clinical pathology

Question 1

define tumour

Answer 1

any kind of mass-forming lesion

Question 2

types of tumour

Answer 2

neoplasm, hamartoma, inflammatory

Question 3

define neoplasm

Answer 3

autonomous growth of tissue which has escaped normal constraints of cell proliferation

Question 4

types of neoplasm

Answer 4

benign and malignant

Question 5

define benign

Answer 5

remains localised

Question 6

define malignant

Answer 6

invades locally and/or spreads to distant sites

Question 7

define cancers

Answer 7

malignant neoplasms

Question 8

define hamartoma

Answer 8

localised, benign overgrowth of one or more mature cell types (i.e. lung)

Question 9

hamartoma abnormalities

Answer 9

architectural not cytological as contains malformed normal tissue

Question 10

define heterotopia

Answer 10

normal tissue found in place not normally present (i.e. pancreas in stomach wall)

Question 11

how are neoplasms classified

Answer 11

based on cell origin and whether benign or malignant

Question 12

define teratoma

Answer 12

tumour derived from germ cells

Question 13

what do teratomas contain

Answer 13

immature/mature/cancerous tissue derived from all 3 germ cell layers

Question 14

4 differences between benign and malignant tumours

Answer 14

invasion, metastasis, differentiation, growth pattern

Question 15

benign vs malignant: invasion

Answer 15

malignant is a direct extension into adjacent tissue/other structure by breaking through basement membrane

Question 16

benign vs malignant: metastasis

Answer 16

all malignant tumours have capacity to metastasise and spread via blood to other parts of body

Question 17

define cytological

Answer 17

how much do the tumour cells resemble the cells of its derived tissue, including function

Question 18

benign vs malignant: differentiation

Answer 18

tumour cells have larger nuclei so higher nuclei:cytoplasmic ratio and more (abnormal) mitoses, as well as marked nuclear pleomorphism (variability in nuclear size and shape)

Question 19

define architectural

Answer 19

how much does the tumour architecture resemble derived tissue

Question 20

benign vs malignant: growth pattern

Answer 20

tumours have less well defined architecture, benign grow relatively slowly

Question 21

can a benign tumour turn into a malignant tumour

Answer 21

yes

Question 22

5 routes of malignant neoplasm (cancer) spread

Answer 22

direct extension, haematogenous, lymphatic, transcoelomic, perineural

Question 23

malignant neoplasm (cancer) spread: direct extension

Answer 23

associated with stromal response to tumour (includes fibroblastic proliferation “desmoplastic response”, vascular proliferation angiogenesis and immune response)

Question 24

malignant neoplasm (cancer) spread: haematogenous

Answer 24

usually venules and capillaries as thinner walls; most sarcomas metastasise first via blood stream

Question 25

malignant neoplasm (cancer) spread: lymphatic

Answer 25

via lymphatics to lymph nodes and beyond; spread pattern dictated by normal lymphatic drainage of organ; most epithelial cancers metastasise first via lymphatics

Question 26

malignant neoplasm (cancer) spread: transcoelomic

Answer 26

seeding of body cavities; commonest are pleural (intrathoracic) and peritoneal (intra-abdominal)

Question 27

malignant neoplasm (cancer) spread: perineural

Answer 27

via nerves

Question 28

3 methods to assess tumour spread

Answer 28

clinically, radiologically, pathologically

Question 29

describing tumour spread (TNM)

Answer 29

tumour (size/extent of local invasion), nodes (no. lymph nodes involved), metastases (presence of distant metastases)

Question 30

prognosis of tumour: grade and spread

Answer 30

grade (how differentiates tumour is) is less important for prognosis than stage (how far tumour has spread using TNM)

Question 31

define carcinogen

Answer 31

agent that causes genetic damage and induces neoplastic transformation of cells

Question 32

chemial carcinogen types

Answer 32

inducers, promoters and direct

Question 33

radiation carcinogen types

Answer 33

UV, ionising EM

Question 34

microbial carcinogen types

Answer 34

DNA oncogenic viruses, RNA viruses, bacteria (e.g. Helicobacter)