Benign And Malignant Tumours Flashcards

(30 cards)

1
Q

Definition of a tumour

A

Any abnormal swelling e.g. neoplasm, inflammation, hypertrophy, hyperplasia
All neoplasm are tumours but not all tumours are neoplasms

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2
Q

Definition of a neoplasm

A

A lesion resulting from the AUTONOMOUS or relatively autonomous ABNORMAL growth of cells which PERSISTS after the initiating stimulus has been removed
A new and abnormal growth of tissue in a part of the body, especially as a characteristic of cancer

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3
Q

Summary of neoplasms

A

Autonomous, abnormal persist at new growths
Common
High mortality
Benign -> malignant
Tumour cells and stroma
Angiogenesis essential to growth

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4
Q

Behavioural classification of neoplasms

A

Benign
Borderline
Malignant

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5
Q

Behavioural characteristics of benign neoplasms

A

E.g. Tubulovillous adenoma
Localised (no BM invasion)
Slow growing
Well circumscribed
EXOPHYTIC (outward growth)
Rare ulceration + necrosis
Close resemblance to normal tissue
They can cause morbidity and mortality
- pressure on adjacent structures
- obstruct flow
- production of hormones
- transformation to malignant neoplasm
- anxiety

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6
Q

Behavioural characteristics of malignant neoplasms

A

E.g prostate cancers, squamous cell carcinoma
BM invading
V.fast mitotic growth - HYPERDENSE NUCLEI
Poor circumscription
ENDOPHYTIC - inward growing
Common necrosis + ulceration
Poorly differentiated
Can cause morbidity or mortality
- destruction of adjacent tissue
- pressure on structures
- metastasis
- blood loss from ulcers
- obstruction of flow
- hormone production
- paraneoplastic effects (SIADH, Cushings)
- anxiety and pain

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7
Q

Where may neoplasia arise from + general naming rule?

A

Epithelial cells
- non glandular benign = PAPILLOMA
- non glandular malignant = CARCINOMA
- glandular benign = ADENOMA
- glandular malignant = ADENOCARCINOMA
Connective tissue
- SARCOMA
Lymphoid/haematopoietic organs
- leukemia, lymphoma (always malignant)
= All neoplasm have the suffix ‘oma’
= prefix depending on behavioural classification and cell type

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8
Q

Benign epithelial neoplasm nomenclature

A

Prefix with cell type of origin
- papilloma + cell type of origin = squamous cell papilloma
- adenoma + cell type or origin = thyroid adenoma

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9
Q

Papilloma definition

A

Benign tumour of non-glandular, non-secretory epithelium

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10
Q

Adenoma defintion

A

Benign tumour of glandular or secretory epithelium

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11
Q

Malignant epithelium neoplasm nomenclature

A

Carcinoma + epithelial cell type = transitional cell carcinoma
Carcinomas of glandular epithelium = adenocarcinoma

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12
Q

Carcinoma defintion

A

Malignant tumour of epithelial cells

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13
Q

Benign connective tissue neoplasms nomenclature

  • adipocytes
  • cartilage
  • bone
  • vascular
  • muscle, smooth
  • muscle, striated
A

Named according to cell of origin -suffix by ‘oma’
Lipoma - adipocytes
Chondroma - cartilage
Osteomalacia - bone
Angioma - vascular
Leiomyoma - muscle, smooth
Rhabdomyoma - muscle, striated

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14
Q

Malignant connective tissue neoplasms

  • adipose tissue
  • striated muscles
  • smooth muscles
  • bone cartilage
  • bone
  • blood vessels
A

Sarcoma prefixed by cell type of origin
Liposarcoma - adipose tissue
Rhabdomyoscarcoma - striated muscles
Leiomyosarcoma - smooth muscles
Chondrosarcoma - bone cartilage
Osteosarcoma - bone
Angiosarcoma - blood vessels

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15
Q

How are carcinomas and sarcomas classified?

A

According to degree of differentiation - the less differentiated they are the higher the grade

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16
Q

Exceptions to the rule: not all ‘-omas’ are neoplasms

A

Granuloma,
Tuberculoma

17
Q

Exceptions of the rule: Not all malignant tumours are carcinoma or sarcoma

A

Melanoma - malignant neoplasms of melanocytes
Mesothelioma - malignant tumour of mesothelial cells
Lymphoma - malignant neoplasm of lymphoid cells

18
Q

Exceptions of the rule: eponymously named tumours

A

Burkitt’s lymphoma - B cell malignancy caused by EBV
Ewing’s sarcoma - bone malignancy
Grawitz tumour
Kaposi’s sarcoma - vascular endothelial malignancy HIV associated

19
Q

Exclusion of neoplasm: teratoma

A

Neoplasm containing tissues from all 3 embryological layers

20
Q

Tumours graded based on similarity to parent cell

A

Well differentiated (>75% cells resemble parent)
10-75%
Poorly differentiated (<10% cells resemble parent)

21
Q

Characteristics of the neoplastic cell

A

Autocrine growth stimulation = over expression of GF and mutation of tumour suppressor genes e.g p53 and under expression of growth inhibitors
Evasion of apoptosis
Telomerase = prevents telomeres shortening with each replication (this normally rate limits the extent of mitosis a single cell can undergo)
Sustained angiogenesis + ability to invade BM

22
Q

Classes of carcinogenesis (cancer-causing agents)

A

Chemical - e.g. paints, dyes, rubber, soot
Viruses - EBV (Burkitts), HPV (cervical cancer)
Ionising + Non ionising radiation - UVB in skin cancer, ionising is lots
Hormones, parasites, mycotoxins - e.g. increased oestrogen implicated in breast cancer
Misc e.g Asbestos

23
Q

Germ line vs somatic mutations

A

Germ line = mutated ORIGINAL GERM CELL = will pass onto next gen
Somatic = mutated MITOTIC COPY OF GERM CELL = wont pass to next gen

24
Q

Pathway of metastasis

A
  1. Detachment (from 1’)
  2. Invasion of other tissues
  3. Invasion of BV
  4. Evasion of host defence, ADHERENCE of BV wall
  5. Extravasation to distant site
25
Methods of spread
HAEMATOGENOUS = via blood = bone, breast, lung, liver - 5 main mets to bone = BLT KP = breast, lung, thyroid, kidney, prostate LYMPHATIC = 2’ formation in lymph nodes e.g. lymphoma (rubbery lymphadenopathy) TRANSCOLEMIC = via Exudative fluid accumulation, spreads through PLEURAL, PERICARDIAL + PERITONEAL EFFUSIONS
26
Sarcomas spread mostly
Haematogenous
27
Carcinomas spread mostly
Lymphatic * exceptions = - follicular thyroid - chondrocarcinoma - RCC - HCC
28
Staging Tumours
Mostly TNM (Tumour - Node - Metastasis) Different for leukemias + lymphomas and CNS cancers E.g lymphoma = Ann Arbour
29
Mutation involved in colorectal cancer
FAP (familial adenomatous polyposis) = Autosomal dominant mutation APC gene, millions of colorectal adenomas - inevitable adenocarcinoma by 35 years old - over expression of c-MYC and point mutation in KRAS HNPCC (lynch syndrome) = mutated MSH gene, autosomal dominant, this genes involved in DNA mismatch repair
30
Screening
Method of early detection (essentially 2’ prevention, making management easy) Cancers screened for in UK = CERVICAL (cervical swab), BREAST (mammograms), COLORECTAL (faecal occult) Heel prick test birth = sickle cell, CF, hypothyroid