Neoplasia Flashcards
(30 cards)
How do you classify neoplasms
- on cell origin
E.g epithelial - on tumour behaviour
E.g malignant
How do you classify tumours
- Epithelial - carcinoma
- Mesenchymal - liposarcoma
- Neuroectoderm - astrocytoma
- Haemopoietic - lymphoma
- Germ cells - teratoma
Benign vs malignant tumour
Cell growth of tumour cell
See abnormal mitosis in malignant cells
Gross description of tumour
Size
Shape
Number
Consistency
Site
Special features
Grading tumours - how it looks
Grade 1 - well differentiated
Grade 2 - moderately differentiated
Grade 3 - poorly differentiated
Tumour morphology
Tumour staging
The extent of the tumour in the body,
How it has spread
What’s does grade 1 squamous cell carcinoma look like
Tumour resembles normal squamous epithelium and contains proportion of differentiated keratinocyte-like squamous cells.
Intercellular bridges are always present.
Keratin pearls are frequently found.
Mitoses are scanty.
What does grade 2 squamous cell carcinoma look like
Tumour cells exhibits more nuclear pleomorphism.
There is usually less keratinisation.
Increased number of mitoses, including abnormal mitoses.
What does grade 3 squamous cell carcinoma look like
Non-keratinsed basal-type cells predominate.
Barely discernible intercellular bridges,
and minimal
keratinisation.
High mitotic rate, including abnormal mitoses.
Effects of benign tumours
- discomfort
- production of active substance, e.g. hormone (thyroid adenoma)
- Pressure effect on adjacent tissue, e.g. intracranial or intrauterine
Direct effects of malignant tumours
• Pain, rapidly growing infiltrative mass
• Blood loss, ulceration, haemorrhage, anaemia
• Mechanical effect, stenosis or obstruction
What are paraneoplastic syndromes
• Paraneoplastic syndromes are symptoms that occur at sites distant
from a tumour or its metastasis.
• Pathogenesis unclear, but symptoms may be secondary to substances
secreted by the tumour or a result of antibodies directed against
tumours that cross-react with other tissue.
• Up to 20% of cancer patients experience paraneoplastic syndromes.
What is tumour grade
biological nature of tumor, based on histological analysis: differentiation, mitotic activity, pleomorphism
What is tumour stage
extent of tumour: size and spread, after pathological and radiological analysis
5 main modes of tumour spread
• Local invasion.
• Lymphatic spread.
• Vascular spread.
• Other ways of spread: Transcoelomic spread or Intraepithelial spread.
What is local invasion
Tumour spread into surrounding tissues by the direct route. Examples: carcinoma of the breast invading overlying skin and
carcinoma of the cervix invading rectum or bladder
What is lymphatic spread
• Cancer spread via lymphatic vessels
draining the site of primary tumour.
• Neoplastic cells are conducted to local
lymph nodes where they may form
secondary tumours, e.g. breast cancer
spreading to axilla lymph nodes, or
tongue cancer spreading to neck
nodes.
• Form the basis of N (lymph node)
What is vascular spread
• Tumour spread via the veins
draining the primary site.
• Gut tumours tend to spread via
the portal vein to the liver.
• In the systemic circulation,
neoplastic cells may be trapped
in the lung to form pulmonary
metastases.
• The basis of M staging (metastasis)
What is Transcoelomic spread
• Tumours can spread across
coelomic spaces, e.g. across the
peritoneal or pleural cavities.
• Carcinoma of the ovary may
spread transcoelomically to
produce large numbers of
metastatic deposits on the
peritoneal surfaces
What is intraepithelial spread
How to use TNM classification to stage tumours
T- tumour
N- node
M- metastasis
Dysplasia is…
Disordered development of epithelium
It may be pre-malignant
