Lecture 8 Disorders of Growth 1 and 2

Question 1

Define neoplasm

Answer 1

Abnormal mass of tissue whos growth exceeds and is uncoordinated with normal tissues. Continues to excessively grow without the stimuli that envoked change.

Question 2

Define tumour

Answer 2

Literally means swelling, but conventionally used as synonym for neoplasm.

Question 3

Qualities of benign?

Answer 3

Lacks ability to invade or metastasize. Therefore not cancerous. Grows by expansion, displacing adjacent tissue.

Question 4

Qualities of malignant?

Answer 4

Invades surrounding tissue, capable of producing metastases, may recur after removal -> death. Grows by infiltration of local tissues.

Question 5

Malignant tumours can spread by

Answer 5

Local (direct invasion) or distant (metastasis)

Question 6

Define carcinoma

Answer 6

Malignant tumour of epithelial tissue

Question 7

Define sarcoma

Answer 7

Malignant tumour of stromal tissue

Question 8

What are stromal tissues?

Answer 8

Connective tissue calls of any organ

Question 9

Define metastasis 2 ways?

Answer 9

1) a secondary tumour 2) process by which secondary tumour is formed

Question 10

What are the routes of metastasis?

Answer 10

Lymphatics, blood, transcoelomic, along epithelial lined spaces, within epithelium.

Question 11

Explain how lymphatics are metastasis routes?

Answer 11

Tumour may directly invade lymphatics. Tumour emboli filtered out -> grow in lymph nodes.Typical of Epithelial malignancy.

Question 12

Explain how blood is a metastasis route?

Answer 12

Tumour in vessels ->Filtered out by capillary beds (liver or lung). Typical of stromal malignancy and later stages of epithelial malignancy.

Question 13

Define transcoelomic spread

Answer 13

Across body cavity

Question 14

Where are transcoelomic spread tumours found?

Answer 14

Peritoneal or pleural

Question 15

Where are epithelial lined spaces tumours found?

Answer 15

Bronchiolo - alveolar carcinoma of lung

Question 16

Where are epithelial malignancies normally found?

Answer 16

Lymph nodes

Question 17

Where are stromal malignancies and late stage epithelial malignancies found?

Answer 17

Capillary beds (liver and lung)

Question 18

Give an example of when a metastasis occurs within epithelium cells

Answer 18

Paget’s disease of the nipple.

Question 19

How they’re classified?

Answer 19

Naked eye appearance (site, conformation), histological, histogenesis, aetiological, functional.

Question 20

What is histological?

Answer 20

What does the tissue resemble? How close is the resemblance?

Question 21

Define histogenesis?

Answer 21

Cell of origin

Question 22

What is aetiological

Answer 22

Inheritance v environmental

Question 23

What does the naming of neoplams (tumour terminology) depend on?

Answer 23

Site, behaviour, histogenesis.

Question 24

What does a benign tumour end in?

Answer 24

oma

Question 25

Define Polyp

Answer 25

Mass attached to a surface, may or may not be a neoplasm

Question 26

What is leukaemia?

Answer 26

Neoplastic proliferation of haemopoietic stem cells -> spill into blood stream. MALIGNANT

Question 27

What is lymphoma?

Answer 27

Malignant proliferation of cells of lymphoid tissue. 2 types, Hodgkin's disease or non-hodgkin's lymphoma.

Question 28

What is hodgkin's disease?

Answer 28

Lymphoma, mix of cells including Reed-Sternberg cells

Question 29

What is non-hodgkin's disease?

Answer 29

Lymphoma. Lacks cellular mixture.

Question 30

Teratoma?

Answer 30

Arises from totipotential cells, producing tissues prepresenting all three germ cell layers

Question 31

Teratoma in ovary is usually?

Answer 31

Benign. (struma ovarii) AND (Ovarian teratoma with teeth/skin/adnexae)

Question 32

Teratoma in testes is usually?

Answer 32

Malignant

Question 33

Teratoma in midline is usually?

Answer 33

Sequestered primitive cells

Question 34

Define totipotential cells?

Answer 34

Potential to give rise to any and all human cells (for example one celled fertilised egg).

Question 35

What is a premalignant condition?

Answer 35

Lesions with an ^ risk of developing an invasive tumour

Question 36

Give 4 non-neoplastic examples of premalignant conditions?

Answer 36

Chronic inflammation, cirrhosis of liver, chronic ulcerative colitis and xeroderma pigmentosum

Question 37

Give example of how chronic inflammation can cause cancer?

Answer 37

Varicose leg ulcers can lead to skin cancer

Question 38

Give example of how chronic ulcerative colitis can lead to cancer?

Answer 38

Adenocarcinoma of large intestine

Question 39

Give 2 neoplastic examples of premalignant conditions?

Answer 39

Familial polyposis coli and intra-epithelial neoplasia

Question 40

What is familial polyposis coli?

Answer 40

Autosomal dominant, 1000s of large intestinal adenomas -> Carcinoma inevitable

Question 41

What is intra-epithelial neoplasia?

Answer 41

Nuclear changes of carcinoma, without breaching basement membrane - "dysplasia" or "carcinoma in situ". Uterine cervix, vulva, bronchus.

Question 42

What is tumour grading? (Only for malignant tumours)

Answer 42

How bad it looks. Assesses the degree of differentiation of a tumour. Correlates with how aggressive tumour behaves. Usually 3 or 4 grades.

Question 43

Problems with grading?

Answer 43

Subjective. Appearances vary from area to area. Different criteria needed for each histogenesis

Question 44

What is tumour staging?

Answer 44

How far its got (stage it's at). Based on TNM 1) T- Size of tumour (T1-T4) 2) N - lymph node involvement (N0-N3) 3) M- distant metastasis (M0 to M1)

Question 45

Which has the better prediction of outcome, Grading or Staging?

Answer 45

Staging

Question 46

What are the effects of tumours?

Answer 46

1) displacement or destruction of normal structures 2) excess normal function 3) Paraneoplastic phenomena

Question 47

What are the effects of benign tumours?

Answer 47

Mechanical pressure, obstruction, ulceration, infarction of pedunculated tumour, infection, rupture of cystic neoplasm, hormone production, malignant change.

Question 48

What are the effects of malignant tumours?

Answer 48

Tissue destruction, haemorrage, secondary infection, cachexia, pain, anaemia, paraneoplasic syndromes

Question 49

Define paraneoplastic syndromes?

Answer 49

Side effects of cancer (that come with cancer) that are not due to cancer cells?