Neoplasia II: Tumor Invasion and Metastasis
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Questions and Answers

What local effect can benign neoplasms have on surrounding tissues?

  • Compression causing pressure atrophy (correct)
  • Intravenous infiltration
  • Complete tissue destruction
  • Metastatic spread
  • Which of the following is a common systemic effect of neoplasms?

  • Anaemia (correct)
  • Leukocytosis
  • Local inflammation
  • Hyperplasia
  • Which neoplasm can cause ectopic hormone secretion?

  • Benign meningioma
  • Small cell carcinoma of bronchus (correct)
  • Hepatoma
  • Leiomyoma
  • Which effect is specifically associated with malignant neoplasms?

    <p>Infiltration around nerves and blood vessels (D)</p> Signup and view all the answers

    What is a potential consequence of raised intracranial pressure (ICP) due to neoplasms?

    <p>Perforation of tissues (D)</p> Signup and view all the answers

    Which symptom is indicative of cachexia associated with neoplasms?

    <p>Muscle atrophy (A)</p> Signup and view all the answers

    Neuromuscular issues related to neoplasms may include which of the following?

    <p>Sensorimotor neuropathies (C)</p> Signup and view all the answers

    What can result from the infiltration of the bone marrow due to neoplasms?

    <p>Low white cell count (B)</p> Signup and view all the answers

    What primarily causes the need for angiogenesis in a tumor?

    <p>Hypoxia due to insufficient nutrients (B)</p> Signup and view all the answers

    Which of the following is NOT a route of metastasis?

    <p>Nervous system (D)</p> Signup and view all the answers

    Which type of carcinoma is commonly known to metastasize to the liver?

    <p>Bronchial carcinoma (B)</p> Signup and view all the answers

    What is a possible effect of metastasis to bone?

    <p>Pathological fractures due to bone destruction (A)</p> Signup and view all the answers

    Which of the following factors does NOT determine the effects of tumors?

    <p>Site of kidney function (B)</p> Signup and view all the answers

    Angiogenesis is primarily regulated by which of the following factors?

    <p>Pro-angiogenesis factors like VEGF (A)</p> Signup and view all the answers

    What does the term 'primary tumor' refer to?

    <p>The original site of malignant neoplasm (A)</p> Signup and view all the answers

    What can result from vascular spread to the brain?

    <p>Space occupying lesion causing neurological symptoms (A)</p> Signup and view all the answers

    What role do Matrix Metalloproteinases (MMPs) play in tumor cell behavior?

    <p>They aid in the breakdown of the basement membrane. (D)</p> Signup and view all the answers

    Which of the following factors can potentiate the movement of cancer cells through the stroma?

    <p>Cell derived motility factors. (B)</p> Signup and view all the answers

    Which of the following describes the ECM in relation to cancer invasion?

    <p>It can either promote or inhibit cell invasion. (C)</p> Signup and view all the answers

    What is the primary feature of metastasis in cancer cells?

    <p>Invasion into lymphatics and blood vessels. (A)</p> Signup and view all the answers

    Why do not all cancer cells that circulate successfully establish metastases?

    <p>They may encounter unfavorable conditions in target tissues. (A)</p> Signup and view all the answers

    What determines the organ distribution of metastases in relation to the primary tumor?

    <p>Vascular and lymphatic drainage pathways. (C)</p> Signup and view all the answers

    Which chemokine receptor is associated with human breast cancer cells for metastasis?

    <p>CXCR4 (B)</p> Signup and view all the answers

    What is the primary characteristic of malignant cells in terms of adhesion?

    <p>Malignant cells do not adhere as strongly as normal cells. (C)</p> Signup and view all the answers

    What happens once tumor cells reach their target organ?

    <p>They must colonize and adapt to the new environment. (A)</p> Signup and view all the answers

    What type of cancer is associated with the loss of E cadherin?

    <p>Lobular carcinoma of the breast (A)</p> Signup and view all the answers

    Which of the following is a characteristic feature of metastasis?

    <p>Spread of malignant tumors to distant sites (C)</p> Signup and view all the answers

    What role do integrins play in cancer cell invasion?

    <p>They modify the contact between cells and the stroma. (D)</p> Signup and view all the answers

    What is one of the mechanisms facilitating invasion by malignant cells?

    <p>Altered synthesis of enzymes degrading extracellular matrix (A)</p> Signup and view all the answers

    Which factors contribute to the motility of malignant cells?

    <p>Presence of motility factors (A)</p> Signup and view all the answers

    How do malignant cells interact with the surrounding stroma?

    <p>They alter their interactions, leading to looser attachment. (D)</p> Signup and view all the answers

    What is the definition of invasion in the context of tumors?

    <p>Cells break through the basement membrane and invade surrounding tissues. (B)</p> Signup and view all the answers

    Flashcards

    Angiogenesis

    The growth of new blood vessels, often triggered by a lack of nutrients or oxygen in the tumor's microenvironment.

    Metastasis

    The process of cancer cells spreading from the primary tumor site to other parts of the body.

    Lymphatics

    The lymphatic system, a network of vessels that carries lymph fluid throughout the body and is a common route for cancer metastasis.

    Vascular Spread

    The spread of cancer cells via the bloodstream, often to distant organs like the lungs, liver, bone, and brain.

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    Vascular Spread to Lung

    The transfer of cancer cells to the lungs, a common site for metastasis due to the lungs' role in blood circulation.

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    Vascular Spread to Liver

    The transfer of cancer cells to the liver, often due to the liver's role in blood filtration.

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    Vascular Spread to Bone

    The transfer of cancer cells to the bone, potentially leading to bone destruction or increased bone density.

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    Vascular Spread to Brain

    The transfer of cancer cells to the brain, potentially causing neurological symptoms.

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    Matrix Metalloproteinases (MMPs)

    Enzymes that break down the extracellular matrix (ECM). They play a crucial role in cancer progression by allowing tumor cells to break through the basement membrane and invade surrounding tissues.

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    MMP2 and MMP9

    A type of MMP that specifically breaks down collagen type IV, a key component of the basement membrane.

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    MMP1

    A type of MMP that breaks down collagen type I, which is found in the ECM of tissues.

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    Cell Motility

    The movement of cells, often driven by chemical signals or changes in the ECM. In cancer, this term describes the process by which tumor cells move away from the primary tumor site and spread to other parts of the body.

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    Autocrine Motility Factors

    Signals released by cells that promote their own movement. These factors play a role in the spread of cancer cells.

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    Organ Tropism

    The tendency of cancer cells to preferentially metastasize to specific organs.

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    Extravasation

    The process by which cancer cells escape from blood vessels and invade surrounding tissues at distant sites.

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    Invasion

    The ability of cancerous cells to penetrate and destroy surrounding tissues, breaking through the basement membrane and spreading into the extracellular matrix.

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    Altered Cell Adhesion

    Cancer cells have weaker bonds and connections compared to normal cells, allowing them to detach and move more freely. This is due to altered expression of cell adhesion molecules like Cadherins and Integrins.

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    Cadherins

    Calcium-dependent glycoproteins found on the cell membrane that help bind cells together. They interact homotypically, meaning they bind to similar molecules on other cells.

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    Integrins

    Cell surface glycoproteins composed of two subunits, alpha and beta. They play a role in various biological functions, including leukocyte (white blood cell) adhesion and platelet adhesion.

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    Altered Enzyme Synthesis

    Cancer cells produce and secrete enzymes that break down the basement membrane and surrounding connective tissue, allowing them to invade and spread.

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    How do cells spread?

    The process by which cancer cells break away from the primary tumor and travel through the lymphatic or vascular channels to reach distant sites.

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    Primary vs. Secondary Tumor

    The primary tumor is the original site of the cancer, while a metastasis is a secondary tumor that develops at a distant location from the primary tumor.

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    Local Effects of Benign Tumors

    Pressure from a benign tumor can damage surrounding tissue, leading to impaired function. For example, a tumor in the pituitary gland can disrupt hormone production.

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    Tumors in Hollow Organs

    Tumors in hollow organs like the intestines can cause blockages (obstruction) or ulcers, leading to bleeding.

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    Space-Occupying Lesions

    A tumor in the brain, even if benign, can occupy space, putting pressure on other tissues.

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    Local Effects of Malignant Tumors

    Malignant tumors aggressively destroy neighboring tissues, invading blood vessels, nerves, and lymphatic channels.

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    Hematological Effects of Tumors

    Anemia due to ulceration, bone marrow infiltration (like in leukemia), or red blood cell destruction (hemolysis) are common complications of both benign and malignant tumors.

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    Endocrine Effects of Tumors

    Excess hormone production by benign or malignant endocrine tumors (like a parathyroid tumor) can lead to various health problems.

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    Ectopic Hormone Secretion

    Malignant tumors, especially in the bronchus, can produce hormones like ACTH, PTH, or ADH, leading to hormone-related complications.

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    Cachexia

    Waste of muscle and fat, loss of appetite, and general weakness, despite not actively trying to lose weight.

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    Study Notes

    Neoplasia II: Invasion, Metastasis, and Effects of Tumors

    • Invasion: Ability of cells to penetrate the basement membrane and spread through the stroma (extracellular matrix). Two key mechanisms:
      • Spreading into surrounding tissue (Invasive Carcinoma).
      • Entering lymphatic/vascular channels, characteristic of malignant cells.

    Metastasis

    • The spread of a malignant tumor to a distant (non-adjacent) site.
    • A metastasis is also known as a secondary tumor, originating from the primary tumor.

    Mechanisms of Cell Invasion and Spread

    • Malignant cells have altered adhesion compared to normal cells, sticking less.
    • Changes in enzyme production break down basement membranes and stroma.
    • Motility factors help cells move.
    • Malignant cells change their interaction with surrounding stroma.

    Altered Cell Adhesion

    • Cadherins: Calcium-dependent glycoproteins at cell membranes. Interact homotypically to bind cells together. Linked to the actin cytoskeleton via catenins. Reduced expression in cancer cells allows cells to separate. (Examples: esophagus, colon, breast, prostate cancers)
    • Integrins: Cell surface glycoproteins with α and β subunits. Many biological functions (e.g., leukocyte and platelet adhesion). Receptors for different components of the basement membrane (e.g., fibronectin, collagen) . Reduced expression alters cell-stroma contact, facilitating cell movement.

    Altered Enzyme Synthesis and Interaction

    • Different enzymes modify the stroma, allowing cells to breach basement membranes and spread.
    • Matrix metalloproteinases (MMPs) are zinc-dependent enzymes that degrade the extracellular matrix (ECM).
      • MMP2 and MMP9 break down collagen IV.
      • MMP1 breaks down collagen I.
    • These changes in attachment alter tumor cell interactions with ECM proteins.

    Cell Motility

    • Disrupted basement membrane and stroma allow cells to move.
    • Potentiated and directed by factors:
      • Cell-derived motility factors (autocrine motility factors).
      • Cleavage products of matrix proteins (e.g., laminin).
      • Other ligands, such as Wnt5a (in melanoma).
      • Increased expression of receptors for motility factors (e.g., Met oncogene, HGF receptor).

    Metastasis Routes

    • Lymphatics: Spread to local and distant lymph nodes; a frequent route for carcinomas; lungs can be involved.
    • Blood vessels: Spread via capillaries and veins to other organs. Common sites include lungs, liver, bone, and brain.
    • Coelemic spaces: Another pathway.

    Importance of ECM

    • The extracellular matrix (ECM, or stroma) isn't passive; it can promote or inhibit invasion.
    • Malignant cells manipulate the ECM for facilitated passage (e.g., using growth, angiogenic, and chemotactic factors)

    Why Don't All Malignant Cells Metastasize?

    • Cells may invade and circulate but the environment might not be suitable.
    • Incorrect receptor expression or metabolic factors may hinder their growth.
    • Failure of angiogenesis can be another reason.

    Angiogenesis

    • Tumor growth halts beyond 1-2mm³ due to nutrient/oxygen depletion, altering the microenvironment.
    • Upregulation of pro-angiogenesis factors (e.g., angiopoietin, VEGF) occurs, leading to new blood vessel growth.
    • This growth enables continued tumor growth, providing access to the bloodstream.
    • Thalidomide is a therapeutic target in renal cancers.

    Definitions: Primary and Secondary Tumors

    • Primary: The site where the malignant neoplasm first arises (e.g., breast, stomach).
    • Secondary: A metastasis; a cancerous tumor that has spread to another organ (e.g., Breast carcinoma that spread to another organ).

    Effects of Tumors

    • Tumor effects depend on factors:
      • Tumor site.
      • Extent of local spread.
      • Metastatic site.
      • Extent of metastatic spread.
      • Functional effects (e.g., pituitary).

    Local Effects of Benign Neoplasms

    • Compression (pressure atrophy).
    • Altered function.
    • Obstruction (hollow viscus).
    • Erosion/ulceration.
    • Space-occupying lesion.

    Local Effects of Malignant Neoplasms

    • Tissue destruction.
    • Obstruction or constriction.
    • Ulceration.
    • Invasion and infiltration around nerves, blood vessels, and lymphatics.
    • Space-occupying lesion.

    Systemic Effects: Haematological

    • Anemia (due to ulceration, bone marrow infiltration, or haemolysis).
    • Low white blood cell and platelet counts (bone marrow infiltration).
    • Thrombosis (e.g., pancreatic carcinoma).

    Systemic Effects: Endocrine

    • Excessive hormone secretion (benign and malignant endocrine glands).
    • Ectopic hormone secretion (e.g., ACTH by small cell lung cancer).

    Systemic Effects: Skin and Others

    • Pigmentation changes.
    • Herpes zoster.
    • Jaundice.
    • Dermatomyositis.
    • Hodgkin's disease.
    • Neuromuscular issues (e.g., balance problems, neuropathies, myopathy).
    • Cachexia (weight loss).
    • Malaise (general discomfort).
    • Fever (pyrexia).

    Why Neoplasms Kill People

    • Local effects (raised intracranial pressure, perforation, hemorrhage).
    • Replacement of essential body organs (bone marrow, lung, liver).

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    Neoplasia II 2024-2025 PDF

    Description

    Explore the complex mechanisms behind tumor invasion and metastasis in this quiz on neoplasia. Learn about how malignant cells spread through tissues and invade distant sites, including the role of altered adhesion and enzyme production. Test your knowledge on the various strategies employed by tumors to establish secondary sites.

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