Week 4 - Neoplasia

Question 1

Pathology

Answer 1

Science of disease

Question 2

What is the mnemonic for the surgical sieve

Answer 2

VITAMIN CDEF (different types of pathology)

vascular
inflammation
trauma
autoimmune
metabolic
iatrogenic
neoplastic

congenital
degenerative
endocrine
functional

Question 3

3 types of pathology specific investigations

Answer 3

Cytology sampling (study of individual cells) - fluid sampling, fine needle aspiration

Tissue sampling - biopsy or resection

Immunohistochemistry/genetic profiling

Question 4

What is neoplasia

Answer 4

An excessive, irreversible and uncontrolled growth which persists even after withdrawal of the stimuli that caused it

Question 5

What happens when cells are under stress

Answer 5

They undergo changes to help respond to this stress

Question 6

What is hyperplasia

Answer 6

Increase in cell number

Question 7

What is hypertrophy

Answer 7

Increase in cell size

Question 8

What is atrophy

Answer 8

Reduction in cell size

Question 9

What is metaplasia

Answer 9

Change from one cell type to another

Question 10

What is the name for programmed cell death

Answer 10

apoptosis

Question 11

What is the name for uncontrolled cell death

Answer 11

Necrosis

Question 12

When is inflammation initiated

Answer 12

They ‘clean up’ after cell death

Question 13

7 features of benign disease

Answer 13

Not invasive
Slow growing
Damage at local level
Few cell division
Regular nuclei
Resemble the tissue of origin
Well encapsulated

Question 14

How can be identify cancerous cells in terms of h&e colours

Answer 14

Cancerous = very purple since chromosome condenses

Question 15

What is dysplasia

Answer 15

Abnormal structure due to a failure of differentiation contributing to:

Disordered architecture of tissue

Disordered cellular features - PLEOMORPHISM (able to assume different shapes and sizes) nuclei e.g cells with massive nuclei

Mitotic figures (able to see irregular mitotic division is happening) e.g spindle fibres coming from 3 poles

Question 16

6 features of malignant cancer

Answer 16

Invasive
Grows fast
Shows features of dysplasia
Can metastasise
Damage at local OR distant sites
Does NOT resemble site of origin

Question 17

3 ways in which cancer can metastasise

Answer 17

Lymphatics
Through blood
Transcoelomic

Question 18

What do we call cancer that have metastasised so we cannot easily identify the site the cancer originated in

Answer 18

Cancer of unknown primary

Question 19

What is the ending of benign epithelial neoplasms

Answer 19

-oma

Question 20

What is the ending of a malignant epithelial neoplasm

Answer 20

-carcinoma

Question 21

What is the ending of benign connective tissue neoplasms

Answer 21

-oma

Question 22

What is the ending of malignant connective tissue

Answer 22

-sarcoma

Question 23

How are HER2 breast cancers tested

Answer 23

Using immunohistochemistry

Question 24

Microsatellite instability

Answer 24

MSI occurs when there is a failure to repair damaged DNA in the cell cycle

Question 25

How are neoplasms graded

Answer 25

how closely the neoplasm corresponds with the normal cells for that tissue - the more dysplastic the cells are, the higher the grade

Question 26

How are neoplasms given 'stages'

Answer 26

Based on how far the neoplasm has spread through the body

Question 27

TNM classification of staging

Answer 27

Tumour - measures local invasion Node - measures spread to the lymph node Metastasis - measures spread to distant tissues

Question 28

Example of cellular atrophy

Answer 28

Reduction in brain size - brain becomes shrunken (membrane lines more visible, with fewer material in between)

Question 29

Example of cellular hyperplasia

Answer 29

Endometrium can become too thick

Question 30

Example of cellular hypertrophy

Answer 30

Skeletal muscle hypertrophy following exercise

Question 31

Example of cellular metaplasia

Answer 31

Barrett's oesophagus stratified squamous epithelium becomes like cells found in the intestine

Question 32

Pleomorphism

Answer 32

cells with disrupted structures e.g massive nucleus

Question 33

What is anaplasia

Answer 33

Poorly differentiated cells so can't trace the cancerous cells to their origin

Question 34

Mitotic figures

Answer 34

Atypical mitosis e.g spindle fibres coming from 3 poles

Question 35

Which type of cancer will less likely become dysplastic or metastasise

Answer 35

Benign cancer

Question 36

Difference between invasion and metastasis

Answer 36

Invasion is spread within the region of the original site whereas metastasis is when cancer spreads to a distinctly different site

Question 37

Example of symptoms due to metastasis

Answer 37

Lung cancer causing deposits in the liver, causing abdomen pain

Question 38

Example of a systemic symptom of cancer

Answer 38

Weight loss

Question 39

Explain how a failure of p53 could cause cancer

Answer 39

If p53 can't arrest the cell cycle to check for DNA damage, cells with mutated DNA will be able to replicate uncontrolled These mutations confer a higher risk of dysplastic cells and then malignancy secondary to uncontrolled and unregulated cell division