Flashcards
Week 5
Cards in this deck (46)
- 1What is a neoplasm?Mass of cells that:
-undergone an irreversible change from normal
-proliferate uncontrollably
-partially/completely independent of controlling factors of cell growth
-persists even if initiating stimulus is withdrawn - 2Define cancerA malignant neoplasm
- 3Define carcinomaA malignant epithelial neoplasm
- 4What do malignant neoplasms have the capacity to do?-Local invasion into surrounding tissue
-Spread to distal sites to form metastases - 5Define stagingExtent of spread (local or distant). Important in predicting prognosis
-Includes TNM staging system
-Duke's staging for colon cancer - 6What type of neoplasms do epithelial and mesenchymal tissues show?Epithelial- malignant
Mesenchymal- benign - 7Define differentiation How is it different for benign/malignant neoplasms?Degree to which a neoplasm histologically resembles its tissue of origin
Benign: well-differentiated (closely resembles origin)
Malignant: variable differentiation - 8Define gradingDescribes the degree of differentiation
-1: well differentiated, 3: poorly differentiated
-Poorly differentiated neoplasms behave more aggressively - 9Define anaplasticMalignant tumours that are so poorly-differentiated that it is impossible to determine their histiogenesis
- 10What is benign cancer called if it is of the...? -squamous -transitional -glandular-Squamous cell papilloma
-Transitional cell papilloma
-Adenoma - 11What is malignant cancer called if it is of the...? -squamous -transitional -glandular-Squamous cell carcinoma
-Transitional cell carcinoma
-Adenocarcinoma - 12What is benign cancer called if it is of the...? -fat -fibrous tissue -smooth muscle -skeletal muscle -cartilage -bone-Lipoma
-Fibroma
-Leiomyoma
-Rhabdomyoma
-Chondroma
-Osteoma - 13What is malignant cancer called if it is of the...? -fat -fibrous tissue -smooth muscle -skeletal muscle -cartilage -bone-Liposarcoma
-Fibrosarcoma
-Leiomyosarcoma
-Rhabdomyosarcoma
-Chondrosarcoma
-Osteosarcoma - 14What are teratomas?-Neoplasms derived from embryonic germ cells
-Capacity to form representatives of all 3 germ cell layers
-Ovary: benign
-Testis: malignant
-Midline structure: variable behaviour - 15Describe embryonic tumours-Arise from neoplastic transformation occurring in the developing organ
-Suffix: -blastoma
-Present at/soon after birth
-Highly malignant - 16What are hamartomas?-Not genuin neoplasms but tumour-like malformations
-Present at birth and stop growing when host stops growing - 17Describe the difference in benign vs. malignant neoplasms in terms of: -shape -size -haemorrhage -ulceration -necrosis-Well circumscribed vs. irregular
-Smaller vs. larger (generally)
-Unusual vs. common
-Unusual vs. common
-Unusual vs. common - 18Describe the difference in benign vs. malignant neoplasms in terms of: -nuclear size -nucleoli -pleomorphism -mitosis -differentiation-Normal vs. enlarged
-Small vs. prominent
-Absent vs. marked
-Infrequent vs. frequent
-Good vs. variable - 19Do neoplasms exert mechanical pressure?Benign: yes
Malignant: no
Not usually fatal (unless in brain) - 20Describe a fibroadenoma-Commonest benign breast neoplasm
-Occurs in young women (<30)
-Smooth
-Well circumscribed
-Highly mobile on palpation - 21Describe a breast carcinoma-Commonest malignant breast neoplasm
-Commonest cause of cancer death in women
-Occurs in older women (>50)
-Irregular
-Poorly circumscribed
-Rarely mobile on palpation (invades surrounding structures) - 22Describe the effects of a colon carcinoma in the ascending colon-Polypoid
-Rarely causes bowel obstruction
-Insidious presentation - 23Describe the effects of a colon carcinoma in the sigmoid colon-Stenosing (narrowed lumen)
-Frequent bowel obstruction
-Presents with alteration in bowel habit - 24What are biopsies used for? Disadvantages?Confirms diagnosis of malignancy and identifies histological type.
Plan further treatment
-Tumour is not the same everywhere
-Lesion has to be targeted accurately - 25Describe cytology specimens for pathological assessment-Less invasive method
-Fine needles used for aspiration are much thinner
-Smaller tissue samples are provided but interpretation may be harder - 26Describe surgical resection specimens for pathological assessment-Definitive treatment for cancer (/palliative)
-Confirms diagnosis
-Determines grade and stage of cancer
-Examine completeness of excision
-Basis for determining further treatment - 27How is immunohistochemistry used in tumour pathology?-Establish a diagnosis of malignancy
-Identify prognostic markers (eg. cell turnover markers)
-Identify therapeutic options eg. HER2 mutation for herceptin treatment - 28Describe in-situ hybridisation for pathological assessment-Probes recognising specific RNA/DNA sequences can be applied to tissue sections
-More sensitive than immunohistochemistry - 29Describe molecular techniques for pathological assessmentRNA/DNA extracted from fresh/paraffin embedded samples of tumour tissue can be used for molecular studies
- 30What type of mutation is associated with head and neck cancers?p53 mutation
- 31How are oropharyngeal squamous cell carcinomas caused? Consequences of this?HPV infections
-On rise due to rise in infections
-Earlier onset than in HPV negative cancers
-Wider spread of metastases in HPV positive cancers - 32Describe the mutations involved in thyroid cancer-Drivers are oncogenes
-Uncontrolled activation of the MAP kinase pathway
-BRAF mutation results in severe disease progression
-p53 is rarely mutated. When it is, progression occurs from a well to a poorly differentiated cancer - 33What is Cowden's syndrome?-Germline mutation
-Autosomal dominant
-Many tissue types are affected: thyroid, GIT, breast, skin etc. - 34Describe FAP-Autosomal dominant mutation in APC gene
-Lots of polyps
-High risk of colorectal cancer
-Regular screening and possibly a total colectomy is needed - 35Describe HNPCC-Autosomal dominant condition
-Germline mutation of mismatch repair genes resulting in microsatellite instability
-Increased risk of colorectal cancer (+ others) - 36Describe the status of colorectal cancer in a patient with HNPCC-Develops by 44 yrs old
-Affects the RHS of the colon
-Presence of tumour infiltrating lymphocytes/Crohn's type lymphocyte reaction - 37What are the uses of chemotherapy?-Primary induction treatment
-Neo-adjuvant treatment (before localised treatment)
-Adjuvant treatment (after another modality)
-Regional treatment - 38What are the different options a cell can take if it incurs damage?-Go into G0
-Apoptosis
-Carry on with cell cycle (malignancy) - 39What is the difference between cytotoxic chemo and most conventional drugs in terms of dose toxicity?-Chemo drugs are very toxic molecules
-Toxicity only occurs at very high doses in most conventional drugs - 40How does 5-flurouracil (anti-metabolite) work?-Mimics a pyrimidine
-Fd (metabolite) blocks the replicative fork in DNA synthesis (therefore blocking it) - 41How does methotrexate (anti-metabolite) work?-Works in S phase
-Impaired DNA synthesis and repair - 42How do anthracyclines work?-Planar molecules
-Topoisomerase II inhibitors
-Causes ss and ds DNA breaks
-Forms free radicals which binds to DNA - 43How do monomeric topoisomerase inhibitors work?-DNA replication causes an irreversible ds DNA break
-Cell is arrested in G2
-Apoptosis occurs in S phase - 44Describe alkylating agents-Affects selectivity of DNA binding
-Some are prodrugs
-Affects replication, repair and transcription of DNA - 45How does cisplatin work? Consequences and alternative?-Forms cross-links/kinks in DNA
-DNA can't be replicated and repair is faulty
-Unspecific, so causes toxicities
-Carboplatin which is a safer, less potent drug with a more prolonged effect - 46Difference between reversible and irreversible toxicities?Reversible: affects rapidly dividing cells eg. bone marrow, GIT, lymph tissue
Irreversible: targets slow growing cells eg. kidney, nerves, lungs
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- Classification of neoplasms Role of pathology in management and diagnosis of neoplasms Chemotherapy
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- Dolu Falowo
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