Pathology of Neoplasia: classification and characteristics

Question 1

Define Tumour

Answer 1

literally means “a swelling” not necessarily neoplastic

Question 2

Define neoplasm

Answer 2

literally means “new growth”

an abnormal mass of tissue, the growth of which exceeds and is un-coordinated with that of the adjacent normal tissue and persists in the same excessive manner after cessation of the stimulus that provoked the change

Question 3

Whats the difference between benign and malignant neoplasms

Answer 3

Benign - usually harmless

Malignant - usually harmful

Question 4

How might a benign neoplasm threaten life

Answer 4

Meningioma = raised intracranial pressure

Insulinoma produces insulin = Hypoglycaemia

Question 5

Define Histogenesis

Answer 5

The cellular origin of a neoplasm

Question 6

Define Differentiation

Answer 6

The degree to which a neoplasm resembles its normal cell of origin

Question 7

What is the difference between a well and poorly differentiated neoplasm

Answer 7

Well differentiated - close resemblance to normal cell of origin
Poorly Differentiated - little resemblance to normal cell of origin

Question 8

Define Anaplasia

Answer 8

Complete lack of differentiation in a neoplasm

Question 9

What does the suffix of -oma mean for neoplasms and give examples

Answer 9

• benign neoplasms

e. g. papilloma, adenoma, lipoma

Question 10

What is the name of the benign epithelial neoplasms that you can find from stratified squamous epithelium and give and example of this epithelium

Answer 10

Squamous Cell Papilloma

e.g. skin

Question 11

What is the name of the benign epithelial neoplasms that you can find from transitional cell epithelium and give and example of this epithelium

Answer 11

Transitional cell papilloma

e.g. urogenital tract

Question 12

What is the name of the benign epithelial neoplasms that you can find from glandular epithelium and give and example of this epithelium

Answer 12

Adenoma

e.g. gastrointestinal tract

Question 13

What is the name for benign connective tissue neoplasms in fat cells

Answer 13

Lipoma

Question 14

What is the name for benign connective tissue neoplasms in smooth muscle cells

Answer 14

Leiomyoma

Question 15

What is the name for benign connective tissue neoplasms in nerve cells

Answer 15

Neurofibroma

Question 16

What is the name for benign connective tissue neoplasms in striated muscle cells

Answer 16

Rhabdomyoma

Question 17

What is the name for benign connective tissue neoplasms in endothelium cells

Answer 17

Haemangioma

Question 18

What exceptions are there to the benign neoplasm -oma rule

Answer 18

• Lymphoma
• Myeloma
• Melanoma
• mesothelioma

Question 19

What is the suffix for malignant neoplasms of epithelial tissue and give examples

Answer 19

• carcinoma

e. g. squamous cell carcinoma, adenocarcinoma

Question 20

What is the suffix for malignant neoplasms of connective tissue and give examples

Answer 20

• sarcoma

e. g. liposarcoma. leiomyosarcoma

Question 21

What is the suffix for malignant neoplasms of embryonic tissue and give examples

Answer 21

• blastoma

e. g. retinoblastoma

Question 22

What is the name for malignant epithelial neoplasms that you can find from stratified squamous epithelium and give an example of this epithelium

Answer 22

Squamous cell carcinoma

e.g. skin

Question 23

What is the name for malignant epithelial neoplasms that you can find from transitional cell epithelium and give an example of this epithelium

Answer 23

Transitional cell carcinoma

- urogenital tract

Question 24

What is the name for malignant epithelial neoplasms that you can find from glandular epithelium and give an example of this epithelium

Answer 24

Adenocarcinoma

e.g. gastrointestinal tract

Question 25

What is the name for malignant connective tissue neoplasms in fat cells

Answer 25

Liposarcoma

Question 26

What is the name for malignant connective tissue neoplasms in smooth muscle cells

Answer 26

Leiomyosarcoma

Question 27

What is the name for malignant connective tissue neoplasms in nerve cells

Answer 27

Neurofibrosarcoma

Question 28

What is the name for malignant connective tissue neoplasms in striated muscle cells

Answer 28

Rhabdomyosarcoma

Question 29

What is the name for malignant connective tissue neoplasms in endothelium cells

Answer 29

Haemangiosarcoma

Question 30

What is the name for malignant embryonic neoplasms from kidney cells

Answer 30

Nephroblastoma

Question 31

What is the name for malignant embryonic neoplasms from neural tissue cells

Answer 31

Neuroblastoma

Question 32

What is the name for malignant embryonic neoplasms from retina cells

Answer 32

Retinoblastoma

Question 33

Where are germ cell found

Answer 33

In the ovary and testes

Question 34

What is the name for neoplasms derived from germ cells

Answer 34

Teratomas

Question 35

How do teratomas differentiate and are they benign or malignants

Answer 35

Along more than one germ cell line | Teratomas can be benign or malignant

Question 36

Describe the macroscopic appearance of a benign and a malignant neoplasm

Answer 36

Benign - well-defined outline, smooth surface Malignant - Irregular or ill-defined outline, craggy surface

Question 37

Describe the microscopic margin of benign and malignant neoplasms

Answer 37

Benign - Blunt, pushing Malignant - Infiltrative, Invasive

Question 38

Describe the nucleus:cytoplasm ratio of benign and malignant neoplasms

Answer 38

Benign - Usually normal Malignant - Often high

Question 39

Describe the nucleus pleomorphism of benign and malignant neoplasms

Answer 39

Benign - uncommon Malignant - common

Question 40

Describe the necrosis of benign and malignant neoplasms

Answer 40

Benign - Very uncommon Malignant - Often present

Question 41

Describe the mitotic rate of benign and malignant neoplasms

Answer 41

Benign - Low, normal mitoses Malignant - Usually high, abnormal mitoses frequent

Question 42

What is Metastasis

Answer 42

Secondary growth of a neoplasm at one or more locations distant from the primary site, only occurs with malignant neoplasms

Question 43

How might spread of neoplasms occur

Answer 43

- Lymphatics - Blood vessels - Across mesothelial-lined cavities - Through cerebrospinal fluid

Question 44

Name as many mechanisms of invasion and metastasis as you can

Answer 44

- Detachment of tumour cells from each other - Attachment of ECM via specific receptors - Locomotion through the ECM via secretion of motility factors - Vascular intravasation - Interaction of tumour cells with host lymphocytes - Formation of tumour embolus - Adhesion to endothelium at a distant site via adhesion molecules

Question 45

Describe the patterns of metastasis for carcinomas

Answer 45

Via lymphatics (early) -> lymph nodes Via bloodstream (late) -> liver and lungs

Question 46

Describe the patterns of metastasis for sarcomas

Answer 46

Via bloodstream (early) -> lungs

Question 47

What other organs can bony metastasis affect

Answer 47

- Prostate - Lung - Thyroid - Kidney - Breast

Question 48

Why is anaemia common in cancer patients

Answer 48

- haemorrhage from the neoplasm - decreased life span or erythrocytes - replacement of bone marrow by metastatic tumour - autoantibodies against red cells

Question 49

What are the symptoms of cancer cachexia

Answer 49

- Weight loss - Anorexia - Fever - Weakness

Question 50

What does cancer cachexia probably result from

Answer 50

Cytokines (TNF-alpha, IL-1, IF-gamma) secreted by the tumour or reactive host cells

Question 51

Why do patients die from cancer

Answer 51

- Widespread disease in multiple organ sites - Metastatic disease in vital sites - Immunosuppression -> opportunistic infections - Organ failure - Haemorrhage - Late second malignancies