18 - Characteristics of Tumours

Question 1

Histogenic classification

Answer 1

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

Question 2

Epithelial cell tumours

Answer 2

Carcinomas

Question 3

Connective tissue tumours

Answer 3

Sarcomas

Question 4

Lymphoid

Haematopoietic organs

Answer 4

Lymphomas/leukaemias

Question 5

Characterising tumours

Answer 5

Differentiation
Rate of growth
Local invasion
Metastasis

Question 6

Malignant tumours vs benign tumours growth wise

Answer 6

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

Question 7

differentiation definition

Answer 7

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

Question 8

benign tumour differentiation

Answer 8

usually well-differentiated and mitoses are rare

Question 9

malignant neoplasm differentiation

Answer 9

wide-range of parenchymal differentiation where most exhibit morphological alterations

Question 10

anaplasia

Answer 10

neoplasms comprised of poorly-differentiated cells are described as anaplastic

Question 11

differentiation - morphological changes

Answer 11

pleomorphism
abnormal nuclear morphology
mitoses
loss of polarity
other changes

Question 12

pleomorphism

Answer 12

variation in size or shape

Question 13

differentiation in abnormal cells

Answer 13

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

Variable nuclear shape
Chromatin distribution
Hyperchromatism
Abnormally large nuclei

Question 14

Mitoses in abnormal cells

Answer 14

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

Question 15

Loss of polarity means what

Answer 15

orientation of cells disturbed and there is disorganised growth

Question 16

Well differentiated means:

Answer 16

closely resembles origin tissue with little or no anaplasia

Mostly benign

Question 17

Moderately differentiated means:

Answer 17

somewhere inbetween

Question 18

poorly differentiated means:

Answer 18

little resemblance to tissue origin

highly anaplastic appearance

Question 19

undifferentiated / anaplastic

Answer 19

cannot be identified by morphology alone and needs molecular techniques

Question 20

Grading and differentiation

Answer 20

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

Question 21

Grading vs stage

Answer 21

Stage is a measure of prognostication / therapeutic decisions

Question 22

A change in function can be called a … syndrome

Answer 22

Paraneoplastic syndrome

Question 23

Bronchogenic carcinoma

Answer 23

Corticotrophin
Parathyroid-like hormone
Insulin
Glucagon
Others

Question 24

Benign tumours encapsulate… what does this mean

Answer 24

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.

Question 25

Pseudoencapsulation in malignant tumours

Answer 25

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

Question 26

methods of metastasis

Answer 26

direct seeding lymphatic spread haematogenous spread

Question 27

Direct seeding is

Answer 27

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

Question 28

most common spread of mets

Answer 28

lymphatic

Question 29

carcinomas spread by...

Answer 29

lymphatics

Question 30

sarcomas spread by...

Answer 30

haematogenous

Question 31

carcinoma vs sarcoma

Answer 31

sarcoma is for mesodermal tissue carcinoma is for epithelial tissue

Question 32

Sentinel node definition

Answer 32

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

Question 33

haematogenous spread features

Answer 33

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

Question 34

stroma definition

Answer 34

connective tissue framework that neoplastic cell are embedded in

Question 35

what does stroma supply

Answer 35

mechanical support intercellular signalling nutrition

Question 36

desmoplastic rxn

Answer 36

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

Question 37

Stroma contains:

Answer 37

cancer-associated fibroblasts myofibroblasts blood vessels lymphocytic infiltrate

Question 38

Cachexia

Answer 38

profound weight-loss despite apparent adequate nutrition tumour-derived humoral effects that interfere with protein metabolism

Question 39

Warburg effect

Answer 39

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