Neoplasm Flashcards
(19 cards)
What is neoplasia
Abnormal Growth of tissue - can be benign or malignant; Malignant Neoplasm is cancer
Gross Differences between Benign and Malignant (2)
Smooth surface, FIBROUS capsule (encapsulated), well-circumscribed; Irregular surface (of infiltrative border), poorly-circumscribed;
Unlikely to show necrosis; involves necrosis (cells outgrow blood vessels), hemorrhage;
Microscopic Differences
- Cytology: Pleomorphism (variation in size, shape of cells), hyperchromic, irregular, enlarged nuclei and large nucleolus, high NC ratio, clumped chromatin; VS: cells similar to one another, uniform appearance;
- Increased DNA also
- mitotic figures, increased mitotic activity;
- necrosis & hemorrhage seen, metatasis
- invasion of surrounding tissues; compression of surrounding
- poorly differentiated anaplasia (end stage dysplasia - abnormal development); highly differentiated, resemble normal tissue
- more numerous blood vessels! poorly formed; well-formed blood vessels
- desmoplastic - growth of fibrous tissues
Absolute Difference (2)
Infiltration and Metastasis
Carcinoma Definition
- malignant epithelial neoplasms
Infiltration involves passing basement membrane;
Sarcoma Definition
- malignant mesenchymal neoplasms
Squamous Cell Carcinoma features
- Keratin Pearls
- Intercellular Bridges
- Basement membrane invasion
Adenoma and Papilloma Definitions
Adenoma - benign of glandular origin
Papilloma - benign papillary pattern of growth
Teratoma Definition
Germ Cell tumors
- mature ones are usually benign; immature ones can be malignant
Paraneoplastic syndrome Definition
Symptoms not due to spread of tumor or indigenous hormonal effects to the tissue involved in tumor
eg Squamous Cell carcinoma - produce ACTH - Cushing’s Syndrome
Dysplasia Definition
disordered growth, has premalignant connotation;
eg Polyps in FAP, dysplastic glands, lack infiltrative or metastasis abilities, if bounded by basement membrane can be removed
dysplastic cells cannot breach BM yet;
Cervical Intraepithelial Neoplasia
- risk factor?
No such thing as sarcoma in-situ, on site is for epithelium only;
HPV 16 ,18
Carcinoma in-situ: Endocervix epithelial dysplasia
Cervical intraepithelial neoplasia (CIN), also known as cervical dysplasia
Intraepithelial neoplasia VS Infiltrative carcinoma
- if excised, IN can be cured
have cytological hallmarks of cancer but no invasive ability is not cancer - precancerous
Note all carcinomas begin as in situ
Spread of Cancer (5)
Local Infiltration - surrounding tissues eg Rectal to Bladder
Spread through body cavities - SEEDING eg Peritoneal cavities, pleural cavities, pericardial, Subarachnoid space, joints
Lymphatic spread
Venous Spread
- GI goes to Liver due to first pass - portal system
- Rest goes to Lungs - caval system
Hematogenous spread
- Pass lungs microcirculation capillaries, then arteries to distant organs eg Brain, Bone
- AV shunting;
TNM Staging System
T - Primary Tumor (Site) extension of INVASION, infiltration, spread; size can be considered too
N - Regional Lymph Node
M - Distant Metastasis
- Stage 3 means Lymph Node yes
- Stage 4 means metastasis yes
Metaplasia Definition
Transformation of Cell type
Cancer Grading
Based on histology and extent of differentiation
1 is well differentiated
- Cytologic evidence of anaplasia / cytologic atypia includes variation in size and shape of the cells especially the nuclei, enlarged and hyperchromatic nuclei, high N/C ratio , clumped chromatin, prominent nucleoli, atypical mitoses and bizarre cells
Random description of a malignant breast cancer
Poor circumscription - Irregular mass
Invasion in to fibrous tissues, muscles - fixed
Desmoplastic stroma - Hard
Nipple retraction, due to desmoplastic rxn and fibrosis, pulling skin backwards
Squamous Differentiation
Means Squamous Cell Carcinoma, no gland involvement
- Keratin Pearls - concentric layering of cells
- Intercellular Bridges
- Cells w eosinophilic cytoplasm (granules)
- basement membrane inflitration
Lung Cancer Paraneoplastic syndromes
From which type of lung cancer?
PTH- related protein - Hypercalcemia
- Bone resorption
- Increased Ca2+ reabsorption
- Increased intestinal absorption
ACTH-like - Cushing’s Syndrome
ADH - SIADH
Due to its high grade neuroendocrine nature, small-cell carcinomas can produce ectopic hormones, including adrenocorticotropic hormone (ACTH) and anti-diuretic hormone (ADH).
- Small Cell Carcinoma
but non-small cell Lung Carcinoma can also
- Squamous Cell Carcinoma
