24 Questions
What is the primary characteristic of dysplastic epithelium?
Loss of uniformity in the size and shape of individual cells
What is typically seen in the nuclei of dysplastic cells?
Hyperchromatic and large nuclei
What is the significance of mitotic figures in dysplastic epithelium?
They are unusually abundant and may appear in abnormal locations
What is the grading of dysplasia based on?
Severity and extent of the changes
What is the prognosis of mild to moderate dysplasia?
It may regress completely with removal of inciting causes
What is carcinoma in situ?
A pre-invasive stage of cancer
What is the characteristic of invasive carcinoma?
Tumor cells move beyond the normal confines through breaching the basement membrane
What is the relationship between dysplasia and cancer?
Dysplasia does not necessarily progress to cancer
What is a key characteristic that distinguishes benign tumors from malignant tumors?
Benign tumors are surrounded by a fibrous capsule.
Which of the following is NOT a characteristic of benign tumors?
They can metastasize to distant sites.
Which of the following is a definitive criterion of malignancy?
Metastasis to distant sites.
Which of the following types of tumors are less likely to metastasize?
Malignant gliomas of the CNS.
What is the term used to describe the destructive invasiveness of basal cell carcinomas?
Rodent ulcer.
Why is surgical resection of cancers often difficult?
Because they are invasive and can penetrate surrounding tissues.
During surgery, what is often removed adjacent to the tumor?
A margin of apparently normal tissue.
What is a characteristic of a breast mass that makes it suspicious for malignancy?
It is fixed during clinical examination.
What is the primary cavity affected by peritoneal seeding?
Peritoneal cavity
Which type of cancers is most likely to involve the pleural cavity?
Lung and breast carcinomas
What is the Sentinel lymph node?
The first node in a regional lymphatic basin that receives lymph flow from the primary tumor
What is the typical pathway for the initial dissemination of carcinomas?
Lymphatic spread
What is the reason why veins are more readily penetrated than arteries during hematogenous spread?
Veins have thinner walls than arteries
What is the most frequent site of metastases in hematogenous spread?
Liver and lungs
Which pathway is probably the cause of frequent vertebral (bone) metastases of carcinomas of the thyroid and prostate?
Paravertebral plexus of veins
What is the outcome of serous membrane involvement by metastases?
Pouring of exudates into these cavities
Study Notes
Dysplasia
- Dysplasia refers to disorderly proliferation of cells, characterized by loss of uniformity in individual cells and their architectural orientation.
- Typically occurs in epithelial membranes, such as squamous epithelium of the cervix uteri, skin, and metaplastic bronchial mucosa.
Characteristic Changes in Dysplasia
- Pleomorphism and loss of orientation of affected cells.
- Frequent presence of hyperchromatic and large nuclei.
- Unusually abundant mitotic figures, often in abnormal locations within the epithelium.
Grading of Dysplasia
- Mild to moderate dysplasia: dysplastic changes do not involve the entire thickness of the epithelium and may regress completely if inciting causes are removed.
- Severe dysplasia (carcinoma in situ): dysplastic changes involve the entire thickness of the epithelium.
Invasive Carcinoma
- Occurs when tumor cells move beyond the normal confines, breaching the limiting basement membrane.
- Dysplastic changes are often found adjacent to foci of invasive carcinoma, but dysplasia does not necessarily progress to cancer.
Local Invasion and Metastasis
- Invasive tumors infiltrate, invade, and destroy surrounding tissues, whereas benign tumors grow as cohesive expansile masses.
- Benign tumors remain confined to the site of origin, without invading locally or metastasizing to distant sites.
- Metastasis is the only definitive criterion of malignancy, as benign neoplasms do not metastasize.
Pathways of Spread
- A. Seeding of Body Cavities and Surfaces: cancer cells penetrate into natural "open fields", affecting cavities such as peritoneal, pleural, pericardial, and joint spaces.
- B. Lymphatic Spread: follows the natural routes of lymphatic drainage, with sentinel lymph node being the first node in a regional lymphatic basin.
- C. Hematogenous Spread: typical of sarcomas, but also seen with carcinomas, where cancer cells follow venous flow, often affecting the liver and lungs.
Learn about dysplasia, a disorderly proliferation of cells, its characteristics, and effects on epithelial membranes. Understand the changes in cell orientation and presence of hyperchromatic nuclei.
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