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1Principles of Biomedicine - MD1 > 92 - Neoplasia 1 > Flashcards

92 - Neoplasia 1 Flashcards

1
Q

Cancer deaths vs cardiovascular deaths in Australia

A

33% of deaths cardio, 30% are from malignancy per year.

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2
Q

Age group where most cancers are diagnosed

A

68% in people aged 60 and older.

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3
Q

Proportion of people over 85 diagnosed with cancer

A

1/2 males, 1/3 females.

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4
Q

Cancers accounting for over 60% of cancers diagnosed

A

Prostate, colorectal, breast, melanoma of the skin, lung

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5
Q

Most common cancers

A

Basal cell cancer, squamous cell carcinoma of the skin.

Very rarely lead to death. Not very aggressive.

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6
Q

Most common cancers in Australia

A

Basal cell cancer, squamous cell carcinoma of the skin.

Very rarely lead to death. Not very aggressive.

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7
Q

Neoplasia

A

Excessive and unregulated cell proliferation.

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8
Q 
Features of neoplasia
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A

1) Multistep process beginning in a single cell.
2) Aberrant genetic, epigenetic control mechanisms affecting cell cycle, apoptosis, DNA repair
3) Acquire other features that allow neoplastic growth to progress
4) Comprise neoplastic cells and reactive stroma.
5) Can be benign or malignant

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9
Q

Examples of cells in reactive stroma

A

Inflammatory cells, fibroblasts, blood vessels

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10
Q

Tumour

A

Any mass lesion. Commonly used to describe neoplastic lesions, but this is very broad.

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11
Q 
Characteristics of malignant cells
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A 
Sustaining proliferative signalling
Evade growth suppressors
Activating invasion and angiogenesis
Enabling replicative immortality
Inducing angiogenesis
Resisting cell death
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12
Q

Most common cancers in males and females

A

Prostate in males, breast in females.

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13
Q

Most common cancers in males and females in Victoria

A

Prostate in males, breast in females.

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14
Q

Leading causes of cancer death in males and females in Victoria

A

Lung cancer leading cause in both.

Prostate and breast are second-most.

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15
Q

Who diagnoses a cancer?

A

A pathologist.

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16
Q

Most common cancer globally

A

Lung

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17
Q

Why is liver cancer more common globally than in Australia?

A

Prevalence of hepatitis B and C

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18
Q 
Examples of paediatric cancers
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A

Certain leukaemias.
Neuroblastomas
Wilm’s tumour
Certain lymphonmas

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19
Q

What can paediatric cancers be referred to as?

A

Blastomas

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20
Q 
Features of benign cells 
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A 
• Local expansile, generally slow growth, often (not always) well circumscribed (+/-
encapsulated)
• Well differentiated cells
• Unable to metastasise
• Rarely life threatening
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21
Q 
Features of malignant cells
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A
  • Locally invasive, destructive growth, often (not always) poorly circumscribed
  • Frequently induce ‘desmoplasia’ in stroma as they invade
  • Sometimes necrosis: from tumour outgrowing blood supply
  • Variable differentiation: well, moderate, poor or anaplastic
  • Potential to metastasise: spread and grow at a site separate to the primary tumour
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22
Q

Ways in which tumours can metastasise

A
  • Lymphatic
  • Haematogenous
  • Transcoelomic
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23
Q

Most important features of malignant cells

A

Invasive, can metastasise

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24
Q

Transcoelomic

A

Metastasis via body cavities

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25
Q 
Features of benign cells 
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4
A
  • Local expansile, generally slow growth, often (not always) well circumscribed (+/- encapsulated - capsule not v common)
  • Well differentiated cells
  • Unable to metastasise
  • Rarely life threatening
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26
Q

Transcoelomic

A

Metastasis via body cavities

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27
Q 
Features of malignant cells
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3
4
A
  • Locally invasive, destructive growth, often (not always) poorly circumscribed
  • Frequently induce ‘desmoplasia’ in stroma as they invade
  • Sometimes necrosis: from tumour outgrowing blood supply
  • Variable differentiation: well, moderate, poor or anaplastic
  • Potential to metastasise: spread and grow at a site separate to the primary tumour
28
Q

Transcoelomic

A

Metastasis via body cavities

29
Q

Uncertain malignant potential/borderline

A

Neoplastic cells with an appearance betwween benign and malignant.
Often non-aggressive with a slow course, but can metastasise. Uncertain.
EG: In ovary

30
Q

One of the most common benign lesions

A

Leiomyoma.

Smooth muscle benign growth in the uterus.

31
Q

One of the most common benign lesions

A

Leiomyoma.

Smooth muscle benign growth in the uterus.

32
Q

Main route of cancer metastasis

A

Lymphatic.

Move to local lymph nodes. Often grow in the first lymph node in the lymphatic drainage pathway.

33
Q

Main route of cancer metastasis

A

Lymphatic.
Move to local lymph nodes. Often grow in the first lymph node in the lymphatic drainage pathway.
Can then get into the blood by draining from the lymph.

34
Q

Difference between tumour growth and metastasis

A

Metastasis must be tumour cells growing completely separately from the primary tumour.

35
Q 
Common sites of metastases
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A 
Local lymph nodes
Bone
Lung
Brain
Liver
36
Q 
Common sites of metastases
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5
A 
Local lymph nodes
Bone
Lung
Brain
Liver
37
Q

Common sites of distant metastases

A 
Bone
Lung
Brain
Liver
(local lymph node is not considered 'distant')
38
Q

Common sites of distant metastases

A 
Bone
Lung
Brain
Liver
(local lymph node is not considered 'distant')
39
Q

Name for metastasis in lung where there is a diffuse pattern of malignancies in the lung, from spreading through the lymph

A

Lymphangitis carcinomatosis

40
Q 
Cytological histopathological appearance of neoplasia 
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A

Larger nuclei
Pleomorphic nuclei
Coarser nuclear chromatin
Hyperchromatic nuclei (can be from extra copies of chromosomes, therefore stain more intensely with haemotoxylin)
Larger, more prominent nuclei
More mitotic activity, +/- abnormal mitotic figures.

41
Q

Mitotic figures

A

Evidence of cells about to divide

EG: Separate sets of chromosomes

42
Q

Desmoplastic stroma

A

Abnormal stroma in benign and malignant neoplastic lesions

43
Q

Desmoplastic stroma features

A

Many more fibroblasts, fibroblast proliferation
Many more inflammatory cells
More collagen deposition
Contributes to tumour firmness

44
Q

What contributes to the firmness of a tumour?

A

Desmoplastic stroma

45
Q

How can malignant cell lineage be determined?

A

Histologically, by looking at the phenotype of the cells. Often resembles that of the cells where malignancy originated

46
Q

Features of glandular cell-lineage malignancies
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3

A

Form a lumen.
Signet ring cells
Formation of mucin

47
Q

Signet ring cells

A

Cells with mucus within the cells.

Classical of EG: cancers from stomach cells

48
Q 
Features of squamous cell-lineage malignancies
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A

Show features of stratified squamous epithelium.
Eosinophilic cytoplasm
Intercellular bridges (spikes of cytoplasm between cells, where desmosomes hold cells together).
Keratinisation.

49
Q

How does keratinisation appear histologically?

A

A swirl of anucleate cells (circular)

50
Q

Features of smooth muscle cell-lineage malignancies
1
2

A

Elongated nuclei, with rounded ends.

Looks like smooth muscle

51
Q

Differential diagnosis of a mass lesion

A

Neoplastic or non-neoplastic?
If neoplastic: Benign or malignant?
Type: mesenchymal, epithelial, etc
If malignant: primary or metastatic?

52
Q 
Differential diagnosis of a mass lesion
1
2
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4
A

Neoplastic or non-neoplastic?
If neoplastic: Benign or malignant?
Type: mesenchymal, epithelial, etc
If malignant: primary or metastatic?

53
Q

Clinical course of action if there is a suspected malignancy

A

Biopsy

54
Q 
Things that a pathologist looks for in a biopsy of a possible malignancy
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A

Cytological features
Architecture +/- necrosis
Stroma
Cell lineage

55
Q

Prefixes in cancer naming

A
  • Adeno: glandular
  • Squamous cell
  • Leiomyo: smooth muscle
  • Osteo: osteobastic (osteoid forming)
56
Q

Suffixes in cancer naming

A

• Benign: -oma
• Malignant:
– Carcinoma: epithelial
– Sarcoma: mesenchymal

57
Q

Suffixes in cancer naming

A

• Benign: -oma
• Malignant:
– Carcinoma: epithelial
– Sarcoma: mesenchymal

58
Q

Seminoma

A

A malignant testicular lesion (breaks rule of -oma for a benign lesion)

59
Q

What does the ‘grade’ of a cancer refer to?

A

Degree of differentiation

60
Q

Features of well-differentiated lesions
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3

A

• More closely resemble mature cells
• Less cytologic atypia (smaller more uniform nuclei, inconspicuous nucleoli), less
mitotic activity
• Architecturally more organised

61
Q

Features of poorly-differentiated lesions
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3

A

• Poorly resemble mature cells
• More cytologic atypia (enlarged pleomorphic nuclei, prominent nucleoli, nuclear
hyperchromasia or coarse nuclear chromatin), more mitotic activity +/- atypical
mitoses
• Architecturallly less organised

62
Q

What does the ‘grade’ of a malignant tumour refer to?

A

Degree of differentiation

63
Q

Well-differentiated vs poorly-differentiated malignancies

A

Well-differentiated are less-aggressive than poorly-differentiated (in general)

64
Q

Example of poorly-differentiated vs well-differentiated malignancies

A

Well-diff adenocarcinoma will have lumens, as is a glandular cancer. Loses these as it becomes less diff.

Well-diff squamous cell carcinoma has keratinisation.

More atypia in poorly-differentiated nuclei

65
Q

Example of poorly-differentiated vs well-differentiated malignancies
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3

A

Well-diff adenocarcinoma will have lumens, as is a glandular cancer. Loses these as it becomes less diff.

Well-diff squamous cell carcinoma has keratinisation.

More atypia in poorly-differentiated nuclei

66
Q

Which cell types do malignancies arise from?

A

Potentially adult stem cells.

67
Q

Which cell types do malignancies arise from?

A

Potentially adult stem cells.

1Principles of Biomedicine - MD1 (157 decks)

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