

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differentiation - morphological changes

pleomorphism
abnormal nuclear morphology
mitoses
loss of polarity
other changes

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pleomorphism

variation in size or shape

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differentiation in abnormal cells

nuclear appear too large e.g. nuclear:cytoplasm ratio of 1:1 vs 1:6

Variable nuclear shape
Chromatin distribution
Hyperchromatism
Abnormally large nuclei

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Mitoses in abnormal cells

An indication of proliferation
Seen in normal tissues with rapid turnover and in hyperplasias but weird mitosis can occur in malignant cells e.g. multipolar, trikaryokinesis

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Loss of polarity means what

orientation of cells disturbed and there is disorganised growth

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Well differentiated means:

closely resembles origin tissue with little or no anaplasia

Mostly benign

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Moderately differentiated means:

somewhere inbetween

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poorly differentiated means:

little resemblance to tissue origin
highly anaplastic appearance

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undifferentiated / anaplastic

cannot be identified by morphology alone and needs molecular techniques

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Grading and differentiation

Well differentiated = low/one
Moderately = intermediate/two
Poorly = high/three

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Grading vs stage

Stage is a measure of prognostication / therapeutic decisions

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A change in function can be called a ... syndrome

Paraneoplastic syndrome

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Bronchogenic carcinoma

Corticotrophin
Parathyroid-like hormone
Insulin
Glucagon
Others

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Benign tumours encapsulate... what does this mean

rim of compressed fibrous tissue around the outside.

ECM (extracellular matrix) deposited by stromal cells activated by hypoxia from pressure of tumour

The tissue plane is: discrete, moveable, easily palpable and easily excised.

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Pseudoencapsulation in malignant tumours

usually slow-growing but, microscopically, shows rows of cells penetrating margin

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methods of metastasis

direct seeding
lymphatic spread
haematogenous spread

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Direct seeding is

neoplasm penetrating a natural open field w/o physical barriers e.g. subarachnoid

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most common spread of mets

lymphatic

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carcinomas spread by...

lymphatics

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sarcomas spread by...

haematogenous

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carcinoma vs sarcoma

sarcoma is for mesodermal tissue

carcinoma is for epithelial tissue

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Sentinel node definition

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

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haematogenous spread features

typical of sarcomas

veins are more easily penetrated - thinner walls

bloodbourne cells follow the venous flow draining site of the neoplasm - rests in first encountered capillary bed

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stroma definition

connective tissue framework that neoplastic cell are embedded in

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what does stroma supply

mechanical support
intercellular signalling
nutrition

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desmoplastic rxn

fibrous stroma formation due to induction of connective tissue fibroblast proliferation by growth factors from the tumour cells

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Stroma contains:

cancer-associated fibroblasts
myofibroblasts
blood vessels
lymphocytic infiltrate

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Cachexia

profound weight-loss despite apparent adequate nutrition

tumour-derived humoral effects that interfere with protein metabolism

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Warburg effect

Produces energy by high rate of glycolysis with fermentation of lactic acid. This is what is imaged in PET scan