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1

Define a Tumour

Define a Neoplasm

Define Cancer

Define a Metastasis

Tumour: A clinically detectable lump or swelling

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

Cancer: A malignant neoplasm

Metastasis: A malignant neoplasm that has spread from its original site to a new non-contiguous site

2

Compare Primary and Secondary Sites of a malignant neoplasm

Primary site: Original location of the malignant neoplasm

Secondary site: Place to which a malignant neoplasm has spread (Metastasis)

3

Compare the Behaviour of a Benin and Malignant Neoplasm

Benign Neoplasms:
- Remain confined to their site of origin and do not produce metastases

Malignant Neoplasms:
- Invade distant sites and can metastasise

4

Compare the Apperance to the Naked Eyes (Macroscopic features) of Benign and Malignant Neoplasms

Benign Neoplasm;
- Grow in a confined local area
- Have a pushing outer margin
- Rarely dangerous (due to location)

Malignant Neoplasm;
- Irregular outer margin and shape
- May have ulcerations and necrosis
- Infiltrative

5

Compare the Microscopic appearances of Benign and Malignant neoplasms

What are Anaplastic cells

Benign:
- Closely resemble the parent tissue( are well differentiated)

Malignant:
- Range from well to poorly differentiated

Cells with no resemblance to any tissue

6

How do the following change with worsening differentiation;

1. Nuclear size
2. Nuclear to cytoplasmic size
3. Nuclear staining
4. Mitotic figures (Lacking a nuclear membrane, hairy projections of chromosomes)
5. Size and shape of cells and nuclei

1. Increase
2. Increase
3. Increase (Hyperchromasia)
4. More + Abnormal
5. Increased variation (Pleomorphism)

7

What term do clinicians use to indicate differentiation of a tumour

What does Mild, Moderate and Severe dysplasia indicate

Grade (High grade= poorly differentiated)

Indicates worsening differentiation

8

Compare Invasive and In-Situ malignancy

Invasive: Breach of basement membrane

In-situ: Basement membrane not breached

9

What causes Neoplasia

What 2 things cause these? What do they do?

Accumulated mutations in somatic cells

Initiators: Cause mutations
Promotors: Cause cell proliferation

10

What is the result of a combination of Initiators and Promotors

By what process does this lead to a Neoplasm forming?
What characterises this process?

An expanded monoclonal population of mutant cells

Progression, characterised by accumulation of more mutations

11

Name the 3 main initiators/ promoters that cause a neoplasm

What is another way cells can be mutated

- Chemicals (Smoking/ Alcohol/ Diet and Obesity)
- Infections (HPV)
- Radiation

- Inherited mutations

12

What 4 types of genes are affected by genetic alterations, leading to mutations.

1. Proto-oncogenes (Growth promoting)
2. Tumour suppressor genes (Growth inhibiting)
3. Genes that regulate apoptosis
4. Genes involved in DNA repair

13

How do mutations generally affect proto-oncogenes to activate them?

How do Oncogenes cause growth of the cell

Are oncogenes dominant over (normal) proto-oncogenes

Generally cause in excessive increase in 1/ more normal functions (Gain of function mutations)

Produce Oncoproteins that can promote cell growth in the absence of normal growth promoting signals

Yes

14

How do mutations affect Tumour Suppressor genes to lead to cancer?


How do mutations generally Apoptosis Regulating genes to cause cancer?

Loss of function mutations, leading to failure of growth inhibition

Apoptosis regulating genes may acquire abnormalities that result in less cell death, and enhanced cell survival

15

How do mutations affect DNA Repair genes to lead to cancer in 2 ways?

(Loss of function mutations)

1. Impair the ability of the cell to recognise and repair non-lethal genetic damage in other genes

2. Leads to cells acquiring mutations at an accelerated rate (Mutator Phenotype, marked by genomic instability)

16

What do Benign tumours usually end in?
What do Maligant tumours usually end in?

Benign: End in -oma
Malignant: End in -carcinoma (90% of neoplasms)/ sarcoma

17

Malignant tumours generally end in Carcinoma or Sarcoma. When do you use each?

Carcinoma- Epithelial
Sarcoma- Stroma

18

What is a Papilloma?
What is an Adenoma?

Papilloma: Any benign tumour with finger-like projections

Adenoma: A benign tumour formed from glandular structures in epithelial tissue

19

What is Leukaemia?

What is a Lymphoma?

What is a Myeloma?

Leukaemia: A maligant neoplasm of blood cells arising in blood marrow

Lymphoma: Maligant neoplasms of lymphocytes (mainly affecting lymph nodes)

Myeloma: A Maligant neoplasm of plasma cells

20

What do Germ Cell neoplasms arise from?

What do Neuroendocrine tumours arise from?

Germ cell: Arise from pluripotent cells (mainly in testis or ovary)

Neuroendocrine: Arise from endocrine cells distributed throughout the body (All are malignant)

21

Name 1 tumour that can arise from the Testis and 1 from the Ovary

Testis;
Malignant Teratoma

Ovary;
Benign Teratoma/ Dermoid cyst (A saclike growth present at birth, contains hair/ fluid/ teeth/ skin glands)

22

Neuroendocrine tumours can affect any organ, but in which 2 organ systems are they most common?

What do they produce

Respiratory
Gastrointestinal

Produce excess secretory products

23

Name 2 conditions that can be caused by Neuroendocrine tumours secreting excess products

Cushing’s syndrome

Carcinoid syndrome;
- (Excess serotonin, as well as others like Histamine/ Bradykinin/ prostaglandins etc. Which can be detected in blood and urine)
- More common with metastatic disease

24

What are 5 symptoms of Carcinoid syndrome

- Flushing
- Abdominal pain
- Diarrhoea
- Nausea
- Vomiting

25

Outline the classification of Neuroendocrine tumours in the gastrointestinal system

Separated into;
- Well differentiated Neuroendocrine tumours (Grade 1,2)
- Poorly differentiated Neuroendocrine tumours (Grade 3)

26

Outline the classification of neuroendocrine tumours in the respiratory system

The presence of what 2 process are key in these

A spectrum from lower grade malignant tumours to height grade carcinomas

Present of necrosis and mitotic activity is key

27

What are Carcinoid tumours

Well differentiated Neuroendocrine tumours in appendix