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Semester 2 > MoD Session 8 > Flashcards

MoD Session 8 Flashcards

0
Q

What does cell growth become in neoplasm?

A

Autonomous

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1
Q

What is neoplasm?

A

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

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2
Q

How is neoplasm distinguished from inflammation clinically?

A

Neoplasm is cold to touch

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3
Q

When would neoplasm not cause a lump?

A

In leukaemia

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4
Q

What is malignant neoplasm?

A

An abnormal growth of cells that persists after the initial stimulus is removed and which invades surrounding tissue w/potential to spread to distant sites

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5
Q

What must be present in cells to cause neoplasia?

A

Genetic alterations

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6
Q

What is a tumour?

A

Any clinically detectable lump or swelling

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7
Q

What two types of tumour can form?

A

Non-neoplastic

Neoplastic

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8
Q

What two types of neoplastic tumour are there?

A

Benign

Malignant

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9
Q

What is metastasis?

A

Malignant neoplasm that has spread from its original location to a new non-contiguous site

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10
Q

Why might removal of a primary malignant neoplasm not prevent spread of cancer?

A

Each secondary tumour has the potential to spread

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11
Q

Is tumour formation reversible?

A

Nope

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12
Q

What is dysplasia?

A

Pre-neoplastic alteration in which cells show disordered tissue organisation

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13
Q

Is dysplasia reversible?

A

Yes

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14
Q

How are benign neoplasms characterised?

A

Remain confined to site of origin
Do not produce metastases
Create a pseudocapsule

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15
Q

What does the danger of a benign neoplasm depend on?

A

What tissue it is pressing on

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16
Q

What characteristics do malignant neoplasms display?

A

Irregular outer margin and shape
Can show ulceration in centre due to inadequate blood supply formation
Have the potential to metastasise

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17
Q

What do the cells of a benign neoplasm closely resemble?

A

Parent tissue

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18
Q

How can the cells in a malignant neoplasm vary?

A

From well to poorly differentiated

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19
Q

What term is used to describe cells with no resemblance to any tissue?

A

Anaplastic

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20
Q

What examines tissue cells ex situ so there is no architecture surrounding them?

A

Cytology

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21
Q

How do poorly differentiated cells compare to sell differentiated cells?

A 
Increased:
Nuclear size
Nucleus:cytoplasm ratio
Pleomorphism
Hyperchromasia
Mitotic figures
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22
Q

What is pleomorphism?

A

Variance in cell and nuclei size and shape

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23
Q

How may mitotic figures appear in poorly differentiated cells?

A

May be abnormal

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24
Q

How is the grading of neoplasm determined?

A

Grade 1-3 with decreased differentiation with each stage

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25
Q

What happens to mortality with each increase in neoplasm grade?

A

It increases by 40%

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26
Q

What indicates worsening differentiation?

A

Mild –> moderate –> severe dysplasia

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27
Q

At what point does dysplasia become neoplasia?

A

When the worsening differentiation becomes irreversible

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28
Q

How long can the development of dysplasia into neoplasia take?

A

Years

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29
Q

What three aspects does the Modified Bloom Richardson grading for breast cancer examine?

A

Tubules
Mitoses
Nuclear pleomorphism

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30
Q

What percentage of cancer risk is extrinsic?

A

~85%

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31
Q

What change is seen in skin which has undergone reversible dysplasia?

A

Decreased specialisation causing loss of keratin

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32
Q

What change is seen in skin which has undergone irreversible dysplasia?

A

Tripolar mitosis

Invasive carcinoma

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33
Q

What causes neoplasia?

A

Accumulated mutations in somatic cells

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34
Q

How are the 10 million opportunities for somatic cell mutation per second dealt with to prevent neoplasia?

A

Apoptosis

Cell senescence

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35
Q

What causes a cell to enter G0?

A

Oncogene

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36
Q

What two things are needed to cause neoplasia?

A

Initiators

Consistent promoters

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37
Q

What are the main initiatiors of neoplasm which can also act as promoters?

A

Chemicals
Infection
Radiation

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38
Q

What causes early onset of cancer by skipping the initiator/promoter step of neoplasm?

A

Inheritance of a germline mutation

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39
Q

What is progression?

A

Formation of a neoplasm by accumulating more mutations by subclonal expansion

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40
Q

What causes heterogenous cells to be present within a neoplasm?

A

Progression

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41
Q

Is a neoplasm formed from progression monoclonal?

A

Yes, from same founding cells

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42
Q

What is a monoclonal tumour?

A

Tumour which originates from a single founding cell

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43
Q

What can be studied to identify monoclonal tumours?

A

X-linked G6PD

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44
Q

How are different alleles of G6PD gene switched off during female embryogenesis?

A

Randomly by lyonisation

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45
Q

What expression of G6PD izoenzyme is seen in normal tissue?

A

Patchwork of cells expressing both heat stable and heat labile isoenzymes

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46
Q

What isoenzyme expression of G6PD is seen in neoplastic tissue?

A

Either only maternal or paternal isoenzyme expressed

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47
Q

What genetic alteration occurs in proto-oncogenes which favours neoplasm formation?

A

Abnormally activated oncogenes

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48
Q

Why does abnormal activation of a proto-oncogene only need activation of one allele?

A

It is positively acting

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49
Q

What is the effect of abnormal activation of proto-oncogenes?

A

Abnormally pushes cell through cell cycle

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50
Q

What happens to tumour suppressor genes to favour neoplasm formation?

A

Inactivation of growth factor
Cyclin inactivators
Inactivation of receptors

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51
Q

Why is deletion of both alleles of tumour suppressor genes needed to cause neoplasia formation?

A

Alleles have an inhibitory function

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52
Q

What words with the suffix -oma are not neoplasms?

A

Granuloma
Atheroma
Haematoma

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53
Q

What suffix do neoplastic blood disorders have?

A

-aemia

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54
Q

What are the two types of benign epithelial tumour?

A

Papilloma

Adenoma

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55
Q

What are papillomas?

A

Benign non-glandular/non-secretory epithelial tumours

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56
Q

What do adenomas consist of?

A

Glandular/secretory epithelium

57
Q

What prefixes the papilloma/adenoma in benign epithelial tumours?

A

Name of specific cell type origin

58
Q

What is a carcinoma?

A

A non-glandular malignant epithelial tumour

59
Q

What is an adenocarcinoma?

A

A glandular malignant epithelial tumour

60
Q

What is also included in malignant epithelial tumour names in addition to carcinoma/adenocarcinoma?

A

Name of tissue of origin - type of epithelial cell

61
Q

What is the difference between in-situ and invasive carcinoma?

A 
In-situ = no basement membrane penetration
Invasive = penetrated basement membrane
62
Q

What are the four names of benign epithelial tumours?

A

Squamous cell papilloma
Transitional cell papilloma
Basal cell papilloma
Adenoma

63
Q

What are the four names of malignant epithelial tumours?

A

Squamous cell carcinoma
Transitional cell carcinoma
Basal cell carcinoma
Adenocarcinoma

64
Q

What are the eight types of benign mesenchymal tumours?

A 
Leiomyoma
Rhabdomyoma
Lipoma
Angioma
Osteoma
Chondroma
Benign mesothelioma
Synovioma
65
Q

What is a leiomyoma?

A

Benign smooth muscle tumour

66
Q

What is a rhabdomyoma?

A

Benign striated muscle tumour

67
Q

What are the eight types of malignant mesenchymal tumours?

A 
Leiomyosarcoma
Rhabdomyosarcoma
Liposarcoma
Angiosarcoma
Osteosarcoma
Chondrosarcoma
Malignant mesothelioma
Synovial sarcoma
68
Q

What is a cyst?

A

Fluid-filled space lined by epithelium

69
Q

Are cysts neoplasms?

A

Some are, some are not

70
Q

What five types of cyst are there?

A 
Neoplastic
Congenital
Parasitic
Retention
Implantation
71
Q

What is Burkitt’s lymphoma?

A

B-cell lymphoma associated w/Epstein-Barr virus and malaria

72
Q

Where is Burkitt’s lymphoma endemic?

A

Certain parts of Africa

73
Q

What is Ewing’s sarcoma?

A

Malignant tumour of bone of uncertain histiogenesis

74
Q

What is Hodgkin’s lymphoma?

A

Malignant lymphoma characterised by the presence of Reed-Sternberg cells

75
Q

What is Kaposi’s sarcoma?

A

Malignant neoplasm derived from vascular endothelium

76
Q

What is Kaposi’s sarcoma commonly associated with?

A

AIDS

Human herpesvirus-8

77
Q

What are harmatomas?

A

Tumour-like lesions lacking autonomy of true neoplasm

78
Q

What are teratomas?

A

Neoplasms forming cells representing all 3 germ layers

79
Q

Where are teratomas most common?

A

Gonads

80
Q

How does the presence of teratoma in the ovaries compare to that in the testes?

A

Ovaries - usually benign

Testes - usually malignant

81
Q

Why does a retinoblastoma form?

A

Inherited predisposition

82
Q

Where does a retinoblastoma arise?

A

In the eye

83
Q

Where does a nephroblastoma/Wilms’ tumour arise?

A

In the kidney

84
Q

Where does a neuroblastoma arise where it can mature into a harmless, benign ganglioneuroma?

A

Adrenal medulla

Nerve ganglia

85
Q

Where do hepatoblastomas arise?

A

In the liver

86
Q

What do mixed tumours exhibit?

A

Characteristic combination of cell types e.g. mixed parotid/fibroadenoma of breast

87
Q

What is a neuroendocrine tumour?

A

Cells scattered diffusely in various epithelial tissues form hormone or carcinoid tumours

88
Q

What is a carcinoid neuroendocrine tumour?

A

A neuroendocrine tumour which does not secrete a peptide hormone

89
Q

Where are embryonal tumour almost exclusively seen?

A

In young

90
Q

What do embryonal tumours have histiological resemblance to?

A

Embryonic form of organ

91
Q

What types of tumour are embryonal?

A

Blastomas
Mixed
Neuroendocrine

92
Q

What is the name given to a normal gene that is expressed inappropriately?

A

Oncogene

93
Q

Give four characteristics of malignant tumours.

A

Purposeless
Atypical - cells are structurally and functionally abnormal in varying degrees
Autonomous
Aggressive

94
Q

What is transformation in neoplasia?

A

Change of a normal cell to a malignant cell

95
Q

What can be said about the nature of blastomas?

A

Tend to be very aggressive

96
Q

What is the name of a club-shaped tumour dangling from a surface by means of a stalk?

A

Polyp

97
Q

What do type of tissue do polyps grow out of?

A

Skin

Mucosa

98
Q

What are sessile polyps?

A

Polyps that lack a stalk

99
Q

What is the name given to an outgrowth from an epithelial surface which has long thin branches and resembles a cauliflower in cross-section?

A

Papilloma

100
Q

Is myeloma malignant or benign?

A

Malignant

101
Q

In what type of tissue is it very unlikely to see a benign tumour?

A

Lymphoid

102
Q

What is odd about a ganglioneuroma?

A

It is a tumour of neurones which are meant to be non-dividing cells

103
Q

What is a glioblastoma?

A

Malignant glial tumour

104
Q

Where do tetaromas tend to arise?

A

Along the midline - base of the skull, anterior mediastinum, along aorta, in gonads

105
Q

How do harmatomas develop during growth?

A

Present at birth and grow with the person

106
Q

Where does the lump of tissue found in a harmatoma belong?

A

To the organ in which the lump was found

107
Q

What are choristomas/ectopic tissue?

A

Lumps of normal tissue that do not belong in the organ where they are found

108
Q

What is the likely method by which tumours contain cells which are less differentiated?

A

Contain undifferentiated stem cells whose progeny fail to mature

109
Q

Why do tumour cells have increased cytoplasmic basophilia?

A

Increased RNA therefore more active protein synthesis

110
Q

Why can the number of mitoses be used as a measure of malignancy?

A

Their number is proportional to the rate of growth

111
Q

What tends to parallel the degree of aggressiveness?

A

Atypical

112
Q

What causes a signet ring cell?

A

Abnormal mucus secretion causing it to be retained as a large droplet that distends the cell

113
Q

Why might cells be seen floating in mucus in malignant cells?

A

Abnormal mucus secretion due to atypia

114
Q

What properties do malignant cells possess?

A

Immortality
Loss of anchorage dependence
Loss of contact inhibition
Decreased requirement for growth factors

115
Q

Why do malignant cells have decreased requirement for growth factors?

A

They supply their own by autocrine secretion

116
Q

How do cancer cells move around, allowing their invasion?

A

Like amoebae

117
Q

Between which cells is decreased adhesion seen in malignant cells?

A

Same type

Stroma

118
Q

How can a tendency of malignant cells to shed surface molecules such as proteins, glycoproteins and enzymes help malignant cells to function?

A

Shedding enzymes e.g. collegenase helps them to invade through ECM
Tissue factor exaggerates clotting

119
Q

How can surface molecules shed by malignant cells be useful clinically?

A

Some are found in blood (tumour markers) and can be used for diagnosis

120
Q

What two components do all tumours consist of?

A

Neoplastic parenchyma

Non-neoplastic stroma

121
Q

How do some benign tumours develop a fibrous capsule?

A

Laid down by surrounding tissues as a response to pressure

122
Q

Why can some benign tumours such as fibroadenoma of the breast be ‘shelled out’ through a clear cut cleavage plane with little surrounding tissue?

A

They are surrounded by a fibrous capsule

123
Q

What must be removed with malignant tumours?

A

Surrounding tissue

124
Q

What type of tumours tend to become ulcerated?

A

Those that arise from a bacteria only containing tend surface

125
Q

What is the formation of an ulcerated tumour in the gut thought to be secondary to?

A

Bacterial infection and digestive enzymes

126
Q

How is a non-healing ulcer formed on a tumour?

A

Surface eroded by friction –> colonised by bacteria –> ulcer

127
Q

What does an ulcer with a raised/rolled edge strongly suggest?

A

Ulcerated tumour rather than non-neoplastic ulcer

128
Q

What is any ulcer on the skin present for more than 3-4 weeks a suspect for?

A

Malignancy

129
Q

What are scirrhous carcinomas?

A

Tumours with lots of connective tissue stroma

130
Q

How do melanomas, angiomas, hepatoma and most other tumours appear on cross section?

A

Melanomas = black
Angiomas = red with blood
Hepatomas = green with bile
Most others = white

131
Q

What do foci of necrosis correlate with in malignant tumours where they are more commonly seen?

A

Poor prognosis

132
Q

How can BV within the stroma of a tumour arise?

A

Incorporated by growing tumour

Newly developed by angiogenesis

133
Q

How are tumour cells that are so undifferentiated they have lost identifying structural features recognised?

A

Usually retain some cell-specific antigen that can be recognised by a specific antibody

134
Q

What secondary changes are seen in tumours?

A

Ulceration
Necrosis
Calcification
Torsion

135
Q

When is necrosis seen in tumours?

A

Secondary to ischaemia in the centre of tumour

Can be due to impaired blood flow by high tissue pressures in the centre of the tumour

136
Q

When is calcification of a tumour seen?

A

In dead cells or necrotic masses

137
Q

What is used in breast screening by mammography to identify malignancy?

A

Calcification of tumours

138
Q

What is torsion?

A

An accident seen in benign or malignant pedunculated tumours

139
Q

What does torsion result in?

A

Veins compressed first –> congested tissue –> red infarct

Semester 2 (45 decks)

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