Neoplasia Lectures Flashcards

Questions and Answers

What is the difference between dysplasia and anaplasia?

Dysplasia does not involve invasion of the tissue and is pre-malignant, while anaplasia does involve invasion and is considered malignancy.

Dysplasia involves cellular pleomorphism and nuclear pleomorphism. What does this mean?

Cellular pleomorphism refers to variation in the shape and size of cells, while nuclear pleomorphism involves variation in the shape and size of the cell nuclei.

What is aplasia? What is hypoplasia? What is agenesis?

Aplasia is the absence of an organ with only a rudimentary structure present. Hypoplasia is a reduced size of an organ as a result of incomplete development. Agenesis is the complete lack of an organ.

Why is it important to detect dysplasia early?

If detected early, treatment can prevent dysplasia from developing into a neoplastic condition or cancer. Signup and view all the answers

What is a neoplasm?

A neoplasm is an abnormal mass of tissue whose growth exceeds normal tissue and persists even after the stimulus has been removed. Signup and view all the answers

How are benign tumors named?

Benign tumors are usually named for the type of cell they originate from followed by -oma. Signup and view all the answers

What do we call a benign tumor that forms glands?

Adenoma. Signup and view all the answers

What do we call a malignant tumor that has mesenchymal origin?

Sarcoma. Signup and view all the answers

What is divergent differentiation?

Divergent differentiation refers to a tumor showing more than one pattern, often involving both mesenchymal and epithelial tissue. Signup and view all the answers

What is a teratoma?

A teratoma is a tumor that involves at least two germ cell layers, commonly seen in ovarian or testicular cancer. Signup and view all the answers

What is a choristoma? What is a hamartoma? What is a cyst?

A choristoma is leftover tissue in an area not normally located there. A hamartoma is disorganized normal tissue. A cyst is a fluid-filled space. Signup and view all the answers

What is fibromatosis? Histologically do they appear to be benign or malignant?

Fibromatosis is a soft tissue tumor composed of proliferating fibroblasts. Histologically, they appear benign. Signup and view all the answers

What is a carcinoid tumor?

A carcinoid tumor is a low-grade malignant tumor composed of neuroendocrine cells. Signup and view all the answers

What is an endophytic tumor? What is an exophytic tumor?

An endophytic tumor grows inwardly, while an exophytic tumor grows outwardly. Signup and view all the answers

What terminology is used to refer to cancers that are commonly seen in children? What is a well-known example?

The terminology used is _blastoma, with retinoblastoma being a well-known example. Signup and view all the answers

What are the four characteristics that help to determine whether a neoplasm is benign or malignant?

Differentiation and anaplasia, rate of growth, invasion, and metastasis. Signup and view all the answers

What is differentiation?

Differentiation is the extent to which tumor cells resemble their normal precursor cells both morphologically and functionally. Signup and view all the answers

How does differentiation relate to benign and malignant tumors? What is the term used for lack of differentiation?

All benign tumors are well differentiated, while malignant tumors can vary. The term for lack of differentiation is anaplasia. Signup and view all the answers

True or false: All well-differentiated tumors are benign.

False Signup and view all the answers

What commonly occurs in the following in anaplastic cells: cell size and shape, nucleus size and shape, nuclear cytoplasmic ratio, amount of DNA, mitosis?

Cell size and shape become variable, nucleus size and shape becomes variable, nuclear-cytoplasmic ratio increases, amount of DNA increases (hyperchromatic), and there is increased mitosis and abnormal mitosis. Signup and view all the answers

Would a poorly differentiated carcinoma of an endocrine organ lead to high or low hormone levels?

Low hormone levels. Signup and view all the answers

What is the difference in growth between benign and malignant tumors?

Benign tumors grow slower than malignant tumors. Signup and view all the answers

What is the exception to the slower growth rate of benign tumors?

A leiomyoma of the uterine smooth muscle grows at a fast rate during pregnancy due to hormonal dependence. Signup and view all the answers

Do poorly differentiated tumors grow fast or slow? How does rate of growth correlate with blood supply?

Poorly differentiated tumors grow fast. Better blood supply to tumor cells correlates with faster growth. Signup and view all the answers

What can occur to cells in the center of rapidly growing tumors and why?

They can undergo central necrosis due to rapid growth leading to poor vascularization. Signup and view all the answers

How do benign tumors grow? How does malignancy and invasion relate?

Benign tumors grow through expansion within the initial tissue, while malignant tumors are invasive. Signup and view all the answers

What is the term for a tumor of epithelial origin that has yet to invade? Give three names. Once it invades, what is it called?

The term is carcinoma in situ, severe dysplasia, or intraepithelial neoplasia. Once it invades, it is called carcinoma. Signup and view all the answers

What is metastasis? What does this indicate?

Metastasis is the implantation of tumor tissue in an area other than where it originated, indicating malignancy. Signup and view all the answers

Describe the three methods of metastasis: seeding via body cavities, lymphatic spread, and hematogenous spread.

<ol> <li>Seeding via body cavities: Tumors spread through body cavities (e.g., peritoneal). 2. Lymphatic spread: Tumors spread via the lymphatic system. 3. Hematogenous spread: Tumors spread through the bloodstream.</li> </ol> Signup and view all the answers

Where is the most common site of metastasis through seeding? What is the favored method of dissemination favored by sarcomas? What is the most common initial dissemination method for carcinomas?

The most common site of metastasis through seeding is through the peritoneal cavity. Sarcomas favor hematogenous spread, while carcinomas typically disseminate through lymphatic spread. Signup and view all the answers

Does a benign tumor typically progress into a malignant tumor? What is the exception? What cellular adaptation usually precedes malignancy?

No, benign tumors do not typically progress to malignant tumors. An exception is colonic adenomas, which may progress. Dysplasia usually precedes malignancy. Signup and view all the answers

Does cancer usually start as a single cell (monoclonal) or does it typically result from damage/mutation to multiple cells (polyclonal)?

False Signup and view all the answers

What are some common genetic transformations that can occur in cancer cells?

They become autonomous for growth signals, resistant to inhibitory signals, resistant to apoptosis, have DNA repair mutations, unrestricted division via telomerase reactivation, and stimulate angiogenesis. Signup and view all the answers

What is the doubling time of a tumor? How long is it?

The doubling time is the amount of time it takes for a tumor cell mass to double in size or weight. It varies with each cancer type. Signup and view all the answers

How do you calculate growth fraction? How can we use this in our treatment decision?

Growth fraction is calculated as the number of replicating cells divided by the total number of cells. Tumors with high growth fractions are more susceptible to chemotherapy. Signup and view all the answers

A clinically detectable tumor is approximately what size and weight? How many doubling times are required for the tumor to get to this size and how many cells does it include? How many doubling times are required from this stage to make the tumor lethal?

A clinically detectable tumor is approximately 1 cm³ (1 g). It requires 30 doubling times to reach 10⁸ - 10⁹ cells, and 10 more doubling times to reach 1 kg. Signup and view all the answers

What releases angiogenic factors for tumor growth?

Tumor cells and inflammatory cells that infiltrate the tumor release angiogenic factors. Signup and view all the answers

What do FGF, VEGF, PDGF, and HIF1α cause?

They all cause angiogenesis. Signup and view all the answers

What is CIN1, CIN2, and CIN3? What does CIN stand for?

CIN1 is associated with mild dysplasia, CIN2 with moderate dysplasia, and CIN3 with severe dysplasia. CIN stands for cervical intraepithelial neoplasia. Signup and view all the answers

What strains of HPV are associated with cancer?

HPV 16 and 18. Signup and view all the answers

What are two goals of screening?

To detect dysplasia and treat before it becomes neoplastic, or detect cancer before it causes clinical symptoms. Signup and view all the answers

What is tumor dormancy?

Tumor dormancy refers to some tumors not metastasizing immediately and becoming dormant before reappearing without obvious cause. Signup and view all the answers

What is the progression of metastasis? What is homing?

Metastasis involves tumor cells detaching, destroying ECM, and spreading to new sites. Homing is the movement to new sites influenced by various stimulants. Signup and view all the answers

What antigen can be detected through a blood test in patients who have ovarian cancer?

CA125. Signup and view all the answers

Because the immune system plays a key role in tumor suppression, what patients are at an increased risk of tumor development? How does TGFβ lead to immunosuppression?

The immunocompromised are at increased risk of tumor development. TGFβ suppresses the immune system, leading to further tumor growth. Signup and view all the answers

Once a malignancy is identified, what needs to be determined? Which is usually more important?

Grade and stage need to be determined, with stage usually being more important. Signup and view all the answers

What is the grade of a cancer? What are the common classifications given?

The grade is the level of differentiation, with classifications being well, moderately, and poorly differentiated. Signup and view all the answers

What is the stage of a cancer? What is the difference between clinical and pathological stage?

The stage is the extent of spread. Clinical stage is based on evidence obtained prior to treatment, while pathological stage is determined during surgery and biopsy. Signup and view all the answers

What are the three stages of cancer classification? What does each mean?

TNM: T = size of the tumor, N = extent of spread to lymph nodes, M = presence or absence of spread to other organs. Signup and view all the answers

Study Notes

Dysplasia vs. Anaplasia

Dysplasia is a pre-malignant condition without tissue invasion, while anaplasia indicates malignant transformation involving invasive characteristics.
Dysplasia presents pleomorphic cellular and nuclear features, whereas anaplasia relates to complete loss of cellular differentiation.

Cellular Pleomorphism

Dysplasia exhibits cellular pleomorphism (variability in cell shape and size) and nuclear pleomorphism (variability in nuclear shape and size).

Developmental Abnormalities

Aplasia: complete absence of an organ; hypoplasia: reduced organ size due to incomplete development; agenesis: total lack of organ formation.

Importance of Early Detection

Early detection of dysplasia allows for interventions that can prevent progression to cancer.

Neoplasm Definition

A neoplasm is an abnormal tissue mass with uncontrolled growth that persists despite the removal of its initiating stimulus.

Tumor Naming Conventions

Tumors are typically named based on the cell type and suffixed with -oma, with exceptions like melanoma and lymphoma which denote malignancies.

Benign Tumor Types

Adenomas originate from glandular tissue; cystadenomas contain cystic spaces; papillomas display finger-like projections; and polyps are raised mucosal lesions.

Malignant Tumor Classifications

Sarcomas arise from mesenchymal tissue, whereas carcinomas originate from epithelial cells.

Mixed Tumors

Tumors exhibiting divergent differentiation show both mesenchymal and epithelial characteristics and can be either benign or malignant.

Teratoma

A teratoma is a tumor with cells derived from two or more germ layers, often found in gonadal tissue.

Tissue Remnants

Choristoma: tissue in abnormal locations from embryonic development; hamartoma: disorganized normal tissue; cyst: fluid-filled space.

Fibromatosis Characteristics

Fibromatosis is a benign soft tissue tumor composed of fibroblasts, typically locally invasive without metastasis.

Carcinoid Tumor

Carcinoid tumors are low-grade malignancies derived from neuroendocrine cells.

Tumor Growth Patterns

Endophytic tumors grow inward, while exophytic tumors extend outward.

Pediatric Cancers

Cancers commonly seen in children are often termed with the suffix -blastoma, with retinoblastoma as a notable example.

Neoplasm Characteristics

Key characteristics to differentiate benign from malignant tumors include differentiation/anaplasia, growth rate, invasion, and metastasis.

Definition of Differentiation

Differentiation refers to how closely tumor cells resemble their normal precursor cells in structure and function.

Tumor Differentiation Classifications

Tumors are classified as well, moderately, or poorly differentiated, with anaplasia indicating a lack of differentiation.

Tumor Growth Rates

Benign tumors generally grow slower than malignant tumors, with notable exceptions like hormone-dependent growth during pregnancy in leiomyomas.

Metastasis Indications

Metastasis is a definitive sign of malignancy, involving the spread of tumor cells to distant sites.

Metastatic Spread Methods

Seeding occurs through body cavities; lymphatic spread travels via lymphatic vessels; hematogenous spread occurs through blood vessels.

Tumor Detection Size

A clinically detectable tumor is typically 1 cm³ (about 1 g) and requires approximately 30 doubling times to reach this size from initiation.

Tumor Cells and Angiogenesis

Tumor and inflammatory cells contribute to the production of angiogenic factors, supporting tumor growth.

Angiogenic Factors

FGF, VEGF, PDGF, and HIF1α are key factors that promote angiogenesis, facilitating tumor nutrient supply and growth.

Cervical Intraepithelial Neoplasia (CIN)

CIN1, CIN2, and CIN3 reflect increasing severity of dysplastic changes in cervical epithelial cells, progressing from mild to severe dysplasia.

HPV and Cancer

HPV types 16 and 18 are strongly associated with cervical cancer development.

Screening Goals

Objectives of cancer screening include early detection of dysplasia to prevent progression and identifying cancer before clinical symptoms arise.

Tumor Dormancy

Tumor dormancy refers to the period when tumors remain undetectable but may become active without clear cause later.

Metastasis Progression

Metastasis involves detachment from the primary tumor, invasion of the extracellular matrix, and establishment at distant sites, guided by homing mechanisms.

Ovarian Cancer Antigen

CA125 is a biomarker detectable in blood for patients with ovarian cancer.

Immunosuppression and Tumor Growth

Immunocompromised individuals are at heightened risk for tumor development, exacerbated by factors like TGFβ, which suppresses the immune system.

Cancer Grading and Staging

Determining the grade (level of differentiation) and stage (extent of spread) of a malignancy is crucial, with stage often more impactful for treatment decisions.

Cancer Grade and Classification

Cancer grade indicates tumor differentiation: well, moderately, or poorly differentiated.

Cancer Staging

Cancer stage describes the extent of spread, using clinical and pathological classifications to determine treatment interventions.

TNM Staging System

The TNM system classifies tumors based on tumor size (T), lymph node involvement (N), and metastasis (M).

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Description

This quiz covers key concepts and definitions related to neoplasia, focusing on dysplasia and anaplasia. Understand the differences between these two terms, including implications like invasiveness and pleomorphism. Perfect for students studying pathology or oncology.