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ESA2 - Pathological Processes > Neoplasia > Flashcards

Neoplasia Flashcards

1
Q

What is a neoplasm?

A

An abnormal growth of cells that persists after the initial stimulus is removed

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2
Q

What is the full definition of a malignant neoplasm?

A

An abnormal growth of cells that persists after the initial stimulus is removed AND invades surrounding tissue with potential to spread to distant sites

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3
Q

What is a tumour?

A

Any clinically detectable lump or swelling

A neoplasm is just one type of tumour

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4
Q

What is a cancer?

A

Any malignant neoplasm

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5
Q

What is a metastasis?

A

A malignant neoplasm that has spread from its original site to a new non-contiguous site

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6
Q

What is dysplasia?

A

A pre-neoplastic alteration in which cells show disordered tissue organisation - not neoplastic because the change is reversible

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7
Q

What is the difference between a benign and malignant neoplasm?

A

Benign neoplasms remain confined to their site of origin and do not produce metastases

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8
Q

How do benign and malignant neoplasms appear differently?

A

Benign tumours grow in a confined local area so have a pushing outer margin

Malignant tumours have an irregular outer margin and shape and may show areas of necrosis and ulceration

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9
Q

What is meant by the varying degrees of differentiation shown by neoplasms under the microscope?

A

A benign neoplasm has cells that closely resemble the parent tissue - well differentiated

Malignant neoplasms can range from well to poorly differentiated

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10
Q

What are cells with no resemblance to any tissue called?

A

Anaplastic

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11
Q

What is seen with worsening differentiation?

A

Individual cells have increasing nuclear size and nuclear to cytoplasmic ration

Hyperchromasia (increased nuclear staining)

More mitotic figures

Increasing variation in size and shape of cells and nuclei (pleomorphism)

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12
Q

What is used by clinicians to indicate differentiation?

A

Grade (high grade = poorly differentiated)

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13
Q

What is neoplasia caused by?

A

Accumulated mutations in somatic cells

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14
Q

What do the actions of initiators and promoters result in?

A

An expanded, monoclonal population of mutant cells

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15
Q

What is the process in which a neoplasm emerges from the monoclonal population of cells called?

A

Progression

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16
Q

How can a collection of cells be monoclonal?

A

If they all originated from a single founding cell

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17
Q

How do we know neoplasms are monoclonal?

A

Evidence from the study of the X linked gene for G6PD in tumour tissue from women

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18
Q

On what basis are neoplasms named?

A

Site of origin
Benign or malignant
Type f tissue the tumour forms
Gross morphology

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19
Q

What suffix do benign neoplasms end in?

A

-oma

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20
Q

What suffix do malignant neoplasms end in?

A

Carcinoma if epithelial

-sarcoma if stromal

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21
Q

What does it mean when a carcinoma is in-situ?

A

No invasion through epithelial basement membrane

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22
Q

What does it mean when a carcinoma is invasive?

A

Penetrated through basement membrane

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23
Q

What is leukaemia?

A

Malignant neoplasm of blood-forming cells arising in bone marrow

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24
Q

What are lymphomas?

A

Malignant neoplasms of lymphocytes

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25
Q

What is myeloma?

A

Malignant neoplasm of plasma cells

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26
Q

What do germ cell neoplasms arise from?

A

Pluripotent cells, mainly in testis or ovary

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27
Q

What do neuroendocrine tumours arise from?

A

Cells distributed throughout the body

28
Q

When are some neoplasms called -blastomas?

A

Mainly in children, formed from immature precursor cells

29
Q

What are some benign epithelial neoplasms?

A

Squamous papilloma, transitional cell papilloma, adenoma (eg adenomatous polyp of colon)

30
Q

What is an adenoma?

A

Benign tumour of epithelial tissue with glandular origin

31
Q

What are some malignant epithelial neoplasms?

A

Squamous cell carcinoma, transitional cell carcinoma, adenocarcinoma, basal cell carcinoma

32
Q

What is a benign neoplasm in smooth muscle called?

A

Leiomyoma

33
Q

What is a benign neoplasm in fibrous tissue called?

A

Fibroma

34
Q

What is a benign neoplasm in bone called?

A

Osteoma

35
Q

What is a benign neoplasm in fat called?

A

Lipoma

36
Q

What is a benign neoplasm in a nerve called?

A

Neuroma

37
Q

What is a benign neoplasm in a nerve sheath called?

A

Neurofibroma

38
Q

What is a benign neoplasm in glial cells called?

A

Glioma

39
Q

What is a malignant neoplasm in smooth muscle called?

A

Leiomyosarcoma

40
Q

What is a malignant neoplasm in bone called?

A

Osteosarcoma

41
Q

What is a malignant neoplasm in fibrous tissue called?

A

Fibrosarcoma

42
Q

What is a malignant neoplasm in cartilage called?

A

Chondrosarcoma

43
Q

What is a malignant neoplasm in fat called?

A

Liposarcoma

44
Q

What is a malignant neoplasm in glial cells called?

A

Malignant glioma

45
Q

What is a teratoma?

A

A teratoma is a tumor with tissue or organ components resembling normal derivatives of more than one germ layer

46
Q

What is a benign teratoma of the ovary called?

A

Dermoid cyst

47
Q

What is tumour burden?

A

Refers to the number of cancer cells, the size of a tumourr, or the amount of cancer in the body.

48
Q

What things lead to a greatly increased tumour burden?

A

The ability of malignant cells to invade and spread to distant sites

49
Q

What must malignant cells do to get from a primary site to a secondary site?

A

1) Grow and invade at the primary site
2) Enter a transport system and lodge at a secondary site
3) Grow at the secondary site to form a new tumour (colonisation)

50
Q

What does invasion into surrounding tissue by carcinoma cells require?

A

Altered adhesion, stromal proteolysis and motility

51
Q

What is epithelial to mesenchymal transition (EMT)?

A

The epithelial–mesenchymal transition (EMT) is a process by which epithelial cells lose their cell polarity and cell-cell adhesion, and gain migratory and invasive properties to become mesenchymal stem cells

52
Q

What does altered adhesion between malignant cells involve?

A

Reduction in E-cadherin expression

53
Q

What does altered adhesion between malignant cells and stromal proteins involve?

A

Changes in integrin expression

54
Q

What do the cells require to be able to degrade the basement membrane and stroma

A

Altered expression of proteases, notably maxtrix metalloproteinases (MMPs)

55
Q

What does altered motility of the malignant cells involve?

A

Changes in the actin cytoskeleton

56
Q

What are the three routes by which the malignant cells can reach distant sites?

A

1) Blood vessels via capillaries and venules
2) Lymphatic vessels
3) Fluid in body cavities, which is known as transcoelomic spread

57
Q

What is cancer dormancy?

A

Dormancy is a stage in cancer progression where the cells cease dividing but survive in a quiescent state while waiting for appropriate environmental conditions to begin proliferation again

58
Q

What does the site of a secondary neoplasm depend on?

A

1) Regional drainage of blood, lymph or coelomic fluid

2) The seed and soil phenomenon

59
Q

What do carcinomas typically spread to first?

A

Lymph nodes

60
Q

What are common sites of blood borne metastasis?

A

Lung, bone, liver and brain

61
Q

Which neoplasms most frequently spread to bone?

A

Breast, bronchus, kidney, thyroid and prostate

62
Q

How do sarcomas tend to spread?

A

Via blood stream

63
Q

What is an example of a neoplasm that metastasise early in their course?

A

Small cell bronchial carcinoma

64
Q

What is an example of a neoplasm that almost never metastasises?

A

Basal cell carcinoma of the skin

65
Q

What is the likelihood of metastasis related to?

A

Size of primary neoplasm

66
Q

What are some local effects of neoplasms?

A

1) Direct invasion and destruction of normal tissue
2) Ulceration at surface leading to bleeding
3) Compression of adjacent structures
4) Blocking tubes and orifices

67
Q

What are some systemic effects of neoplasms?

A

Reduced appetite and weight loss (cachexia), malaise, immunosuppression, thrombosis

ESA2 - Pathological Processes (9 decks)

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