Pathology of Dysplasia and Neoplasms
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Questions and Answers

Which substance is linked to hepatocellular carcinoma?

  • Nickel
  • AflatoxinB1 (correct)
  • Benzene
  • Chromium

What type of cancer is associated with exposure to alkylating agents?

  • Prostate cancer
  • Lung cancer
  • Hepatic angiosarcoma
  • Acute myeloid leukaemia (correct)

Which of the following is considered an indirect-acting carcinogen?

  • Vinyl chloride
  • Radon
  • AflatoxinB1 (correct)
  • Benzene

What role do promoters play in the process of chemical carcinogenesis?

<p>They stimulate the proliferation of initiated cells. (A)</p> Signup and view all the answers

Which agent is primarily associated with lung cancer as a result of occupational exposure?

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

What is a common effect of a functioning tumor in the adrenal cortex?

<p>Cushing syndrome (C)</p> Signup and view all the answers

Which of the following is a potential complication of advanced cancer known as cancer cachexia?

<p>Progressive loss of body fat and lean mass (D)</p> Signup and view all the answers

What is a significant feature of paraneoplastic syndrome?

<p>Symptoms unrelated to tumor spread or hormone release (B)</p> Signup and view all the answers

What might be a clinical manifestation of a malignant tumor with an ulcerative growth pattern?

<p>Hematemesis or melena (D)</p> Signup and view all the answers

What common issue might a leiomyoma of the uterus cause?

<p>Infertility and abortion (A)</p> Signup and view all the answers

What type of cancer is most commonly associated with ultraviolet (UV) rays?

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

Which virus is known to be linked to hepatocellular carcinoma?

<p>Hepatitis B virus (A)</p> Signup and view all the answers

What condition involves a predisposing factor for cancer characterized by chronic inflammation?

<p>Chronic inflammation (A)</p> Signup and view all the answers

Which of the following tumors primarily invades and destroys surrounding normal tissue?

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

Which of the following is a common virus associated with squamous cell carcinoma?

<p>Human papillomavirus (D)</p> Signup and view all the answers

What increases the incidence of cancer as individuals age?

<p>Accumulation of somatic mutations (D)</p> Signup and view all the answers

Which of the following conditions is specifically linked to bladder cancer?

<p>Schistosoma haematobium (C)</p> Signup and view all the answers

The effects of tumors on the host can include which of the following?

<p>Tumors can compress surrounding normal tissue (B)</p> Signup and view all the answers

What is a defining feature of dysplastic cells?

<p>Abnormal large and hyperchromatic nuclei (D)</p> Signup and view all the answers

Which statement accurately describes the difference between benign and malignant tumors?

<p>Benign tumors show no local invasion, whereas malignant tumors typically invade nearby tissues. (B)</p> Signup and view all the answers

What component of a neoplasm is responsible for providing structural support and blood supply?

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

Which of the following is classified as a malignant neoplasm?

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

What is typically the suffix used for benign tumors?

<p>-oma (C)</p> Signup and view all the answers

Which condition involves complete regression of mild to moderate dysplasia?

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

Dysplasia is considered a precancerous condition. What is one of its key characteristics?

<p>Disorderly proliferation and loss of architectural orientation. (D)</p> Signup and view all the answers

Which of the following is a characteristic feature of malignant neoplasms?

<p>Unlimited growth potential (C)</p> Signup and view all the answers

What characterizes benign neoplasms in comparison to malignant neoplasms?

<p>Mitoses are usually rare and normal in configuration. (C)</p> Signup and view all the answers

What is a key feature of malignant tumors that distinguishes them from benign tumors?

<p>They can metastasize and infiltrate surrounding tissues. (C)</p> Signup and view all the answers

Which of the following describes a typical characteristic of anaplastic cells in malignant tumors?

<p>Atypical mitotic figures. (C)</p> Signup and view all the answers

Which type of tumor is least likely to metastasize?

<p>Basal cell carcinoma. (C)</p> Signup and view all the answers

What type of spread is most commonly associated with sarcomas?

<p>Blood spread. (C)</p> Signup and view all the answers

What is the result of local invasion by malignant tumors?

<p>Progressive infiltration and destruction of normal tissues. (D)</p> Signup and view all the answers

What is a hallmark feature of malignant tumors?

<p>Ability to metastasize. (D)</p> Signup and view all the answers

Which of the following is NOT a pathway through which tumors may metastasize?

<p>Airborne spread. (D)</p> Signup and view all the answers

What characterizes malignant tumors in terms of differentiation?

<p>Lack of differentiation (anaplasia) (D)</p> Signup and view all the answers

Which of the following features is typically associated with benign tumors?

<p>Slow rate of growth (A)</p> Signup and view all the answers

What is a key difference between benign and malignant tumors regarding their effect on surrounding tissues?

<p>Benign tumors compress normal tissues without invading (A)</p> Signup and view all the answers

In cancer grading, what does a poorly differentiated tumor indicate?

<p>Aggressive behavior (D)</p> Signup and view all the answers

Which categorization is used in grading a cancer?

<p>Determined by cytologic appearance and differentiation (C)</p> Signup and view all the answers

What method is primarily used in tumor staging?

<p>Surgical exploration or imaging (C)</p> Signup and view all the answers

What determines the clinical staging of a tumor?

<p>The size of the primary lesion and spread (A)</p> Signup and view all the answers

Which statement is true regarding nonbacterial thrombotic endocarditis?

<p>It can occur in patients with lung cancer. (B)</p> Signup and view all the answers

Flashcards

Dysplasia Definition

Disorderly cell growth in epithelium, characterized by abnormal cell shape and arrangement.

Neoplasm Definition

Abnormal tissue mass, growing uncontrollably and persistently.

Benign Tumor Suffix

Named with "-"oma suffix (e.g., fibroma).

Malignant Tumor Origin

Originates from epithelial cells (carcinoma), mesenchymal tissue (sarcoma), blood cells (leukemia/lymphoma).

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Tumor Components

Tumors have parenchyma (neoplastic cells) and stroma (supporting tissue).

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Differentiation in Tumors

How much a tumor resembles its original cell type.

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Distant Metastasis

Cancer cells spreading to other parts of the body.

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Local Invasion (Cancer)

Spread of cancer cells into nearby surrounding tissues.

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Benign Neoplasm

A non-cancerous tumor composed of well-differentiated cells that closely resemble the tissue of origin. Growth is slow and localized.

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Malignant Neoplasm

A cancerous tumor with a wide range of differentiated cells, able to invade and spread to distant locations (metastasis).

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Anaplasia

Loss of differentiation in malignant cells; they lose their specialized functions.

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Metastasis

Spread of cancer cells to distant sites in the body through blood or lymph.

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Local Invasion

The direct spread of cancer into surrounding tissues.

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Cellular Pleomorphism

Variation in the size and shape of cancer cells.

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Atypical Mitoses

Abnormal or irregular cell division in cancer cells.

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Tumour Giant Cells

Large, abnormal cells found in some cancers.

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Carcinogen definition

A substance capable of causing cancer.

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Indirect-acting carcinogen

A procarcinogen that needs metabolic conversion to become an active carcinogen.

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Initiator in carcinogenesis

A mutagenic chemical damaging DNA through reactive electrophile groups.

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Promoter in carcinogenesis

A non-mutagenic substance that increases the growth of initiated (mutated) cells.

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Alkylating agents

A type of cancer-causing chemical, often linked to acute myeloid leukemia

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Functioning Tumor Effect

Tumors can produce excess hormones, leading to hormonal imbalances. For example, an adenoma in the pancreas can cause hyperinsulinism.

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Non-functioning Tumor Effect

Tumors can compress surrounding organs, causing dysfunction. For example, a uterine fibroid can lead to infertility or urinary frequency.

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Ulceration from Tumors

Tumors can cause ulcers on surfaces, leading to bleeding and infection. For example, breast cancer can invade the skin and cause an open sore.

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GIT Cancer Growth Patterns

Cancer in the gastrointestinal tract can grow in different ways, leading to specific symptoms. Polypoid growth causes obstruction, while ulcerative growth causes bleeding.

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Cancer Cachexia

A severe wasting syndrome associated with advanced cancer, characterized by weight loss, muscle wasting, and weakness.

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Cancer from UV rays

Exposure to ultraviolet (UV) rays from sunlight can cause skin cancers such as squamous cell carcinoma, basal cell carcinoma, and melanoma.

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Microbes and Cancer

Certain microbes, like viruses and bacteria, can contribute to cancer development. For example, Epstein-Barr virus can cause Burkitt lymphoma, while Helicobacter pylori is linked to stomach cancer.

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Chronic Inflammation's Role

Persistent inflammation in the body can increase the risk of cancer. This is because inflammation can damage cells and create a favorable environment for cancer growth.

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Precancerous Conditions

These are abnormal cell changes that are not cancerous yet but have a higher risk of developing into cancer. Examples include hyperplasia (excessive cell growth) and dysplasia (disordered cell growth).

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Cancer's Effect on the Body

Tumors can disrupt normal tissues and organs. Benign tumors compress surrounding areas, while malignant tumors invade and destroy tissues.

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Endocrine Gland Tumors

Tumors originating in endocrine glands can disrupt hormone production, leading to various health problems.

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Increased Cancer Risk with Age

The incidence of cancer increases with age due to factors like the accumulation of genetic mutations and a weaker immune system.

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Inherited Predisposition to Cancer

Certain genetic mutations inherited from parents can increase an individual's susceptibility to specific cancers.

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Cushing syndrome

A condition caused by prolonged exposure to high levels of cortisol, often due to a tumor in the adrenal gland. It can lead to symptoms like weight gain, muscle weakness, and high blood pressure.

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Hypercalcemia

A medical condition characterized by abnormally high levels of calcium in the blood.

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Venous thrombosis

The formation of a blood clot in a vein, often in the legs or pelvis.

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Nonbacterial thrombotic endocarditis

A rare heart condition characterized by the formation of small clots on the heart valves, usually occurring with chronic illness or cancer.

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What are some common features of benign tumors?

Benign tumors are usually slow-growing, well-differentiated, and surrounded by a clear margin. They often have a capsule and do not invade surrounding tissues.

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What are some common features of malignant tumors?

Malignant tumors are usually fast-growing, poorly differentiated, and invade surrounding tissues. They can spread to distant sites (metastasis).

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What is tumor grading?

Tumor grading is based on the degree of differentiation of the tumor cells, the number of mitoses, and the extent of tumor necrosis. It helps determine the aggressiveness of the cancer.

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What is clinical staging?

Clinical staging is used to describe the extent of the cancer based on the size of the primary tumor, spread to lymph nodes, and presence of metastasis. It helps determine the best treatment plan.

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Study Notes

Learning Outcomes

  • Defining dysplasia
  • Describing the features of dysplasia
  • Defining neoplasm
  • Classifying tumors
  • Describing benign and malignant neoplasms
  • Identifying carcinogenic agents
  • Explaining the effects of tumors on the host
  • Describing the grading and staging of cancer
  • Explaining the laboratory diagnosis of cancer

Dysplasia

  • Dysplasia is characterized by disorderly proliferation.
  • Dysplastic epithelium shows a loss of cell uniformity (pleomorphism) and architectural orientation.
  • Dysplastic cells have abnormally large, hyperchromatic nuclei.
  • Mitotic figures are more abundant than usual and appear in an abnormal location in the superficial epithelium.
  • Dysplasia is a precancerous condition.
  • Pathological hyperplasia and epithelial metaplasia can progress to dysplasia.
  • Mild to moderate dysplasia can regress if inciting causes are removed.
  • Severe dysplasia involves the entire thickness of the epithelium.
  • Dysplastic cells do not penetrate the basement membrane in carcinoma in situ.
  • Invasive cancer involves cancer cells penetrating the basement membrane.
  • Examples include cervical dysplasia caused by human papillomavirus type 16 and squamous cell dysplasia in skin exposed to ultraviolet light.

Neoplasm

  • A neoplasm is an abnormal mass of tissue.
  • The growth of a neoplasm exceeds that of normal tissues.
  • The growth of a neoplasm is uncoordinated with that of normal tissues.
  • The growth of a neoplasm persists even after removal or cessation of the stimulus.
  • All tumors have two basic components:
    • Parenchyma: transformed or neoplastic cells
    • Stroma: supportive host-derived, non-neoplastic connective tissue, inflammatory cells, and blood vessels.

Tumor Nomenclature

  • Benign tumors have a suffix of "-oma".
  • Malignant tumors arise from:
    • Epithelial cells: carcinoma
    • Mesenchymal tissue: sarcoma
    • Blood cells: leukemias or lymphomas
    • The suffix of "-oma" is used in malignant tumors, with exceptions.
  • Examples of tumor types were listed

Characteristics of Benign and Malignant Neoplasms

  • Differentiation: the extent to which a neoplasm resembles its cells of origin.
    • Benign neoplasms are composed of well-differentiated cells and resemble the tissue of origin. Mitoses are usually rare.
    • Malignant neoplasms exhibit a wide range of parenchymal cell differentiation, from well-differentiated to poorly differentiated or undifferentiated cells (anaplastic).
  • Local invasion: the ability of a neoplasm to grow locally infiltrating and destroying surrounding tissue.
    • Benign tumors grow slowly as cohesive, expansile masses. They compress surrounding tissues and have a fibrous capsule.
    • Malignant tumors often (but not always) grow rapidly. They infiltrate, invade, and destroy surrounding tissues.
  • Distant metastasis: the ability of a neoplasm to spread to distant sites via blood or lymphatic systems.
    • Metastasis is a hallmark of malignant tumors.
    • It describes the spread of a tumor to sites physically discontinuous from the primary tumor.
    • All cancers except basal cell carcinomas can metastasize.

Anaplasia

  • Anaplasia is the lack of structural or functional differentiation.
  • It is a hallmark of malignant tumors.
  • Anaplastic cells show cellular and nuclear pleomorphism, large hyperchromatic nuclei, and an increased nuclear-to-cytoplasmic ratio (1:1).
  • Prominent nucleoli and numerous atypical mitoses, often including tripolar or quadripolar mitotic spindles.
  • Anaplastic cells typically display loss of polarity (normal orientation characteristics).

Metastasis

  • Metastasis is the spread of a tumor to distant sites.
  • Common pathways include blood spread and lymphatic spread.
  • Some cancers can spread through seeding within body cavities or iatrogenically.

Carcinogenic Agents

  • Carcinogenic agents: These agents are chemicals, radiation, and microbes.
  • Chemicals: Direct-acting (do not require metabolic conversion to become active) and indirect-acting (require metabolic conversion).
  • Radiation: can be various forms like UV rays, radiographs, nuclear fission, and radionuclides.
  • Microbes: various viruses and bacteria are noted.
  • Oncogenes and tumor suppressor genes are also noted.

Acquired Predisposing Conditions to Cancer

  • Chronic inflammation
  • Precancerous conditions
  • Immunodeficiency states

Clinical Staging

  • Tumor staging determines the extent of a tumor.
  • Staging is determined by surgical exploration or imaging.
  • Staging is based on three factors:
    • Size of the primary lesion
    • Spread to regional lymph nodes
    • Presence or absence of metastases.

Laboratory Diagnosis of Neoplasms

  • Morphologic methods:
    • Histology: biopsy analysis with methods like hematoxylin and eosin staining.
    • Cytology: fine-needle aspiration or Pap smears
  • Tumour markers: blood-based tests determining tumour presence, recurrence, response to treatment
  • Molecular diagnosis: includes BCR-ABL, HER-2/neu.

Effects of Tumor on the Host

  • Tumors can affect the body in several ways and can increase and decrease hormone production.
  • They can cause injury leading to bleeding and infection.
  • They may alter the growth patterns in the body, leading to obstructions, ulceration, or bleeding.
  • Cancer cachexia (complication of advanced cancer) involves progressive loss of lean body mass with profound weakness, anorexia, and anemia.

Paraneoplastic syndromes

  • Symptoms not explained by tumor spread, or by release of tissue-specific hormones
  • Occur in 10% - 15% of cancer patients.
  • Mimic metastatic disease, making treatment difficult.

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Description

This quiz covers essential concepts related to dysplasia and neoplasms, including definitions, classifications, and characteristics of both benign and malignant tumors. It focuses on the effects of carcinogenic agents and the laboratory diagnosis of various cancer stages and grades. Assess your understanding of these critical pathology topics.

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