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Unit 10 > Week 5: Neoplasia > Flashcards

Week 5: Neoplasia Flashcards

1
Q

In cancer cell growth is…..

A

Dysregulated

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2
Q

What is cancer?

A

Many different diseases
Characterised by dysregulated cell growth (increased proliferation and decreases apoptosis)
But can have different causative agents, aetiology and molecular profiles.

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3
Q

What are the key features of neoplastic cells?

A

Invade surrounding normal tissue
Metastasise
May kill host in which it originates.

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4
Q

Define neoplasia

A

Autonomous/idependent growth of abnormal cell or tissue, more rapid that normal and continues in the absence of the growth signal.

Genetic mutation in cell - survival and growth advantage resulting in excess proliferation

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5
Q

How do normal cells grow?

A

Highly regulated
Cell death is equal to cell division
Confined within a specific compartment and have a specific organisation within that compartment

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6
Q

What are the clinical questions that must be considered with cancer?

A

Is it cancer?
What type of cancer?
How will it behave? benign/malignant indolent/aggressive
How should the patient be treated
is the tumour completely removed?
Are there any associated diseases of relevance?
Are there any complications for relatives?

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7
Q

What features effect the pronosis of cancer diagnosis?

A

Bening or malignant
Tumour stage
Biological characteristics

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8
Q

What are the different tumour stages?

A

Carcinoma in situ
Invasvie
Metastatic

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9
Q

Define dysplasia

A

means disordered growth
Where several morphological changes occur in the cells
Architectural disarray and loss of orderly differentiation.
Reversible
Confined to the epithelium

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10
Q

What is the link between dysplasia and neoplasia?

A

Start with dysplasia
When the enitre epitheium is dysplastic and no normal epithelial cells are left is said to be neoplastic

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11
Q

What is meant by carcinoma in situ?

A

Severe dysplasia - now consider neoplasia.
No orderly differentiation of cell type.
Over the full thickness of the epithelium but is confined to the epithelium due to the intact basement membrane
Does not penetrate the basement membrane

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12
Q

What is invasive carcinoma?

A

Neoplastic cells that invade the basement membrane
Spread past the epithelial layer into the lamina propia and beyond

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13
Q

What are the growth features of benign tumours?

A

Slow
Expansive
Non-metastatic
non-invasive
Capsulated

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14
Q

What are the growth features of malignant tumours?

A

Fast
Invasive
Metastatic
destructuve
No capsule

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15
Q

What are the cellular features of benign tumours?

A

Uniform shape size and colour
Resembles normal cells
Normal nuclear to cytoplasmic ratio (1:4 to 1:6)
Low mitotic count (normal mitosis rate)
Adequate or normal amount of chromatin

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16
Q

What are the cellular features of malignant tumours?

A

Pleomorphic - varied, shape size and colour
Disorganised and haphazard appearance - does not resemble original tissue
Increased and disproportionately large nucleus (1:1 ratio with cytoplasm)
Low to high mitotic count - abnomrla apoptosis
Hyperchromatc (abundant DNA and dark stain)
Large nucleoli are often present

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17
Q

What are some gross features to differentiate between benign and malignant tumours?

A

Benign - clear borders, well circumscribed, Resembles tissue of origin
Malignant - disorganised appearance, no clear borders, does not resemble tissue of origin, may have infiltration into the surrounding tissue.

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18
Q

Define anaplastic

A

lack of differentiation - no longer resemebles the normal parenchymal cells
Neither morphologically or functionally.
Nucleus tends to vary in size and shape
Feature of malignant tumours

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19
Q

Define pleomorphic

A

Variation in size and shape
of both cells and nuclei
Feature of malignant tumour

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20
Q

What is meant by a hyperchromatic nuclei?

A

Dark staining nucleus
Contains abundant chromatin

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21
Q

Why do malignant tumours tend to have a higher nuclear to cytoplasmic ratio?

A

As dividing not functioning.

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22
Q

What is angiogenesis?
Why do cancer cells do this?

A

The growth of new blood vessels from the host vasculature
Aid metastic cascade, provide nutrients, provide oxygen, eliminate waste.

23
Q

Define metastasis.

A

Spead of tumour from a primary organ to distant sites in the body

24
Q

How does metastasis affect cancer prognosis?

A

Responsible for 90% of deaths in cancer
Difficult to treat (colonial expansion - more likely to have intratumor heterogenicity)
Needs more specific therapies

25
Q

What ist he process of cancer development?

A
  1. Transformation from normal to abnormal cells - may be described as dysplasia and neoplasis
  2. Angiogenesis - provides the tumour which the nutrients needed to continue to proliferate and a potential mechanism to spread.
    Will invade local tissue
  3. Motility and invasion - undergoes a epithelial to mesenchymal transition (loss of E cadherin 3) as arrests and escapes into blood stream or other method to spread (requires retraction of endothelial cells)
  4. Evolved to survive as a singular cells in circulation
  5. Is arrested in emoboli and adheres to capillary bed, grow in emobli
  6. Invades target tissue (requires retraction of endothelial cells)
  7. Neovascularisation and proliferation of tumour cells will continue
  8. Has metastasis and the process repeats.
26
Q

What is the difference between intravasation and extravasation in relation to cancer cells?

A

Intravasation - cancer cell penetrate bv or lymph vessels
Extraversion - escape from blood vessels or lymph

27
Q

What are the different hypothesis behind where tumours spread during metastasis?

A

Seed and soil
Mechanical

28
Q

What is the seed and soil mechanism of metastasis?

A

Certain tissues (soil) have an environment that is receptor to particular tumour cells (seeds)
- large number of cancer cells will circulate without finding a receptive environment so metastasis will not occur

29
Q

What is the mechanical hypothesis of metastasis?

A

Metastatis is likley to occur at sites based on the pattern of blood flow from the primary organ

30
Q

Where do these common cancers normally metastasise to?
Prostate
Colon
gastric
Breast
Melonama
Lung
(small cells)
(non- small cell)

A

Bone
Liver
Liver
Liver or Lung
Melanoma - Liver or Lung (lymph nodes, brain)
Liver
Loco-regional

31
Q

What are the most common routes of tumour spread?

A

Blood vessels
Lympahatic system
Movement within body cavities

32
Q

How do cancerous cells spread by direct extension?

A

Binding to ECM
Enzymatic lysis of the ECM
Grows into surrounding tissues

33
Q

What are the key features of lymphatic spread?

A

Main type in early carcinoma
Step wise spread
In transit deposits can occur (melanomas)
Natural route to drainage

34
Q

What are some common examples of lymphatic spread?

A

Breast carcinoma to axillary nodes
Lung carcinoma to mediastinal nodes

35
Q

What are the barriers that metastasising cells face?

A

Must survive in vasculature (unattached to surfaces and subject to stress)
Must undergo epithelial to mesenchymal transition - acquire ability to invade, resist cell death and spread, this requires a certain microenvironment spread and change in adhesion molecules

36
Q

What are the processes of extravasation?

A

Arrest
retraction of endothelial cells
invasion

37
Q

What are the future improvements that are needed in cancer treatment/diagnosis?

A

Identification, prediction and treatment of precursor lesions
Increased accuracy of screening
Become minimally invasive in treatment
Target therapies
Point of care testing - to improve early diagnosis

38
Q

Where might angiogenesis occur in health?

A

Development and growth
reproductive system (menstrual cycle in females)
Repair

39
Q

When might angiogenesis occur in pathologica circumstances?

A

Vascular malformation
Chronic inflammatory disease
Malignant tumours

40
Q

What is a biomaker?

A

A biological molecule found in blood or other body fluids that indicate a normal/abnormal process or disease/condition

41
Q

What are the roles of a cancer biomarker?

A

Screening for cancer in the general population
Diagnosis
Classification: staging, localisation, estimate tumour volume
Efficacy of treatment/prognosis
Detection of disease recurrence/relpase
Prognostic indicators of disease progressions

** prognosis, diagnostic, predictive

42
Q

What are the properties of an ideal biomarker?

A

Specific to the condition (absent in health)
Easy to detect (cheap and easy to quantify)
Higly sensitive (detectable in all cases)
early detectable
Proportional to the extent of tumour
Blood/saliva/urine found rather than by biopsy

43
Q

What are some fetal biomakers fo cancer?

A

AFP Alpha-fetoprotein - teratomas and hepatomas
CEA carcinoembryoninc antigen- GI tumour

44
Q

What are some examples of hormaonl biomakers for cancer?

A

HCG - teratomas, choriocarcinoma

45
Q

What are some tumour assoaicted antigens that can be used as biomarkers of cancer?

A

CA125 - ovarian cancer
PSA - prostate cancer

46
Q

How do tumour biomaker identification realte to tumour growth rate?

A

Aim to identify tumours are early as possible (sensitive to low levels of growth)

47
Q

What stage of cancer progression is this? Dysplatic cells shown

A

Carcinoma in situ

48
Q

What is shown in the image? How do you know?

A

Benign lipoma on surface of small intestine
Defined birder, mimics structure of origin

49
Q

What is shown in the image? How do you know?

A

Small hepatic bending adenoma
Function maintained as green indicate bile production
Small clear boundaries and resembles tissue of origin

50
Q

What is shown in the image? How do you know?

A

Hepatocellialr carcinoma in cirrhosis liver
Large
And normal appareacne
No clear boundary and infiltrate into surrounding tissue

51
Q

How would you describe the tissue shown?
What are the key features circled?

A

Aplastic
Apoptosis
Abnormal tripolar spindle

52
Q

Is this benign of malignant and how do you know?

A

Benign
Monomorphic nuclues resembles tissue of origin
Architecture preserved

53
Q

Is this benign of malignant and how do you know?

A

Malignant
Pleomoprhic nuclei

54
Q

What is the malignant feature in this image?

A

High nuclear to cytoplasmic ratio
Hyperchromatic nucleus

Unit 10 (37 decks)

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