Lecture 14 - Neoplasia 1

Question 1

What is the definition of a Tumour?

Answer 1

Any clinical detectable lump or swelling

Question 2

What is the definition of a neoplasm?

Answer 2

An abnormal growth of cells that persists after the initial stimulus is removed

Question 3

What is oncology?

Answer 3

Study of tumours and neoplasms

Question 4

Do tumours and neoplasms have a relationship with normal growth signals?

Answer 4

No they are independent of normal growth signals

Question 5

What is Hyperplasia?

Answer 5

Increase in the number of cells

Question 6

Is hyperplasia reversible?

Answer 6

Yes

Hyperplasia = reversible

Question 7

What is Neoplasia?

Answer 7

Formation of an abnormal growth of cells

Question 8

What is a Benign Neoplasm?

Answer 8

A neoplasm with gross and microscopic appearances that are considered to be innocent, implying that it will remain localised and will not spread to other sites

Question 9

Describe the innocent appearance of a benign Neoplasm?

Answer 9

Nice smooth edges
Well circumscribed
Not looking likely it will spread

Question 10

What is deemed as a Cancer?

Answer 10

A malignant neoplasm

Question 11

What is the definition of a malignant neoplasm?

Answer 11

An abnormal growth of cells that persists after the initial stimulus is removed and invades surrounding tissue with the potential to spread to distant sites

Question 12

What is the definition of a Metastasis?

Answer 12

Malignant neoplasm that has spread from its original site to a new non-contiguous site

Question 13

What is meant be a new non-contiguous site for a metastasis?

Answer 13

No physical connection between the 2 tumours

Question 14

What is Dysplasia?

Answer 14

A pre-neoplastic alteration in which the cells show disordered tissue organisation

Question 15

Is dysplasia reversible?

Answer 15

Yes reversible

Question 16

How can dysplasia look like neoplasia?

Answer 16

Hyperchromatic nuclei
High nuclear to cytoplasmic ratios

Question 17

What are some examples of a non-neoplastic tumour?

Answer 17

Abcess
Haematoma

Question 18

What is the difference between a primary malignant neoplasm and secondary metastasis?

Answer 18

The primary malignant neoplasm is the original neoplasm whereas the metastasis has spread from the primary neoplasm

Question 19

What is the difference between the primary site and secondary site of malignant neoplasms?

Answer 19

Primary site = original site of malignant neoplasm

Secondary site = Place original neoplasm has spread to

Question 20

What is the difference between benign and malignant neoplasms?

Answer 20

Benign = Remain confined to sit of origin, DO NOT METASTASISE

Malignant = Invade and CAN METASTASISE

Question 21

What is coning?

Answer 21

When the intercranial pressure increases leading to the brainstem being forced through the foramen magnum leading to death

Question 22

What is pleomorphism?

Answer 22

When cells and their nuclei have a varying size and shape

Question 23

What is tumour burden?

Answer 23

The amount of cancer in the body

Higher tumour burden = increased fatigue and weight loss

Question 24

How do benign tumours grow?

Answer 24

In a confined local area
Have a Pushing outer margin
Only dangerous when in certain locations

Question 25

How do malignant tumours grow?

Answer 25

Irregular outer margin and shape May have ulcerations and necrosis Infiltration

Question 26

What is meant by benign tumours having a pushing outer margin?

Answer 26

They appear to push tissue away/outwards rather than being invasive/infiltrative

Question 27

Why can malignant tumours have centres of necrosis?

Answer 27

Rapid growth means that the centre cells don’t get enough nutrients and oxygen

Question 28

What is the definition of differentiation?

Answer 28

Process of cells becoming different by growth or development to be specialised for a set function

Question 29

What is the differentiation of a benign neoplasm like?

Answer 29

Well differentiated Closely resemble the parent tissue

Question 30

What is the differentiation like for a malignant neoplasm?

Answer 30

Ranges The worse the malignant neoplasm gets the more poorly differentiated it becomes Gets less and less similar to the parent tissue

Question 31

What is the definition of anaplastic?

Answer 31

Cells with no resemblance to any tissue

Question 32

How do very malignant poorly differentiated tissues appear?

Answer 32

Increased nuclear size Increased nuclear to cytoplasm ratio Hperchromasia (nuclei stain darker) Abnormal mitotic figures (Looks like Merc logo) Pleomorphism (Variation in size and shape of cells and nuclei)

Question 33

How does a melonoma (skin neoplasm) appear?

Answer 33

Dermis has nests and clusters of epithelioid cells Dark staining large nuceli

Question 34

How do cell shapes differ between benign and malignant neoplasms?

Answer 34

Benign = Cells same throughout tumour, resemble tissue of origin Malignant = Pleomorphic, less likely to resemble tissue of origin can have unexpected functions

Question 35

What are the grades used to indicate the degrees of differentiation of a neoplasm? What do these grades mean?

Answer 35

Grade 1 - Well differentiated (resemble origin tissue) Grade 2 - Moderately differentiated Grade 3 - Poorly differentiated

Question 36

What is Dysplasia?

Answer 36

Cells abnormally differentiate into different cell types and become disorganised

Question 37

How is dysplasia classified?

Answer 37

Dependant on worsening differentiation Mild Moderate Severe

Question 38

Is dysplasia reversible?

Answer 38

Yes

Question 39

What is Carcinoma in situ?

Answer 39

Full dysplasia affecting the full thickness of the epidermis No cells have breached the basement membrane so isn’t an invasive cancer

Question 40

What is an invasive carcinoma?

Answer 40

When cells breach the basement membrane The dysplastic cells in a carcinoma have a potential to become an invasive carcinoma

Question 41

What are the basic steps to developing a neoplasm?

Answer 41

Accumulated mutations in somatic cells (caused by initiator) Promoters cause cell proliferation which propagates the genetic damage Tumour forms from the colonial expansion of a single genetically damaged precursor cell

Question 42

What causes the non-lethal genetic damage/mutations that lead to neoplasia?

Answer 42

Initiators/mutagenic agents

Question 43

What are some chemical initiators for neoplasia?

Answer 43

Chemicals: -Smoking -Alcohol consumption -Diet and obesity Infectious agents: -HPV Radiation Inherited mutations

Question 44

What is the definition of progression?

Answer 44

When a single cell mutates and forms many cells (neoplasm) with the mutations Step wise process of developing mutations which aid the cancer development (acquisition of more and more mutations)

Question 45

If a young person has developed a neoplasm what should be done?

Answer 45

Investigate germ line mutations since its likely the person has inherited a defect that has affected a critical gene

Question 46

What 4 regulated genes can be mutated leading to cancer?

Answer 46

Growth promoting proto-oncogenes Growth inhibiting tumour suppressor genes Genes that regulate programmed cell death (apoptosis) Genes involved in DNA repair

Question 47

What are proto-oncogenes?

Answer 47

Genes that participate at some level in driving cell proliferation

Question 48

What are proto-oncogenes referred to as when they are abnormally stimulated?

Answer 48

Oncogenes

Question 49

What are oncogenes?

Answer 49

Genes which favour neoplasm formation (excessive stimulation of growth, division and prevention of apoptosis)

Question 50

What do Oncogenes produce?

Answer 50

Oncoprotiens

Question 51

Why is a single mutation of a proto-oncogene so bad?

Answer 51

Oncogenes are dominant over normal proto-oncogenes Only 1 allele needs to be damaged

Question 52

What is the function of Tumour Suppressor Genes?

Answer 52

Makes proteins: -Stop cell proliferation -Repairs DNA -Stimulate apoptosis in damaged cells

Question 53

What happens if Tumour suppressor genes are mutated?

Answer 53

Loss of function so growth inhibition fails

Question 54

How many alleles of the tumour suppressor gene needs to be mutated to cause failure of growth inhibition?

Answer 54

Both alleles

Question 55

Usually what do the names of benign tumours end in?

Answer 55

-Oma

Question 56

Usually what do the names of malignant tumours end in?

Answer 56

Carcinoma (epithelial) Sarcoma (stromal)

Question 57

Where can transitional cell papilloma occur?

Answer 57

Bladder mucosa

Question 58

What is the name for a glandular benign neoplasm?

Answer 58

Adenoma

Question 59

Where can squamous cell carcinoma form?

Answer 59

Skin Larynx Oesophagus Lungs …..

Question 60

Where can transitional cell carcinoma happen?

Answer 60

Bladder, ureters

Question 61

Where can adenocarinomas form?

Answer 61

Prostate Breast Pancreas Oesophagus Stomach Lung

Question 62

What is a benign smooth muscles neoplasm and malignant neoplasm?

Answer 62

Benign = Leiomyoma Malignant = Leiomyosarcoma

Question 63

What is a benign fibrous tissue neoplasm and malignant neoplasm?

Answer 63

Benign = Fibroma Malignant = Fibrosarcoma

Question 64

What is a benign bone neoplasm and malignant neoplasm?

Answer 64

Benign = Osteoma Malignant = Osteosarcoma

Question 65

What is a benign cartilage neoplasm and malignant neoplasm?

Answer 65

Benign = Chondroma Malignant = Chondrosarcoma

Question 66

What is a benign glial cell neoplasm and malignant neoplasm?

Answer 66

Benign = Glioma Malignant = Malignant glioma

Question 67

What is a Urinary Tract Epithelium benign neoplasm called?

Answer 67

Transitional cell papilloma

Question 68

What is a Urinary Tract Epithelium malignant neoplasm called?

Answer 68

Transitional cell carcinoma

Question 69

What is stroma/stromal tissue?

Answer 69

The supporting tissue that provides the framework for organs like glands, holds tissues in place like blood vessels and nerves It’s a loose connective tissue