TumourPath

Question 1

Type of tumour

Answer 1

• Benign

- Malignant. Ability to invade into adjacent tissue and to metastasise and and grow at other sites within body

Question 2

Nomenclature of epithelium tumours

Answer 2

• Glandular:
  Benign: adenoma and malignant: adeno-carcinoma
• Squamous:
  Benign: squamous papilloma and malignant: squamous carcinoma

Question 3

Nomenclature of connective tissue tumours

Answer 3

• Bone
  Benign: osteoma, malignant: osteo-sarcoma
• Fat
  Benign: lipoma, malignant: lipo-sarcoma

Question 4

Nomenclature of blood tumours

Answer 4

• cells, not vessels

- Malignant: white blood cells, leukaemia

Question 5

Nomenclature of lymphoid tissue tumours

Answer 5

Malignant: lymphoma

Question 6

Nomenclature of neural tissue tumours

Answer 6

• Central nervous system: astrocytoma

- Peripheral nervous system: Schwannoma

Question 7

Nomenclature of germ cell tumours

Answer 7

• Teratomas:
  Tumour composed of various tissues
• Ovarian, benign
• Testicular, malignant

Question 8

Main features of benign tumours

Answer 8

• Non-invasive growth pattern
• Usually encapsulated
• No evidence of invasion
• No mets
• Cells similar to normal
• Tumours ‘well differentiated’
• Function similar to normal tissue
• Rarely cause death

Question 9

Main features of malignant tumours

Answer 9

• Invasive growth pattern
• No capsule or capsule breached by tumour cells
• Cells abnormal
• Cancer are often poorly differentiated, don’t look anything like cells around it
• Loss of normal function
• Evidence of spread of cancer
• Can cause death

Question 10

Properties of cancer cells

Answer 10

• Altered genetics
• Altered cellular function (tumour related proteins and loss of function)
• Abnormal morphology
• Cells capable of independent growth

Question 11

Altered genetics of cancer cells

Answer 11

• Loss of tumour suppressor genes

- Gain of function of oncogenes

Question 12

What can tumour biomarkers be used for?

Answer 12

You can pick up tumour-related proteins and used these for screening, diagnosis, prognosis and predictive (using a particular therapy)

Question 13

Onco-fetal proteins examples

Answer 13

• Alpha-fetoprotein: teratoma of testis, hepatocellular carcinoma

Question 14

Oncogenes

Answer 14

• Kras: colorectal cancer. (know for treatment type)

- Braf: melanoma

Question 15

Growth factors and receptors and what cancer they’re related to

Answer 15

• Oestrogen receptor - predictive biomarker: breast cancer
• Prostate specific antigen: prostate cancer
• EGFR: lung cancer
• Her2 (EGFR related protein): Breast cancer and gastric cancer

Question 16

Loss of cellular function in cancer cells

Answer 16

• Loss of cell-to-cell adhesion

- Altered cell-to-matric adhesion

Question 17

Abnormal morphology

Answer 17

• Balance between cell growth and cell death
• Angiogenesis vs. apoptosis
• Angiogenesis is a route for release of tumour cells into circulation
• Apoptosis regulates cell growth
  Angiogenesis is in favour in cancer

Question 18

Types of cancer spread

Answer 18

• Local
• Lymphatic
• Blood spread
• Transcoelomic spread (thorax and abdo)

Question 19

Local spread of cancer

Answer 19

• Malignant tumour spreads locallt and ends up in lymph or blood vessels

Question 20

Lymphatic spread of cancer

Answer 20

• Tumour cells adhere to lymph vessels and invade the lymphatics
• Mets in lymph node, divide and grow
• This is when it becomes clinically evident

Question 21

Blood spread of cancer

Answer 21

• Same concept as lymphatic
• Invade blood vessels, invade the tissue
• Metastasise, can line vascular endothelium if it is conducive to growth

Question 22

Trans-coelomic spread

Answer 22

• Spread in body cavities, special form of local invasion

Question 23

What influences where they metastasise to?

Answer 23

• blood flood
• tumour related factors
• host factors

Question 24

Common sites of metastasis

Answer 24

• Liver (CRC)
• Lung
• Brain
• Bone: axial skeleton (breast, prostate)
• Adrenal gland

Question 25

Local effects of benign tumours

Answer 25

- Pressure: can apply pressure to adjacent groups - Obstruction: intestinal or urinal tract - You can get pressure effects causing an obstruction

Question 26

Local effects of malignant tumours

Answer 26

- Pressure - Obstruction - Tissue destruction: ulceration/infection. If exposed to microorganisms, you can get a secondary infection - Bleeding: anaemia or haemorrhage - Pain: pressure on nerves, perineural infiltration, bone pain in pathological fractures - Effects of treatment

Question 27

Systemic effects of cancer

Answer 27

- Secretion of hormones - Weight loss: cachexia - Paraneoplastic syndromes - Effects of treatment

Question 28

Secretion of hormones

Answer 28

- Normal: if tumour is in endocrine organs then it has an abnormal control of secretion - Abnormal: hormones not normally produced at site. Can be useful in diagnosing lung cancer

Question 29

Paraneoplastic syndromes

Answer 29

- fever, myopathy, neuropathy - Can present with these symptoms rather than direct symptoms of cancer - could be immune mechanism or production of hormone factor

Question 30

Dysplasia

Answer 30

- Pre-malignant change on pathway to the development of cancer. - Abnormality in cell structure that leads to malignancy - Earliest change in the process of malignancy that can be visualised - Identified in the epithelium - Has the capability of becoming cancer

Question 31

Features of dyplasia

Answer 31

- Disorganisation of cells: increase in nuclear size, increased mitotic activity, abnormal mitoses - The higher that grade, the higher possibility of malignancy - No invasion

Question 32

Early detection of cancer

Answer 32

- Need an effective test - Has to be sensitive/specific - Acceptable to population - Example: detection dysplastic cells from squamous epithelium of cervix