Benign and Malignant disease

Question 1

In adult tissues what is the size of the cell population determined by?

Answer 1

rates of cell proliferation, differentiation and death by apoptosis

Question 2

what is apoptosis?

Answer 2

pre programmed cell death

Question 3

what is the balance in tissue homeostasis?

Answer 3

cell division and cell loss

Question 4

what can alter cell numbers?

Answer 4

rates of stem cell input
cell death by apoptosis
changes in rate of proliferation or differentiation

Question 5

what controls cell cycle?

Answer 5

stimulators and inhibitors

Question 6

in terms of cell cycle, what can result in growth?

Answer 6

shortening cell cycle time
recruiting cells from resting or quiescent population

Question 7

what type of cells are terminally differentiated?

Answer 7

monocytes

Question 8

what does terminally differentiated mean?

Answer 8

not capable of replicating

Question 9

what does quiescent mean?

Answer 9

state of dormancy/ inactivity

Question 10

where would you find quiescent cells that can proliferate when needed?

Answer 10

liver/ kidney

Question 11

where would you find terminally differentiated cells that may be replaced by new cells arising from stem cells?

Answer 11

epithelia of oral cavity, gut and skin

Question 12

what act as inhibitors of apoptosis?

Answer 12

growth factors
cell matrix components
viral proteins

Question 13

what acts as inducers of apoptosis?

Answer 13

withdrawal of GF
loss of matrix attachment
viruses
free radicals
ionising radiation
DNA damage
Fas ligand/ CD95 interaction

Question 14

what are molecular mediators and regulators of apoptosis?

Answer 14

extrinsic pathway
intrinsic pathway
caspases - cascade
p53

Question 15

What is the extrinsic pathway in mediation of apoptosis?

Answer 15

death receptors e.g., CD95/ Fas Ligand

Question 16

what is the intrinsic pathway in molecular mediation of apoptosis?

Answer 16

increased mitochondrial activity
Bcl-2 family
cytochrome c/ Apaf-1
can induce OR inhibit

Question 17

what can be a result of increased apoptosis?

Answer 17

AIDS
neurodegenerative disorders
reperfusion injury

Question 18

what can be a result of decreased apoptosis?

Answer 18

neoplasia
auto-immune disease

Question 19

what is neoplasia?

Answer 19

tumour

Question 20

what is an increase in cell size?

Answer 20

hypertrophy

Question 21

where may hypertrophy occur?

Answer 21

skeletal and cardiac muscle

Question 22

what is an increase in cell number?

Answer 22

hyperplasia

Question 23

where may hyperplasia occur?

Answer 23

hormonally sensitive organs - endometrium, breast, thyroid

Question 24

how may you see hyperplasia in the mouth?

Answer 24

hyperplastic responses within epithelium and underlying connective tissue - enlargement of gingival tissues

Question 25

what is the reduction in cell size by loss of cell substance?

Answer 25

atrophy

Question 26

what are causes of atrophy?

Answer 26

ageing lack of use/ stimulation mechanical functional

Question 27

what is the reduction in size of an organ that never fully developed to normal size?

Answer 27

hypoplasia

Question 28

what is the reversible change in which one adult cell type is replaced by another adult cell type?

Answer 28

metaplasia

Question 29

when may you find metaplasia?

Answer 29

part of adaptive response to stress reprogramming of stem cells e.g., Barett's oesophagus, Bronchus, Salivary ducts (siametaplasia)

Question 30

in what way may metaplasia manifest as dysplasia and progress to malignancy?

Answer 30

environmental changes persisting

Question 31

what disorders of growth and neoplasia are irreversible?

Answer 31

hypoplasia

Question 32

what is dysplasia in general terms?

Answer 32

abnormal growth

Question 33

what are examples of types of dysplasia?

Answer 33

congenital hip dysplasia fibrous dysplasia epithelial dysplasia

Question 34

what tissues is dysplasia commonly found in?

Answer 34

squamous e.g., mouth glandular

Question 35

what do cells show during pre-invasive dysplasia?

Answer 35

abnormal features that are also seen in cancer cells these abnormal cells remain within the epithelium

Question 36

what is neoplasia in general terms?

Answer 36

new growth

Question 37

what results in neoplasia?

Answer 37

aberration of the normal mechanisms that control cell number - cell production by cell division - cell loss by apoptosis

Question 38

what does monoclonal mean?

Answer 38

the cells in a tumour appear to arise from one parent cell which has undergone a genetic change

Question 39

why do tumour clones expand?

Answer 39

tumour cells lack the normal control mechanisms expansion due to uncontrolled profileration

Question 40

what are the classifications of tomours?

Answer 40

behaviour - benign and malignant histogenesis

Question 41

what are features of benign tumours?

Answer 41

histology - resembles tissue of origin nuclei - small, regular, uniform mitoses - few, normal

Question 42

what is pleomorphic adenoma?

Answer 42

common benign salivary gland neoplasm

Question 43

compare the growth pattern of benign and malignant tumours?

Answer 43

benign - expand and remain localised, well-circumscribed, often encapsulated malignant - infiltrate locally, metastasize

Question 44

compare the growth rate of benign and malignant tumours?

Answer 44

benign - slower malignant - faster

Question 45

compare the clinical effects of benign and malignant tumours?

Answer 45

benign - local pressure effects; hormone secretions malignant - local pressure and destruction, inappropriate hormone secretion, distant metastases

Question 46

compare the treatment of benign and malignant tumours?

Answer 46

benign - local excision malignant - excision +/- additional therapy

Question 47

what are the features of malignant tumours?

Answer 47

histology - variable, may differ from tissue of origin nuclei - larger, pleomorphic mitoses - increased, often numerous, abnormal forms

Question 48

what does a pleomorphic adenoma become if it progresses to be malignant?

Answer 48

carcinoma ex pleomorphic adenoma

Question 49

why must be have a prognosis?

Answer 49

prediction of the probable course and outcome of disease appropriate treatment and estimate survival

Question 50

what does a cancer prognosis consist of?

Answer 50

tumour type tumour grade tumour stage - histology, clinical, radiological other parameters - patient, tumour

Question 51

how does an adenoid cystic carcinoma of salivary gland spread?

Answer 51

perineurally

Question 52

what disorder can adenoid cystic carcinoma of salivary gland result in?

Answer 52

CNV11 palsy

Question 53

how is tumour graded?

Answer 53

how well differentiated the tumour cells are

Question 54

how are tumours staged?

Answer 54

anatomical extent of disease - clinical - radiological - pathological findings

Question 55

what is used to stage tumours?

Answer 55

TNM classification of malignant tumours

Question 56

what are the components of the TNM classification of malignant tumours?

Answer 56

T - extent of primary tumour N - absence or presence and extent of regional lymph node metastasis M - described the absence or presence of distant metastasis

Question 57

what is the relation between tumour stage and prognosis?

Answer 57

higher stage = poorer prognosis