Cellular Pathology of Cancer

Question 1

Define Metaplasia.

Answer 1

A reversible change in which one adult cell type (usually epithelial) is replaced by another adult cell type

Question 2

Give two examples of metaplasia, one pathological and one physiological.

Answer 2

Barrett’s Oesophagus – gastro-oesophageal reflux can change the stratified squamous epithelium of the distal oesophagus to simple columnar
Cervix during pregnancy – the cervix opens up and the columnar epithelium of the endocervical canal is exposed to the acidic uterine fluids making it squamous

Question 3

What are the two types of metaplasia that can take place in Barrett’s Oesophagus?

Answer 3

Gastric metaplasia – stratified squamous to simple columnar

Intestinal metaplasia – goblet cells begin to appear

Question 4

State some features of cancer that are seen in dysplasia.

Answer 4

loss of architectural orientation
loss in uniformity of individual cells
nuclei: hyperchromatic (dark nuclei), enlarged, increased nucleus:cytoplasmic ratio
mitotic figures: abundant, abnormal, in places where not usually found

Question 5

What is the difference between low and high-grade dysplasia?

Answer 5

They both show changes of dysplasia but the changes are more severe in high-grade dysplasia
High-grade has a high risk of progression to cancer and has a lower chance of reversal

Question 6

What are the main features of benign tumours that separate them from malignant tumours?

Answer 6

They do not metastasise
They do not invade
They also are usually encapsulated (except for fibroids in the uterus), slow growing and have normal mitoses

Question 7

Under what conditions can benign tumours be dangerous?

Answer 7

If they are in a dangerous location  
If they secrete something dangerous  
If they get infected  
If they bleed  
If they rupture  
If they become twisted

Question 8

What are the features of malignant tumours?

Answer 8

Invade surrounding tissues
Spread to distant sites
They also have no capsule, can be well or poorly differentiated, rapidly growing and have abnormal mitoses

Question 9

Define metastasis.

Answer 9

A discontinuous growing colony of tumour cells, at some distance from the primary cancer

Question 10

What are the two different types of benign epithelial tumour?

Answer 10

Papilloma – of the surface epithelium

Adenoma – of glandular epithelium

Question 11

Define carcinoma.

Answer 11

Malignant tumour derived from the epithelium

Question 12

What are the different types of carcinoma?

Answer 12

Basal cell carcinoma (skin)
Squamous cell carcinoma
Transitional cell carcinoma (transitional epithelium is found in the bladder)
Adenocarcinoma

Question 13

State some different types of benign soft tissue tumour.

Answer 13

soft tissue = of mesodermal origin. can be pretty much used interchangeably with connective tissue
Osteoma –bone
Lipoma - fat
Leiomyoma – smooth muscle

Question 14

Define sarcoma.

Answer 14

Malignant tumour derived from connective tissue (mesenchymal) cells

Question 15

What are the names given to malignant tumours of striated muscle, smooth muscle and the nerve sheath?

Answer 15

Striated muscle – rhabdomyosarcoma rhabdo= rod shaped
Smooth muscle – leiomyosarcoma leio=smooth
Nerve sheath – Malignant peripheral nerve sheath tumour

Question 16

Define leukaemia.

Answer 16

Malignant tumour of bone marrow derived cells, which circulate in the blood

Question 17

Define lymphoma.

Answer 17

Malignant tumour of lymphocytes (usually) in lymph nodes

Question 18

Define teratoma.

Answer 18

A tumour derived from germ cells, which has the potential to develop into tumours of all three germ layers

Question 19

What is an important difference between teratomas in men compared to women?

Answer 19

Gonadal teratomas in men are almost always malignant

Gonadal teratomas in women are almost always benign

Question 20

Define hamartoma.

Answer 20

Localised overgrowth of cells and tissue native to the organ (these are NOT neoplasms)
In other words, the cells and tissues present are appropriate for that particular location but their structural organisation is inappropriate

Question 21

Which group of the population is hamartoma common in?

Answer 21

It is common in children and the hamartoma usually stops growing when the children stop growing

Question 22

What is the difference between grading and staging?

Answer 22

Grading – how well differentiated the cancer is
Staging – how far the cancer has spread
Staging > Grading

Question 23

The grade of a tumour describes its degree of differentiation, what does ‘degree of differentiation’ mean?

Answer 23

The grade of a tumour describes its degree of differentiation (how much does it look like the normal cell/tissue)

Question 24

What are the grading systems for breast and prostate cancer?

Answer 24

Breast –Nottingham scoring system

Prostate – Gleason classification

Question 25

What is the term given to a MALIGNANT tumours that show little or no differentiation?

Answer 25

Anaplastic