Pathology and classification of neoplasms

Question 1

What is a neoplasm?

Answer 1

An new and abnormal growth in tissue. It is a mass of cells that have undergone an irreversible change to proliferate in an uncoordinated manner independently to factors controlling normal growth.

Question 2

What is cancer?

What is a tumour?

Answer 2

A malignant neoplasm

A tissue swelling

Question 3

Does a neoplasm continue to grow?

Answer 3

Even if the initiating stimulus has been removed.

Question 4

In which 4 ways can a neoplasm be classified?

Answer 4

Behavioural
Histogenesis
Histology
Functional

Question 5

What does behaviour classify the neoplasm into?

Answer 5

Benign or malignant

Question 6

What is a malignant neoplasm?

Answer 6

Locally invading and metastasising tissue that forms secondary deposits through lymphatics or blood.

Question 7

How does an intermediate neoplasm behave?

Answer 7

It is locally invading but not metastasising. e.g. basal cell carcinoma of skin

Question 8

Why is staging useful?

Answer 8

Describes the extent of spread and is important for prognosis and treament

Question 9

What is the most common staging system?

Answer 9

TNM
T = Tumour size and local spread
N = Lymph node involvement
M = Metastasis

Question 10

How does histogenesis classify?

Answer 10

Describes the tissue of origin and extent of differentiation.

Question 11

What type of behaviour do mesenchymal neoplasms normally have?

Answer 11

Benign

Question 12

What do haemato-lymphoid neoplasmas lead to?

Answer 12

Lymphoma and leukaemia

Question 13

What do germ cell neoplasms lead to?

Answer 13

Teratoma or seminoma

Question 14

What is differentiation?

Answer 14

The degree to which the neoplasms histologically resembles its tissue of origin.

Question 15

What is the differentiation of a benign neoplasm?

Answer 15

Well differentiated and closely resembles tissue of origin

Question 16

What is the differentiation of a malignant neoplasm?

Answer 16

Less differentiated and resembles origin less. The degree will vary.

Question 17

What is the function of grading?

Answer 17

Describes the degree of differentiation and is useful for prognosis and treatment.

Question 18

What is the normal grading system?

Answer 18

1 = well differentiated
2 = moderately differentiated 
3 = poorly differentiated

Question 19

What is an ANAPLASTIC neoplasm?

Answer 19

A malignant tumour that is too poorly differentiated to be able to determine its tissue of origin.

Question 20

What name is given to a malignant epithelial tumour?

Answer 20

Carcinoma
Papilloma (benign)
Forms the suffix to the tumour name

Question 21

What name is given to a malignant mesenchyme tumour?

Answer 21

Sarcoma

Forms the suffix to the tumour name

Question 22

A neoplasm arising from glandular tissue is called..

Answer 22

Adenoma (benign)

Adenocarcinoma (malignant)

Question 23

A neoplasm arising from cartilage is called..

Answer 23

Chondroma

Chondrsarcoma

Question 24

A neoplasm arising from bone is called..

Answer 24

Osteoma

Osteosarcoma

Question 25

A neoplasm arising from smooth muscles is called..

Answer 25

Leiomyoma | Leiomyosarcoma

Question 26

What is histology classification?

Answer 26

Classifies tumours based on their histological appearance/features

Question 27

What is a papillary feature?

Answer 27

Finger like structures - commonly spread via lymphatics

Question 28

What is a follicular feature?

Answer 28

Forms glandular structures - commonly spreads haematogeneously to form bone metastases

Question 29

Where do anaplastic tumours normal spread?

Answer 29

Locally invade and have poor survival

Question 30

What is functional classification?

Answer 30

Classifies according to the substances it produces.

Question 31

What do endocrine neoplasms produce?

Answer 31

Secrete functioning and active hormones

Question 32

Where is an insulinoma located?

Answer 32

Insulin producing pancreatic islet cell

Question 33

Where is a prolactinoma located?

Answer 33

Prolactin producing Anterior pituitary neoplasm

Question 34

What is a teratoma?

Answer 34

A neoplasm derived from embryonic germ cells which have the capacity to form tissues from any of the 3 germ layers.

Question 35

Where do teratomas commonly occur?

Answer 35

Ovaries (benign cysts), Testes (malignant) and midline structures such as mediastinum and retroperitoneum.

Question 36

What is an embryonic tumour?

Answer 36

A neoplasm occurring in a developing organ, derived from multi-potent embryonic blast cells.

Question 37

What is the name given to an embryonic tumour?

Answer 37

suffix = Blastoma

Question 38

When do blastomas usually present?

Answer 38

Present at or soon after birth Respond well to aggressive treatment Usually have different differentiations within

Question 39

What is a hamartoma?

Answer 39

A tumour like malformation that presents at birth but stops growing as the host stops. e.g. pigmented skin naevi, skin haemangiomas.

Question 40

What is the gross appearance of a malignant tumour?

Answer 40

Irregular shape, large with ulceration, haemorrhage and necrosis

Question 41

What is the gross appearance of a benign tumour?

Answer 41

Well defined and circumscribed, usually smaller with no haemorrhage, ulceration or necrosis

Question 42

What is a key difference between malignant and benign?

Answer 42

Malignant invade and metastasise, benign do not.

Question 43

What is the microscopic appearance of a malignant tumour?

Answer 43

Enlarged nucleus with prominent nucleoli Pleomorphism present (varying cell shape and size) Frequent and atypical mitotsis in cells Variable differentation

Question 44

What is the microscopic appearance of a benign tumour?

Answer 44

Normal nucleus with small nucleoli Absence of pleomorphism Infrequent mitosis Well differentiated

Question 45

What is the difference between the growth of a benign and malignant tumour?

Answer 45

Benign grow slowly and spontaneously arrest. | Malignant grow rapid without arrest

Question 46

What are the main effects of a benign tumour on the host?

Answer 46

It creates mechanical pressure

Question 47

What are the main effects of a malignant tumour?

Answer 47

``` Causes mechanical pressure Invasion damages vital structures Metastasis - common cause of death Development of paraneoplastic syndromes Death is frequent ```

Question 48

What is a paraneoplastic syndrome?

Answer 48

A rare disorder that is triggered by an altered immune system in response to a neoplasm. They are nonmetastatic systemic effects that are not related to the location of the tumour. e.g. SIADH, Cushing's