Neoplasia 1

Question 1

Tumour define

Answer 1

any clinically detectable lump or swelling

Question 2

Neoplasm define

Answer 2

Abnormal new growth of cells that persists after stimulus is removed

(Type of tumour)

Question 3

Oncology define

Answer 3

Study of tumours and neoplasms

Question 4

Benign neoplasm define

Answer 4

Gross and microscopic appearances are considered to be innocent

Implying that it will Remain localised will not spread to other sites

Question 5

Cancer define

Answer 5

Layman

Malignant neoplasm

Question 6

Malignant neoplasm define

Answer 6

Abnormal growth of cells that persists after stimulus is removed
Invades surrounding tissues and potential to spread distally

Question 7

Metastasis define

Answer 7

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

Question 8

What is dysplasia?

Answer 8

Pre-neoplastic alteration in which
cells show disorganised tissue organisation (confined to epithelia layer)
Reversible

Question 9

Appearance dysplasia

Answer 9

Pleomorphism
Large hyperchromatic nuclei
High nuclei to cytoplasm ratio

(similar to poor differentiation malignant)

Question 10

2 sites of malignant neoplasm

Answer 10

Primary site (original location)
Secondary site (spread to)

Question 11

Benign vs Malignant

Answer 11

Benign: Remain confined and DO NOT metastasise
Malignant: Invade and DO metastasise

Question 12

3 features of benign tumours

Answer 12

Confined local area growth 
Psuedocapsule (pushing outer margin)
Rarely dangerous (depending on location though)

Question 13

3 features of malignant tumours

Answer 13

Irregular outer margin and shape
Ulcerations and central necrosis
Infiltrative (breach basement membrane)

Question 14

Differentiation benign vs malignant

Answer 14

Benign: well differentiated (resemble parent tissue)

Malignant well-poor differentiated (don’t resemble origin tissue)

Question 15

Cells with no resemblance to any tissue are called…

Answer 15

Anaplastic tissue

Question 16

What happens as differentiation worsens (poor differentiation)?

Answer 16

Increase:
size of nucleus
nuclear to cytoplasmic ratio
nuclear staining (hyperchromasia)
Numbers of mitotic figures 

Abnormal mitotic figures (Benz)
Variation in cell and nuclei shape/size (pleomorphism)

Question 17

How do clinicians define differentiation?

Answer 17

Grades
Higher grade = more poorly differentiated
(eg grade 3 cancer = very poorly differentiated)

Question 18

Grading breast tissue

Answer 18

Grade 1: glandular structure preserved mostly, uniform cells
Grade 2: loss of some glands, cells larger and variable in shape
Grade 3: minimal glands, lots of mitosis, variable cell shape

Question 19

Gleasons pattern

Answer 19

Prostate grading

1-5 with worsening gland formation

Question 20

Why is grading important?

Answer 20

If later grade, lower chance of survival and determines treatment

eg higher grades need more aggressive treatment

Question 21

Steps of cell becoming neoplastic

Answer 21

Normal
Dysplasia
Carcinoma in situ (no breach of BM)
Invasive carcinoma

Question 22

Cervical dysplasia grading

Answer 22

Normal
CIN 1 (lower grade, lower 3rd affected)
CIN 2 (moderate, lower 2/3rds affected)
CIN 3 (carcinoma in situ, entire thickness affected)

Question 23

Why do we get neoplasia?

Answer 23

Lots of new cells dividing every day 
Introduction of mutations - from INITIATORS
Accumulate 
PROMOTORS cause proliferation
= tumour from clonal expansion

Question 24

What sort of damage causes neoplasia?

Answer 24

Non-lethal genetic damage

Question 25

Initiators of mutations include...

Answer 25

Chemicals (eg smoking, alcohol, diet, obesity) Infectious agents (HPV) Radiation Inherited mutations

Question 26

Steps of neoplasm

Answer 26

Initiator = mutation Promotor (proliferation of cells with mutation) Progression (accumulate more mutations to enhance survival)

Question 27

What genes are often affected by cancer causing mutations? (4)

Answer 27

Proto-oncogenes Tumour suppressor genes Genes that regulated apoptosis DNA repair genes

Question 28

What are proto-oncogenes?

Answer 28

Drive proliferation

Question 29

Proto-oncogene mutation do?

Answer 29

Excessive increase in normal functions or give a new function (GAIN OF FUNCTION mutation)

Question 30

Proto-oncogene mutation explained

Answer 30

Proto-oncogene (mutates) --> oncogene --> oncoprotein oncoproteins promote growth without signals now

Question 31

Oncogene importance

Answer 31

Dominate over counterparts (only one allele needs to be affected)

Question 32

Example of PO mutation

Answer 32

BRAF (v600e) mutation

Question 33

Tumour suppressor gene function mutation

Answer 33

Usually stop cell proliferation Mutation = loss of function (fail to inhibit growth) (p53)

Question 34

Mutations needed TSG

Answer 34

Both alleles must be damaged to occur (recessive)

Question 35

Apoptosis regulating genes mutation

Answer 35

Abnormalities = less programmed cell death and enhanced survival of cells

Question 36

DNA repair gene mutations

Answer 36

Loss of function Impair ability for cell to recognise and repair non-lethal genetic damage Cells acquire mutations quicker

Question 37

DNA repair gene mutation known as

Answer 37

Mutator phenotype (marked by genetic instability)

Question 38

How are neoplasms named?

Answer 38

Benign end in -oma ``` Malignant end -carcinoma (if epithelial 90%) or sarcoma (if stromal) ```

Question 39

benign epithelial neoplasms

Answer 39

``` Squamous papilloma (skin) Transitional cell papilloma (bladder mucosa) ``` Adenoma (glands) Cystadenoma (ovary gland)

Question 40

How are polyps of epithelial neoplasms named?

Answer 40

Villous (finger like) Sessile (box) Tubular (polyp of colon)

Question 41

Malignant epithelial neoplasms

Answer 41

Squamous cell carcinoma (skin, lung) Transitional cell carcinoma (bladder) Adenocarcinoma (glandular) Basal cell carcinoma

Question 42

Connective tissue benign neoplasms

Answer 42

``` Leiomyoma (smooth muscle) Fibroma Osteoma Chondroma (cartilage) Lipoma Neuroma Neurofibroma (nerve sheath) Glioma (glial cells) ```

Question 43

Connective tissue malignant neoplasms

Answer 43

``` Leiomyosarcoma (smooth muscle) Osteosarcoma Fibrosarcoma Chondrosarcoma Liposarcoma Malignant glioma ```

Question 44

Germ cell neoplasms malignant vs benign

Answer 44

Malignant teratoma and Seminoma (testes, exception to -oma benign rule, ITS MALIGNANT) Benign teratoma in ovaries = dermoid cyst (benign, follows rule)