Neoplasia

Question 1

what is pathology?

Answer 1

the science of disease using detailed knowledge of normal cell biology to determine how illness arises

Question 2

what do pathologists do?

Answer 2

get specimens from clinicians, look macroscopically and interperate this in a clinical context to provide a likely diagnosis

Question 3

what is neoplasia?

Answer 3

an excessive, irreversible uncontrolled growth which persists even after withdrawal of the stimuli which caused it

Question 4

what is the difference between a tumour and neoplasia?

Answer 4

a tumour is swelling/lump
neoplasia is wider than this as not all neoplasms are guaranteed to cause swelling/lumps eg leukaemia

Question 4

what are the types of neoplastic diseases?

Answer 4

normal tissue, benign disease, malignancy, dysplasia

Question 5

what is hyperplasia

Answer 5

increase in the number of cells

Question 6

what is hypertrophy?

Answer 6

increase in cell size

Question 7

what is atrophy?

Answer 7

decrease in cell size

Question 8

what is metaplasia?

Answer 8

change in cell type

Question 9

what are some characteristics of benign neoplasms?

Answer 9

localised, well encapsulated, slow growing, resemble the origin, regular nucleus, few mitoses, damage at the local level

Question 9

what is necrosis?

Answer 9

uncontrolled cell death

Question 10

what is dysplasia?

Answer 10

abnorml/atypical cells due to failure in differentiation. in some areas in the body it can be called intraepithelial neoplasia. the degree of dysplasia helps the pathologist identify those tissues which are high risk for malignancy.tumour growing but it is confined to the epithelium (intraepithelial neoplasia)

Question 11

how can dysplasia be detected?

Answer 11

there is a disordered architecture of the tissue, a loss of normal structure

Question 12

what makes cells atypical?

Answer 12

pleomorphic nuclei and mitotic figures

Question 13

what are pleomorphic nuclei?

Answer 13

the nuclei are larger and mis shapen

Question 14

what are mitotic figures?

Answer 14

the cells are rapidly dividing, lots of cell division is noticeable

Question 15

what are features of malignancy?

Answer 15

invasive, can metastasise, grows fast, may not resemble tissue of origin, shows features of dysplasia, damage at local or distinct sites

Question 16

what is metastasis?

Answer 16

where invasive neoplasm spreads to the other areas of the body

Question 17

what are the different ways of metastasis?

Answer 17

-through lymphatics
-through blood
-transcoelomic

Question 18

what are complications of malignancy?

Answer 18

• the site of origin can be difficult to find which is called cancer of unknown primary
• this is important to know to help direct the treatment

Question 19

generally how are benign neoplasms named?

Answer 19

oma eg adenoma, papilloma

Question 20

generally how are malignant neoplasms named?

Answer 20

carcinoma for epithelial, sarcoma for connective tissue

Question 21

why is understanding signalling important for all doctors?

Answer 21

it allows us both to identify the prognosis and use targeted treatment for the patient if we know the specific cell signalling pathways

Question 22

what is metaplasia?

Answer 22

a change from one type of differentiated tissue into another. the resulting tissue is often better adapted to the environment.

Question 23

what is immunohistochemistry?

Answer 23

shows us where certain proteins are expressed within the cell and in roughly what quantities they are expressed

Question 24

how are the cell cycle and neoplasia linked?

Answer 24

we can look for specific changes in the cell cycle in neoplasms as part of diagnosis to help with creating management plans the presence or absence of mutations in the cell cycle can help determine prognosis and treatment

Question 25

what is grading?

Answer 25

how closely to not does the neoplasm correspond to the normal cells for that tissue. the more dysplastic the cells, the higher the grade. usually done by pathologist

Question 26

what is staging?

Answer 26

how far the neoplasm has spread throughout the body. usually done by MDT

Question 27

what is the classic staging tool?

Answer 27

TNM classification tumour -measures local invasion node - measure spread to lymph node metastasis- measures spread to distant tissues

Question 28

what are some examples of local effects

Answer 28

very tissue dependent -generalised symptoms eg pain lump -compression on surrounding structures -ulceration -bleeding/anemia

Question 29

what are some examples of metazoic effects

Answer 29

very site dependent -eg brain mets cause swelling, raised pressure, stroke and seizures

Question 30

what are some examples of systemic effects?

Answer 30

-weight loss, loss of apetite -fever or feeling non specifically not well -infection

Question 31

what are some examples of para neoplastic effects?

Answer 31

-secretion of excess substances eg hormones -raised calcium leading to confusion

Question 32

What are some examples of benign tumours in paediatrics?

Answer 32

Haemangioma Naevus Lymphangiomas Sacroccoygeal teratomas

Question 33

what is hyperplasia?

Answer 33

an increase in the size of an organ as a result of proliferation eg uterus in pregnancy

Question 34

what is hypertrophy?

Answer 34

an increase in the size of an organ due to an increase in the size of constituent cells eg left ventricle in hypertension

Question 35

what is a monoclonal tumour?

Answer 35

when one tumour derives from one cell only

Question 36

what is a liable tumour?

Answer 36

has a very quick turnover and replacement of cells eg epidermal cells on the surface of skin are replaced every week. blood cells last 120 days and then they are replaced

Question 37

what Is a stable tissue?

Answer 37

has a slow turnover eg cells in the bone

Question 38

what is a permanent tissue?

Answer 38

cells have no turnover and have be used for the rest of our lives (eg neural cells)

Question 39

what does hyperplasia lead to?

Answer 39

an increase in the size of an organ as a result of cell proliferation

Question 40

what does hypertrophy lead to?

Answer 40

an increase in the size of an organ due to an increase in the size of constituent cells eg left ventricle of the heart in hypertension

Question 41

what is necrosis?

Answer 41

death of cells in living tissue caused by external factors such as infection, trauma or toxins

Question 41

what is histogenesis?

Answer 41

the differentiation of cells into specialised tissues and organs during growth

Question 42

how are benign epithelial tumour named?

Answer 42

OMA papilloma (covering epithelia) adenoma (lining tubes or hollow organs or solid organs)

Question 43

how are malignant epithelial tumours named?

Answer 43

CARCINOMA eg adenocarcinoma (lining tubes of hollow organs)

Question 44

how are benign tumours of connective tissue named?

Answer 44

OMA

Question 45

how are malignant tumours of connective tissue named?

Answer 45

SARCOMA

Question 46

generally where are no benign tumours recognised?

Answer 46

lymphoids haematopoietic tissues glial cells mesothelium

Question 47

what are malignant tumours of the lymphoid called?

Answer 47

lymphoma (hodgkin or non hodgkin)

Question 48

how are malignant tumours of the haematopoeitc tissues named?

Answer 48

leukaemia

Question 49

how are primitive nerve cell (sense or receptive cell)malignant tumours named?

Answer 49

neuroblastoma retinoblastoma ect

Question 50

how are malignant tumours of glial cells named?

Answer 50

glioma eg astrocytoma

Question 51

how are germ cell tumours named?

Answer 51

teratoma

Question 52

what are moles called>

Answer 52

pigmented naevi

Question 53

what is metaplasia?

Answer 53

change from one type of differentiated tissue to another. resulting tissue is often better suited fro the environment

Question 54

what type of tumours generally spread via blood?

Answer 54

carcinomas (kidney colorectal and prostate) and sarcomas

Question 55

what type of cancer is lymphatic spread rare in?

Answer 55

sarcomas

Question 56

what is transcoelomic spread?

Answer 56

spread of tumours across peritoneum and peritoneal cavity eg. ovary and stomach