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Cell Pathology > L.14 Cancer classification > Flashcards

L.14 Cancer classification Flashcards

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1
Q

What is cancer staging?

A

The process of describing the extent and severity of a person’s cancer

Staging is critical for prognosis estimation, treatment planning, evaluating treatment response, and comparing outcomes across clinical trials.

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2
Q

What are the key components of cancer staging?

A
  • The site of the primary tumour
  • Tumour size and depth of local invasion
  • Regional lymph node involvement
  • Presence or absence of distant metastasis

These components provide essential information for understanding the cancer’s severity.

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3
Q

What does the ‘T’ in the TNM staging system represent?

A

Primary Tumour

The ‘T’ category includes classifications from TX (primary tumour cannot be assessed) to T1-T4 (increasing size and/or extent of the primary tumour).

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4
Q

What does T0 indicate in the TNM staging system?

A

No evidence of a primary tumour

This classification is part of the assessment of the primary tumour in the TNM system.

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5
Q

What does the ‘N’ in the TNM staging system indicate?

A

Regional Lymph Nodes

The ‘N’ category includes classifications from NX (regional lymph nodes cannot be assessed) to N1-N3 (increasing involvement of lymph nodes).

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6
Q

What does N0 signify in the TNM staging system?

A

No regional lymph node involvement

This classification indicates that there is no cancer spread to the regional lymph nodes.

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7
Q

What does the ‘M’ in the TNM staging system represent?

A

Distant Metastasis

The ‘M’ category includes classifications from MX (distant metastasis cannot be assessed) to M1 (distant metastasis confirmed).

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8
Q

What does M0 indicate in the TNM staging system?

A

No distant metastasis

This means that the cancer has not spread to distant parts of the body.

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9
Q

What is cancer grading?

A

A process that assesses how much tumour cells resemble normal tissue (differentiation)

Grading indicates tumour aggressiveness and correlates with prognosis.

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10
Q

What does Grade I in cancer grading indicate?

A

Well-differentiated (low-grade) — cells resemble normal cells, slower-growing

This grade is associated with a better prognosis.

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11
Q

What characterizes Grade III in cancer grading?

A

Poorly differentiated — cells are abnormal and aggressive

This grade indicates a higher risk of rapid growth and metastasis.

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12
Q

What is the significance of poor differentiation in cancer grading?

A
  • Rapid growth
  • Increased risk of metastasis
  • Reduced response to therapy

Poorly differentiated tumours are typically more aggressive and harder to treat.

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13
Q

Fill in the blank: Grade IV in cancer grading is referred to as _______.

A

Undifferentiated (anaplastic)

This grade indicates very abnormal cells, a high mitotic rate, and a poor prognosis.

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14
Q

What is the overall cancer staging system?

A

A numerical staging system from 0 to IV used for patient communication and management.

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15
Q

What does Stage 0 in cancer staging represent?

A

Carcinoma in situ (CIS): Abnormal cells present but confined, no invasion.

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16
Q

What characterizes Stage I of cancer?

A

Localized small tumour, limited to organ of origin.

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17
Q

What is the description of Stage II in cancer staging?

A

Larger tumour, possible limited spread to nearby tissues/nodes.

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18
Q

What does Stage III indicate in cancer stages?

A

More extensive local spread, involvement of regional lymph nodes.

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19
Q

What does Stage IV signify in cancer staging?

A

Distant metastasis present (advanced cancer).

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20
Q

What does ‘in situ’ mean in anatomic extent descriptors?

A

Pre-invasive, confined to epithelium.

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21
Q

What does ‘localized’ refer to in cancer descriptions?

A

Tumour restricted to origin site, no spread.

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22
Q

What is meant by ‘regional’ in the context of cancer spread?

A

Spread to nearby lymph nodes, tissues, or organs.

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23
Q

What does ‘distant’ indicate regarding cancer?

A

Metastatic disease, spread to remote body sites.

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24
Q

What does ‘unknown’ signify in cancer staging?

A

Insufficient information for staging.

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25
What is cancer?
A disease caused by uncontrolled and abnormal cell growth due to disruption in normal cell cycle regulation.
26
What leads to cancer development?
A cascade of genetic and epigenetic mutations leading to loss of growth control.
27
Why is understanding the difference between normal and cancer cells important?
Crucial for diagnosis and treatment.
28
What is the focus of Low Power Examination in cancer microscopic examination?
Pattern disruption and tissue-level abnormalities ## Footnote This includes examining the architecture of tumours such as carcinomas, adenocarcinomas, and sarcomas.
29
What are carcinomas?
Tumours of epithelial origin ## Footnote They typically appear as nests, packets, or lobules.
30
What characterizes adenocarcinomas?
Glandular epithelial cancers forming tubules and acini ## Footnote Acini are berry-like clusters.
31
What defines sarcomas?
Tumours of mesenchymal origin displaying bundles, streams, or whorls of spindle cells ## Footnote These tumours originate from connective tissues.
32
What are some features observed in Low Power Examination?
* Areas of darker staining (hypercellularity) * Indistinct cell borders * Lymphocytic infiltrates indicating immune response ## Footnote These features help identify abnormal tissue structures.
33
What are the cellular features compared in High Power Examination?
Normal vs cancer cells ## Footnote This includes comparing shape, nucleus size, growth patterns, apoptosis, and maturation.
34
How do normal cells differ from cancer cells in terms of shape?
Normal cells are regular and uniform; cancer cells are irregular and pleomorphic ## Footnote Pleomorphic refers to variability in shape.
35
What is the typical nuclear characteristic of cancer cells?
Enlarged and hyperchromatic nuclei ## Footnote Hyperchromatic means dark-staining due to dense chromatin.
36
What is the growth pattern of cancer cells?
Uncontrolled and disorganized ## Footnote This contrasts with the controlled, organized growth of normal cells.
37
What does it mean for a cancer cell to evade apoptosis?
It is immortal and does not undergo programmed death ## Footnote This allows the cancer cell to survive longer than normal cells.
38
What are morphological hallmarks of cancer cells?
* Large, irregular nuclei * Increased nucleus-to-cytoplasm ratio * Irregular nuclear contours * Hyperchromasia * Prominent nucleoli * Scant cytoplasm ## Footnote These features are indicative of malignancy.
39
What are key indicators of malignancy in the nucleus?
* Nuclear volume increase * Increased nucleus/cytoplasm ratio * Pleomorphism * Irregular nuclear surface and density * Coarse, clumped chromatin * Increased atypical mitotic figures ## Footnote Abnormal mitosis can include tripolar or multipolar spindles.
40
Fill in the blank: In cancer, proliferation of basal cells exceeds _______ leading to tumour formation.
requirement ## Footnote This is a key aspect of basal cell carcinoma.
41
What happens to daughter cells in malignancy of basal cells?
Both daughter cells retain proliferative capacity ## Footnote Normally, one would differentiate while the other continues to divide.
42
What is the consequence of daughter cells retaining proliferative capacity?
Disruption of tissue architecture ## Footnote This leads to abnormal growth and potential tumour formation.
43
What are Epithelial Neoplasms also known as?
Carcinomas ## Footnote Epithelial neoplasms arise from epithelial tissues such as skin, glands, and mucosal linings.
44
How do Epithelial Neoplasms typically spread?
Via lymphatics ## Footnote This is a common route for the spread of carcinomas.
45
What is a Squamous Cell Carcinoma characterized by?
Keratin pearls and intercellular bridges ## Footnote It arises from squamous epithelium and is common in skin, cervix, and esophagus.
46
What type of cancer is Basal Cell Carcinoma?
Slow-growing, locally invasive skin cancer ## Footnote This cancer originates from the basal layer of the epidermis and rarely metastasizes.
47
What is Adenocarcinoma commonly associated with?
Breast, lung, colon, prostate ## Footnote Adenocarcinoma is a gland-forming tumor.
48
What characterizes Medullary Carcinoma?
Solid sheets of large cells with prominent nucleoli ## Footnote It is common in thyroid and breast tissues.
49
What is a key feature of Small Cell Carcinoma?
High-grade neuroendocrine tumour ## Footnote This type is aggressive and common in the lung, with early metastasis.
50
What describes Large Cell Carcinoma?
Poorly differentiated, large undifferentiated cells ## Footnote Often originates from lung tissue.
51
What is Carcinoma in Situ?
Dysplastic epithelial cells confined above basement membrane ## Footnote This represents a pre-invasive stage of cancer.
52
What does Mucinous Carcinoma produce?
Extracellular mucin ## Footnote It is commonly found in breast, colon, and ovary.
53
What are Connective Tissue Neoplasms also known as?
Sarcomas ## Footnote These arise from mesenchymal tissues such as bone, muscle, fat, and connective tissue.
54
How do Sarcomas typically spread?
Via hematogenous route ## Footnote This is the common spread route for sarcomas.
55
What is Leiomyosarcoma?
Smooth muscle tumour ## Footnote Common locations include the uterus, GI tract, and soft tissues.
56
What characterizes Osteosarcoma?
Malignant bone tumour producing osteoid ## Footnote It is particularly common in adolescents.
57
What is Fibrosarcoma?
Malignant fibroblast proliferation ## Footnote This type is characterized by a spindle cell appearance.
58
What does Chondrosarcoma produce?
Cartilage ## Footnote It is a malignant tumour typically found in pelvis, ribs, and long bones.
59
What is the origin of Liposarcoma?
Malignant adipocyte tumour ## Footnote Commonly found in the retroperitoneum and thigh.
60
What type of tumour is Neurofibrosarcoma?
Malignant tumour of peripheral nerve sheath ## Footnote Also known as Malignant Peripheral Nerve Sheath Tumour (MPNST).
61
What is Malignant Glioma?
Aggressive brain tumour from glial cells ## Footnote This category includes glioblastoma.
62
What is Angiosarcoma?
Malignant endothelial cell tumour ## Footnote It is associated with vinyl chloride exposure and commonly affects the liver.
63
What is Malignant Fibrous Histiocytoma also known as?
Undifferentiated Pleomorphic Sarcoma ## Footnote This is a high-grade pleomorphic soft tissue sarcoma.
64
What are lymphoid neoplasms?
Cancers of lymphocytes (B, T, NK cells) ## Footnote Lymphoid neoplasms include lymphomas and leukemias.
65
What characterizes Hodgkin Lymphoma?
Characterized by Reed-Sternberg cells, bimodal age distribution, common in cervical lymph nodes ## Footnote Reed-Sternberg cells are a distinctive feature of Hodgkin Lymphoma.
66
What are the types of Non-Hodgkin Lymphoma (NHL)?
Includes: * Mature B cell neoplasms * Mature T cell & NK neoplasms * Precursor lymphoid neoplasms * Immunodeficiency-associated lymphoproliferative disorders ## Footnote Examples of mature B cell neoplasms include diffuse large B-cell lymphoma and follicular lymphoma.
67
Name a type of mature B cell neoplasm.
Diffuse large B-cell lymphoma ## Footnote Follicular lymphoma and chronic lymphocytic leukemia (CLL) are also examples.
68
What is a key feature of precursor lymphoid neoplasms?
Acute lymphoblastic leukemia/lymphoma (ALL) ## Footnote Precursor lymphoid neoplasms primarily affect immature lymphocytes.
69
What are Tumour-Infiltrating Immune Cells (TILs)?
Immune cells that migrate into tumour tissue ## Footnote TILs can influence the outcome of cancer therapies.
70
Name a key player among TILs.
T lymphocytes (CD8+ cytotoxic T cells) ## Footnote Other key players include B lymphocytes, NK cells, macrophages, neutrophils, and dendritic cells.
71
What is the prognostic significance of TILs?
Presence of TILs often indicates better clinical outcomes and predictive of response to immunotherapy ## Footnote This includes therapies like immune checkpoint inhibitors.
72
What does the Tumour Microenvironment (TME) consist of?
Complex ecosystem of tumour cells, immune cells, stromal cells, blood vessels, extracellular matrix ## Footnote TME plays a critical role in cancer progression and treatment response.
73
How do tumour cells interact with infiltrating immune cells?
Tumour cells can modulate TME to evade immune surveillance ## Footnote For example, they may express PD-L1 to inhibit T cell activity.
74
What can CD8+ cytotoxic T cells do to cancer cells?
Directly kill cancer cells by secreting perforin and granzymes ## Footnote This is a crucial mechanism of the immune response against tumours.
75
What are some therapeutic strategies to enhance anti-tumour immune response?
Checkpoint inhibitors, CAR-T therapy ## Footnote These therapies aim to boost the body's immune response against cancer.

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