Characteristics of Tumours (18)

Question 1

Cancer

Answer 1

Uncontrolled growth of cells, can invade and spread to distance sites of body

Question 2

Tumour/neoplasm

Answer 2

Lesion resulting from autonomous growth/abnormal growth of cells that persists in the absence of the initiating stimulus/abnormal swelling

Question 3

Histogenesis

Answer 3

Differentiation of cells into specialised tissues and organs during growth from undifferentiated cells (3 primary germ layer)

Question 4

Carcinoma

Answer 4

Epithelial cells

Question 5

Sarcoma

Answer 5

Connective tissues

Question 6

Lymphoma/leukaemia

Answer 6

Lymphoid/haematopoietic organs

Question 7

Common and fatal cancers

Answer 7

Lung, breast/prostate, colon and rectum

Question 8

Characterising tumours (DRLM)

Answer 8

Differentiation, rate of growth, local invasion, metastasis

Question 9

Differentation

Answer 9

The extent that neoplastic cells resemble the normal parenchymal cells (morphologically and functionally)

Question 10

Benign tumours and differentation

Answer 10

Well-differentiated, mitoses are rare

Question 11

Anaplasia

Answer 11

Neoplasms comprised of poor-differentiated cells (malignant)

Question 12

Differentiation - morphological changes

Answer 12

1. Pleomorphism
2. Abnormal nuclear morphology
3. Mitoses
4. Loss of polarity

Question 13

Abnormal nuclear morphology

Answer 13

Too large (nuclear:cytoplasmic 1:1), irregular shape, chromatin distribution (coarsely clumped, along cell membrane), hyper chromatism (dark colour) abnormally large nucleoli

Question 14

Differentiation - mitoses

Answer 14

Atypical, bizarre mitotic figure - tripolar, quadripolar, multipolar spindles

Question 15

Differentiation - loss of polarity

Answer 15

Orientation of cells disturbed, disorganised growth

Question 16

Well differentiated grade

Answer 16

Low grade/grade 1

Question 17

Moderately differentiated grade

Answer 17

Intermediate/grade 2

Question 18

Poorly differentiated grade

Answer 18

High grade/grade 3

Question 19

Stage

Answer 19

A measure of prognostication/therapeutic decisions

Question 20

Bronchogenic carcinoma secretes

Answer 20

Corticotropin, parathyroid-like hormone, insulin, glucagon

Question 21

Local invasion - cancer

Answer 21

Infiltration, invasion, destruction

Question 22

Local invasion - benign

Answer 22

Cohesive expansile masses, localised to origin of site, no capacity to infiltrate/invade/metastasise

Question 23

Benign tumours - encapsulation

Answer 23

Rim of fibrous tissue, ECM deposited by stromal cells activated by hypoxia from pressure of tumour, tissue plane - discrete, moveable, easily palpable, easily excised

Question 24

Metastasis

Answer 24

Spread of tumour to sites physically discontinuous with primary tumour

Question 25

Pathways of metastasis

Answer 25

Direct seeding, lymphatic (most common), haematogenous (veins more easily penetrated)

Question 26

Sentinel nodes

Answer 26

First node in a regional lymphatic bin that receives lymph flow from primary tumour, frozen during surgery can guide surgeon to appropriate therapy

Question 27

How are sentinel nodes identified?

Answer 27

Injection of radio labelled tracers/coloured dyes

Question 28

Regional nodes

Answer 28

Effective barriers to further tumour dissemination, drainage of tumour cell debris and antigens induces reactive changes in nodes

Question 29

Stroma

Answer 29

Connective tissue framework that neoplastic cells are embedded in

Question 30

What does a stroma provide?

Answer 30

Mechanical support, intercellular signalling, nutrition

Question 31

Desmoplastic reaction

Answer 31

Fibrous stroma formation due to induction of connective tissue fibroblast proliferation by growth factors from tumour cells

Question 32

Stroma contains

Answer 32

Cancer-associated fibroblasts, myofibroblasts, blood vessels, lymphocytic infiltrate

Question 33

Clinical complications of tumours - compression

Answer 33

Displacement of adjacent tissues, benign

Question 34

Clinical complications of tumours - destruction

Answer 34

Invasion, rapidly fatal if vital structures invaded, mucosal surfaces (ulceration)

Question 35

Clinical complications of tumours - metabolic

Answer 35

Paraneoplastic (ACTH/ADH in small cell lung cancer), cachexia (interfere protein metabolism), Warburg effect (energy by high rate glycolysis with fermentation of lactic acid), neuropathies, myopathies, venous thrombosis