Characteristics of tumours

Question 1

define cancer

Answer 1

uncontrolled growth of cells which can invade and spread to distant sites in the body.

Question 2

define tumour

Answer 2

abnormal swelling

Question 3

define neoplasm

Answer 3

lesion resulting from autonomous growth or relatively autonomous growth of cells that persist in the absence of the initiating stimulus.

Question 4

define histogenesis

Answer 4

The differentiation of cells into specialised tissues and organs during growth from undifferentiated cells (3 primary germ layers)

Question 5

Are tumours categorised histogenically

Answer 5

Yes

Question 6

what is the tumour name given to epithelial cell tumours

Answer 6

carcinoma.

Question 7

what is the tumour name given to connective tissue tumours

Answer 7

Sarcomas

Question 8

what is the tumour name given to lymphoid/haematopoietc organs

Answer 8

lymphomas, leukaemias

Question 9

define differentiation in terms of tumours.

Answer 9

The extent that neoplastic cells resemble the corresponding normal parenchymal cells, morphologically and functionally

Question 10

what are the typical features of benign tumours

Answer 10

well differentiated and mitoses are rare.

Question 11

what are the typical features of malignant tumours

Answer 11

wide-range of parenchymal differentiation.
Most exhibit morphologic alterations showing malignant nature.
Well-differentiated malignant tumours and benign tumours can look very similar

Question 12

define anaplasia

Answer 12

Neoplasms, which have poorly differentiated cells

Question 13

what morphological changes take place in tumours

Answer 13

pleomorphism- shape and size.
abnormal nuclear morphology
mitoses
loss of polarity

Question 14

are pleomorphisms extremely variable in different tumours and cells

Answer 14

Yes

Question 15

what changes can cause abnormal nuclear morphology in tumour cells.

Answer 15

nuclei become large
nuclear to cytoplasmic ratio can reach 1:1.
variability in nuclear shape
Chromatin distribution- coarsely clumped or along the cell membrane.
hyperchromatism- dark in colour and large nucleoli.

Question 16

are mitosis seen in normal tissue

Answer 16

Yes- especially in cells with a high turnover

Question 17

what is different about mitoses which are sen in cancer cells

Answer 17

◦ Tripolar
◦ Quadripolar
◦ Multipolar spindles
Lot more proliferation occurring.

Question 18

what does loss of polarity result in

Answer 18

Orientation of cells disturbed

Disorganised growth

Question 19

what are the 4 categories of differentiation of the tumour cells.

Answer 19

Well differentiated
Moderately differentiated
Poorly differentiated
Undifferentiated / anaplastic

Question 20

define grade

Answer 20

related to differentiation / clinical behaviour
well differentiated tumours-lowgrade
poorly differentiated tumours high grade.

Question 21

define stage

Answer 21

A measure of prognostication / therapeutic decisions

Question 22

why are well differentiated tumours better than poor differentiated tumours, an what glands commonly display this

Answer 22

Better differentiation = better retention of normal function

endocrine glands.

Question 23

define paraneoplastic syndromes

Answer 23

caused by substances that are secreted by a benign tumor, a malignant (cancerous) tumor, or a malignant tumor’s metastases. The disturbances caused by paraneoplastic syndromes occur in body organs at sites that are distant or remote from the primary or metastatic tumors.

Question 24

what paraneoplastic features do bronchogenic carcinomas show.

Answer 24

◦ Corticotropin
◦ Parathyroid-like hormone
◦ Insulin
◦ Glucagon

Question 25

are benign tumours encapsulated

Answer 25

YES- within a rim of compressed fibrous tissue.

Question 26

are benign tumours palpable and easily excised

Answer 26

Yes.

Question 27

Are malignant tumours encapsulated

Answer 27

Yes-Pseudo encapsulation

Question 28

define metastases

Answer 28

“Spread of a tumour to sites physically discontinuous with the primary tumour”

Question 29

can benign tumours metastases

Answer 29

No

Question 30

what characteristics predispose a tumour to being metastatic

Answer 30

◦ Lack of differentiation ◦ Local invasion ◦ Rapid growth ◦ Large size

Question 31

what are the 3 methods by which metastases can happen and which is most common

Answer 31

direct seeding lymphatic spread- common haematogenous spread.

Question 32

what is direct seeding metastases

Answer 32

Neoplasm penetrates a natural open field without physical barriers

Question 33

what is lymphatic spread metastases.

Answer 33

Most common pathway Tumours do not contain lymphatic channels Lymphatic vessels at the tumour margins

Question 34

what is haematogenous spread of metastases

Answer 34

via blood

Question 35

does the pattern of lymph node involvement follow lymph node drainage

Answer 35

Yes

Question 36

define sentinel node

Answer 36

The first node in a regional lymphatic basin that receives lymph flow from the primary tumour

Question 37

how is the sentinel node identified.

Answer 37

Injection of radiolabelled tracers/coloured dyes

Question 38

what are the uses of regional nodes

Answer 38

Effective barriers to further tumour dissemination. Cells arrest within node and then can be destroyed by a tumour-specific immune response. Not every enlarged node has cancer in it -Drainage of tumour cell debris and tumour antigens induces reactive change in nodes

Question 39

which type of tumour is more commonly spread haemoatogneously

Answer 39

sarcomas

Question 40

which type of blood vessel is commonly used in haematogneously spread and why

Answer 40

Veins more easily penetrated | -Thinner walls

Question 41

are benign tumours slow growing of fast growing

Answer 41

slow

Question 42

are malignant tumour slow or fact growing

Answer 42

fast

Question 43

do bengin tumours locally invade

Answer 43

no

Question 44

define stroma

Answer 44

connective tissue framework that neoplastic cells are embedded in. Provides: mechanical support, intracellular signalling and nutrition

Question 45

define desmoplastic reaction

Answer 45

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

Question 46

what does the stroma provide

Answer 46

Provides: mechanical support, intracellular signalling and nutrition

Question 47

what does the stroma contain

Answer 47

cancer-associated fibroblasts myofibroblasts blood vessels lymphocytic infiltrate

Question 48

what are local complications of tumours

Answer 48

compression- displacement of adjacent tissues | destruction- invasion of blood vessels and mucosal surfaces.

Question 49

what are the metabolic complications of tumours

Answer 49

well differentiated tumours retain normal function Number of cells exceeds normal organ over function of the cells

Question 50

Non specific metabolic effects of tumours

Answer 50

``` cachexia- weight loss Warburg effect- produces energy by high rates of glycolysis with fermentation of lactic acid neuropathies myopathies venous thrombosis. ```