Flashcards in Lecture 8 Disorders of Growth 1 and 2 Deck (49):
Abnormal mass of tissue whos growth exceeds and is uncoordinated with normal tissues. Continues to excessively grow without the stimuli that envoked change.
Literally means swelling, but conventionally used as synonym for neoplasm.
Qualities of benign?
Lacks ability to invade or metastasize. Therefore not cancerous. Grows by expansion, displacing adjacent tissue.
Qualities of malignant?
Invades surrounding tissue, capable of producing metastases, may recur after removal -> death. Grows by infiltration of local tissues.
Malignant tumours can spread by
Local (direct invasion) or distant (metastasis)
Malignant tumour of epithelial tissue
Malignant tumour of stromal tissue
What are stromal tissues?
Connective tissue calls of any organ
Define metastasis 2 ways?
1) a secondary tumour 2) process by which secondary tumour is formed
What are the routes of metastasis?
Lymphatics, blood, transcoelomic, along epithelial lined spaces, within epithelium.
Explain how lymphatics are metastasis routes?
Tumour may directly invade lymphatics. Tumour emboli filtered out -> grow in lymph nodes.Typical of Epithelial malignancy.
Explain how blood is a metastasis route?
Tumour in vessels ->Filtered out by capillary beds (liver or lung). Typical of stromal malignancy and later stages of epithelial malignancy.
Define transcoelomic spread
Across body cavity
Where are transcoelomic spread tumours found?
Peritoneal or pleural
Where are epithelial lined spaces tumours found?
Bronchiolo - alveolar carcinoma of lung
Where are epithelial malignancies normally found?
Where are stromal malignancies and late stage epithelial malignancies found?
Capillary beds (liver and lung)
Give an example of when a metastasis occurs within epithelium cells
Paget's disease of the nipple.
How they're classified?
Naked eye appearance (site, conformation), histological, histogenesis, aetiological, functional.
What is histological?
What does the tissue resemble? How close is the resemblance?
Cell of origin
What is aetiological
Inheritance v environmental
What does the naming of neoplams (tumour terminology) depend on?
Site, behaviour, histogenesis.
What does a benign tumour end in?
Mass attached to a surface, may or may not be a neoplasm
What is leukaemia?
Neoplastic proliferation of haemopoietic stem cells -> spill into blood stream. MALIGNANT
What is lymphoma?
Malignant proliferation of cells of lymphoid tissue. 2 types, Hodgkin's disease or non-hodgkin's lymphoma.
What is hodgkin's disease?
Lymphoma, mix of cells including Reed-Sternberg cells
What is non-hodgkin's disease?
Lymphoma. Lacks cellular mixture.
Arises from totipotential cells, producing tissues prepresenting all three germ cell layers
Teratoma in ovary is usually?
Benign. (struma ovarii) AND (Ovarian teratoma with teeth/skin/adnexae)
Teratoma in testes is usually?
Teratoma in midline is usually?
Sequestered primitive cells
Define totipotential cells?
Potential to give rise to any and all human cells (for example one celled fertilised egg).
What is a premalignant condition?
Lesions with an ^ risk of developing an invasive tumour
Give 4 non-neoplastic examples of premalignant conditions?
Chronic inflammation, cirrhosis of liver, chronic ulcerative colitis and xeroderma pigmentosum
Give example of how chronic inflammation can cause cancer?
Varicose leg ulcers can lead to skin cancer
Give example of how chronic ulcerative colitis can lead to cancer?
Adenocarcinoma of large intestine
Give 2 neoplastic examples of premalignant conditions?
Familial polyposis coli and intra-epithelial neoplasia
What is familial polyposis coli?
Autosomal dominant, 1000s of large intestinal adenomas -> Carcinoma inevitable
What is intra-epithelial neoplasia?
Nuclear changes of carcinoma, without breaching basement membrane - "dysplasia" or "carcinoma in situ". Uterine cervix, vulva, bronchus.
What is tumour grading? (Only for malignant tumours)
How bad it looks. Assesses the degree of differentiation of a tumour. Correlates with how aggressive tumour behaves. Usually 3 or 4 grades.
Problems with grading?
Subjective. Appearances vary from area to area. Different criteria needed for each histogenesis
What is tumour staging?
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)
Which has the better prediction of outcome, Grading or Staging?
What are the effects of tumours?
1) displacement or destruction of normal structures 2) excess normal function 3) Paraneoplastic phenomena
What are the effects of benign tumours?
Mechanical pressure, obstruction, ulceration, infarction of pedunculated tumour, infection, rupture of cystic neoplasm, hormone production, malignant change.
What are the effects of malignant tumours?
Tissue destruction, haemorrage, secondary infection, cachexia, pain, anaemia, paraneoplasic syndromes