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ESA 2- Mechanisms of Disease > Neoplasms 1 > Flashcards

Neoplasms 1 Flashcards

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1
Q

What is a neoplasm?

A

An abnormal growth of cells that persists after the initial stimulus is response

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2
Q

What must be true for a neoplasm to grow without continuation of the stimulus?

A

Some degree of autonomous growth

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3
Q

What is a malignant neoplasm?

A

A neoplasm that invades the surrounding tissue with the potential to spread to a distant site

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4
Q

Is hyperplasia reversible?

A

Yes

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5
Q

What causes neoplasia?

A

Genetic alterations

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6
Q

It neoplasia reversible?

A

No

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7
Q

What is a tumour?

A

Any clinically detectable lump or swelling

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8
Q

Is a neoplasm a tumour?

A

Yes, but just one type

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9
Q

What is a cancer?

A

Any malignant neoplasm

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10
Q

What is a metastasis?

A

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

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11
Q

What must be true of the spread of a malignant neoplasm?

A

It cannot be due to direct spread, it must have some sort of transport mechanism

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12
Q

What is the primary site?

A

The original location of the tumour

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13
Q

What are the places a cancer has spread to called?

A

Secondary sites

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14
Q

What is dysplasia?

A

A pre-neoplastic alteration in which cells show disordered tissue organisation

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15
Q

Why is dysplasia not neoplastic?

A

Because the change is reversible

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16
Q

What can dysplasia lead to?

A

Neoplasia

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17
Q

What is the difference between benign and malignant neoplasms?

A

They show different behaviour

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18
Q

What behaviour do benign neoplasms show?

A

They remain confined to their site of origin, and do not produce metastases

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19
Q

Are benign neoplasms symptomatic?

A

They may or may not be, depending on location

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20
Q

When may benign neoplasms cause symptoms?

A

If at a critical site, for example a small space

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21
Q

What do malignant neoplasms have the potential to do?

A

Metastasise

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22
Q

What is the problem with malignant neoplasms metastasising?

A

There is an ever increasing tumour burden, the tumour spreads to make new tumours, which then have the potential to make new tumours too

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23
Q

What do benign tumours do?

A

Push and squash

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24
Q

What do malignant tumours do?

A

Invade and destroy

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25
How do benign tumours appear to the naked eye?
They grow in a confined local area and so have a pushing outer margin
26
How do malignant tumours appear to the naked eye?
They have an irregular, jagged outer margin and may show areas of necrosis and ulceration (if on surface)
27
Why do malignant tumours show areas of necrosis?
Often, bits of tumour are growing faster than the blood supply, so undergo ischaemic death
28
Why do malignant tumours cause ulceration?
They cause a break in the surface
29
What do neoplasms show under the microscope?
Varying degrees of differentiation
30
How do benign tumours appear under the microscope?
They have cells that closely resemble the parent tissue, i.e. they are well differentiated
31
How do malignant neoplasms appear under the microscope?
They range from well to poorly differentiated
32
What are cells that have no resemblance to any tissue called?
Anaplastic
33
What happens to cells with worsening differentiation?
They have increasing nuclear size and nuclear to cytoplasmic ratio Increased nuclear staining  More mitotic figures  Increasing variation in size and shape of cells and nuclei
34
What does an increase in nuclear size reflect?
A change in chromosomes
35
What is increased nucleur staining known as?
Hyperchromasia
36
What is a variation in size and shape of nuclear staining called?
Pleomorphism
37
How do clinicians indicate differentiation?
In grades, with high grade being poorly differentiated
38
What does dysplasia represent?
Altered differentiation
39
What indicates worsening differentiation?
Mild, moderate and severe dysplasia
40
What is neoplasia caused by?
Accumulated mutations in somatic cells
41
What are mutations caused by?
Initiators and promoters
42
What are initiators?
Mutagenic agents
43
What do promoters cause?
Cell proliferation
44
What do initiators and promotes result in, in combination?
An expanded, monoclonal population of mutant cells
45
What are the main initiators?
Chemicals  Infections  Radiation
46
Can chemicals, infections and radiation act as promoters?
Some can
47
How can mutations be obtained in some neoplasms?
Inherited, rather than from an external mutagenic agent
48
How does a neoplasm emerge from a monoclonal population?
Through a process called progression
49
What is progression characterised by?
Accumulation of yet more mutations
50
When is a collection of cells monoclonal?
If they all originated from a single founding cell
51
Where does evidence that neoplasms are monoclonal come from?
The study of the X-linked gene for the enzyme glucose-6-phosphate dehydrogenase (G6PD) in tumour tissue in women
52
How does the G6PD gene provide evidence that neoplasms are monoclonal?
The gene has several alleles encoding different isoenzymes. Early in female embryogenesis, one allele is randomly inactivated in each cell (lyonisation). In heterozygous women that happen to have one allele encoding a heat stable isoenzyme and one heat lable isoenzyme, normal tissue will be a patchwork of each type. However, neoplastic tissues only express on isoenzyme indicating a monoclonal group of cells
53
What do genetic alterations affect?
Proto-oncogenes and tumour supressor genes
54
What happens to proto-oncogenes that causes neoplasms?
They become abnormally activated
55
What are proto-oncogenes called when they are activated?
Oncogenes
56
What do tumour suppressor genes normally do?
Suppress neoplasm formation
57
What happens to tumour suppressor genes that causes neoplasms?
They become inactivated
58
What does the organised system for naming neoplasms take into account?
A neoplasms site of origin, wether it is benign or malignant, the type of tissue the tumour forms and sometimes the gross morphology (e.g. a cyst or papilloma_
59
What do benign neoplasms end in?
#NAME?
60
What do malignant neoplasms end in?
-carcinoma if its epithelial  -sarcoma if its a stromal malignant neoplasm
61
What % of malignant tumours are epithelial?
90%
62
What can carcinomas be?
In situ  Invasive
63
What is meant by a tumour being in situ?
There is no invasion through the basement membrane
64
What is meant by a tumour being invasive?
It has penetrated through the basement membrane
65
What is leukaemia?
A malignant neoplasm of blood-forming cells arising in the bone marrow
66
What are lymphomas?
Malignant neoplasms of lymphocytes, mainly affecting lymph nodes
67
What is myeloma?
A malignant neoplasm of plasma cells
68
What do germ cells neoplasms arise from?
Pluripotent cells, mainly in the testis or ovary
69
What do neuroendocrine tumours arise from?
Cells distributed throughout the body
70
Who do -blastomas mainly occur in?
Children
71
What are -blastomas formed from?
Immature precursor cells

ESA 2- Mechanisms of Disease (11 decks)

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