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CAN > L14: Pathology Of Cancer- Management > Flashcards

L14: Pathology Of Cancer- Management Flashcards

1
Q

When we classify neoplasms into benign what are the features of benign

A

Smooth
Well circumscribed
Mobile

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2
Q

When we classify neoplasms as malignant what are the features of malignant

A

Irregular
Poorly defined
Fixed to adjacent structures

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3
Q

For example what are the 2 classifications of breast lumps

A

Fibroadenoma- benign

Breast carcinoma- malignant

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4
Q

What are the fibroadenoma features

A

Smooth
Well circumscribed
Mobile

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5
Q

What are the features of breast carcinoma

A

Irregular
Poorly circumscribed
Rarely moves on palpation
Tethered to other tissue

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6
Q

Why does the majority of cancer arise from epithelial cells n the mucosa layer

A
  • It is a region exposed to high concentration of carcinogen
  • It has a high rate turnover so the rate of mutation is higher
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7
Q

What are the sites of colon carcinoma

A

Ascending Colon

Sigmoid colon

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8
Q

What is the clinical presentation of colon carcinoma at the ascending colon

A

Often polyploid
Rarely causes bowel obstruction
Anaemia
Weight loss

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9
Q

What is the clinical presentation of sigmoid colon carcinoma

A

Often stenosing
Bowel obstruction
Alteration in bowel habit e.g diarrhoea as only liquid can pass the narrowing

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10
Q

What are the 3 types of specimens we can collect

A

1) biopsy
2) cytology specimen
3) surgical resection specimen

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11
Q

What are biopsy

A

Removing a small piece of tissue

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12
Q

What do cytology specimens collect

A

Cells

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13
Q

How are cytology specimens obtained, give examples

A

Smears
Endoscopic brushing
Body fluid
Fine needle aspiration

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14
Q

What does surgically resected specimen O’Brien

A

Removes all cancer

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15
Q

What are the limitations to biopsy

A
  • Tumour heterogeneity- different parts of the tumour may have a different appearance and this may be missed as we collect a small piece
  • targeting the lesion accurately is difficult if the lesion is small, inaccessible, surrounding stromal reaction
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16
Q

What is surgical resection of tumour also a method of

A

Treatment of cancer

17
Q

What is the less invasive method for obtaining a specimen

A

Cytology specimen

18
Q

What are the disadvantages of cytology specimen

A

Specimen can be small

19
Q

Reminder: what is grading about

A

The degree of differentiation

20
Q

Reminder: what is staging about

A

The extend of the spread

21
Q

When we use the TNM staging system, what is T and how is it scored

A

T- tumour size from 1 to 4 (increasing size)

22
Q

What is N in the TNM staging

A

Nodes: extent of lymph node spread

23
Q

What is M in the TNM stage and how is it scored

A

Metastasis scored 0=no metastasis or 1=metastasis

24
Q

When we get a tumour resection sample what do we look

A

Macroscopic assessment

Microscopic assessment

25
Q

In a macroscopic assessment what do we look at

A

Size
Shape
Extent of local spread
Identity of lymph nodes

26
Q

In a microscopic assessment what do we look for

A 
Historical type 
Grade
Frequency of mitosis 
Local invasion- to determine benign or malignant 
Vascular invasion 
Lymph node
27
Q

What is immunohistochemistry

A

Identifying a specific tumours antigen by developing fluorescently tagged antibodies that bind to the antigens

28
Q

What are the 3 reasons immunohistochemistry can be used

A

1) Establish a diagnosis malignancy
2) used a prognostic marker
3) identify therapeutic options as expression of a specific antigen can be targeted

29
Q

What is in-situ hybridisation

A

Applying probes that recognise DNA or RNA sequences

30
Q

When is in situ hybridisation commonly used

A

EBV related neoplasms

31
Q

Name a EBV repeated neoplasms

A

Post transplant lymphoproliferative disease

32
Q

What is post transplant lymphoproliferative disease

A

Patients that receive organ transplant are on immunosuppressive drugs and EBV can therefore affect to the B lymphocytes

33
Q

What are nucleic acid molecular techniques

A

When you take out a sample of tissue and look at the nucleic acid sequence

34
Q

By looking at the nucleic acid what can be identified

A

Immunoglobulin genes

Specific gene mutations that allow for personalised medicine

CAN (25 decks)

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