Pathology Quiz: Neoplasia and Dysplasia Concepts

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Questions and Answers

Which statement accurately describes a malignant neoplasm?

It has irregular edges and can spread to distant sites. (correct)

It is characterized by a benign growth rate.

It grows slowly and has well-defined margins.

It remains localized and does not invade surrounding tissues.

Benign tumors are characterized by their ability to invade surrounding tissues.

False

What is metaplasia?

A disorderly proliferation of cancerous cells

A non-reversible change in cell type

A reversible change in which one cell type is replaced by another (correct)

A permanent change in cellular architecture

What does the term 'neoplasia' literally mean?

new growth Signup and view all the answers

A tumor that is well-defined and remains localized is generally classified as a __________ tumor.

benign Signup and view all the answers

Dysplasia is characterized by uniform cell arrangement and preservation of maturation.

False Signup and view all the answers

Match the following features with the correct type of neoplasm:

Benign = Slow growing, regular edges Malignant = Rapid growing, invasive Carcinoma in-situ = High grade dysplasia Dysplasia = Abnormal cell growth Signup and view all the answers

What happens to the N/C (nucleus to cytoplasm) ratio in dysplastic cells?

Increased N/C ratio Signup and view all the answers

In dysplasia, cells show ________ in size and shape.

variation Signup and view all the answers

What suffix is typically added to the name of a tissue to designate a benign neoplasm?

-oma Signup and view all the answers

Which of the following is NOT a characteristic of dysplastic cells?

Uniform cell size Signup and view all the answers

Dysplasia refers to a normal arrangement of cells in a tissue.

False Signup and view all the answers

What factor can lead dysplasia to develop into carcinoma in-situ?

Persistent injury Signup and view all the answers

Match the descriptions with the correct characteristics of dysplasia:

Pleomorphic = Variation in size and shape Increased N/C ratio = More prominent nucleus relative to cytoplasm Lost polarity = Disorganized cellular arrangement Hyperchromatic nuclei = Nuclei that are darker and larger than normal Signup and view all the answers

Low-grade dysplasia involves the full thickness of the epithelium.

False Signup and view all the answers

Dysplasia is a type of ________ proliferation that is neither neoplastic nor normal.

disorderly Signup and view all the answers

What characterizes benign tumors?

Well differentiated Signup and view all the answers

Malignant tumors can have an anaplastic differentiation grade.

True Signup and view all the answers

Name one type of benign neoplasm.

Adenoma of the colon Signup and view all the answers

A tumor that consists of spindle-shaped smooth muscle fibers is called a _____ muscle tumor.

leiomyoma Signup and view all the answers

Match the type of tumor with its description:

Adenoma = Well differentiated tumor of glandular tissue Lipoma = Benign tumor of adipose tissue Teratoma = Tumor composed of multiple germ layers Leukemia = Malignant blood cancer Signup and view all the answers

Which of the following characteristics is associated with malignant tumors?

Usually present necrosis Signup and view all the answers

Adenomas are typically composed of abnormal cells.

False Signup and view all the answers

What is the significance of the N/C ratio in tumors?

An increased N/C ratio indicates abnormality in malignant tumors. Signup and view all the answers

Which of the following routes of distant spread involves movement through blood vessels?

Haematogenous spread Signup and view all the answers

Transcoelomic spread refers to the movement of malignant cells across body cavities.

True Signup and view all the answers

What is a common site for metastasis in ovarian cancer?

Liver Signup and view all the answers

Metastasis through lymphatics leads to __________ involvement.

lymph node Signup and view all the answers

Match the following types of metastasis with their characteristics:

Haematogenous = Spread through blood vessels Transcoelomic = Spread across body cavities Lymphatic = Spread through lymphatic vessels Direct invasion = Infiltration into surrounding tissue Signup and view all the answers

Which microscopic feature is associated with transitional cell carcinoma?

Presence of pleomorphic cells Signup and view all the answers

The renal pelvis is the only site where transitional cell carcinoma can originate.

False Signup and view all the answers

What gross feature is notable in the specimen of the transitional cell carcinoma of the kidney?

Papillary tumor mass Signup and view all the answers

The ulcerative mass in the lesion has a raised everted edge and a _________ necrotic floor.

red Signup and view all the answers

Match the following features with their characteristics:

Pleomorphic cells = Transitional cell carcinoma Irregular edges = Ulcerative mass Malignant glands invasion = Adenocarcinoma Friable and necrotic = Tumor mass Signup and view all the answers

What is the prognosis for leiomyoma of the uterus?

Excellent prognosis with very rare malignancy Signup and view all the answers

Mitosis is common in the cells of leiomyoma.

False Signup and view all the answers

Describe the microscopic features of well-differentiated squamous cell carcinoma.

Irregular sheets of malignant cells with pleomorphic sizes and shapes, pink cytoplasm, and keratin pearl formation. Signup and view all the answers

Squamous cell carcinoma is a type of ___________ neoplasm.

malignant Signup and view all the answers

Match the following tumors with their associated features:

Leiomyoma = Well-demarcated and regular edges Lipoma = Normal adipose tissue with nuclei on the membrane Squamous cell carcinoma = Irregular sheets of malignant cells Adenocarcinoma = Glandular tissue cancer Signup and view all the answers

Which of the following is NOT a malignant neoplasm?

Lipoma Signup and view all the answers

Keratin pearls are a feature seen in well-differentiated squamous cell carcinoma.

True Signup and view all the answers

List two features of a malignant ulcer from squamous cell carcinoma.

Raised everted edges and irregular outline. Signup and view all the answers

Study Notes

Lab Skills: Pathology of Neoplasia

Unit 1, Problem 10: Breaking Boundaries
The course covers lab skills in pathology related to neoplasia.
Includes information on benign and malignant neoplasms.

Specific Learning Objectives (SLOs)

Define terms like hypertrophy, atrophy, hyperplasia, metaplasia, dysplasia, and neoplasia.
Correlate nomenclature of benign and malignant neoplasms with their tissue of origin.
Differentiate benign and malignant neoplasms.
Explain grading and staging methods for malignant neoplasms.

Neoplasia

Neoplasia is abnormal cell growth.
Tumors come from abnormal cell growth.
Normal skin cell growth = cell cycle.

Disorders of Cell Growth

Non-Neoplastic: Hypertrophy, atrophy, hyperplasia, metaplasia, and dysplasia.
- Reversible changes
Neoplastic (tumors): Benign and malignant.
- Non-reversible changes

Hypertrophy and Atrophy

Hypertrophy: Increase in tissue size due to cell enlargement.
- Example: Left ventricular hypertrophy (LVH) in hypertension.
Atrophy: Decrease in tissue/organ size due to reduced cell size and numbers.

Microscopic Appearance of Normal Tissue

Architecture: Surface epithelium, glands, bundles, etc.
Cells: Uniform size and shape, preserved polarity, uniform nuclei, regular outlines, mitosis limited to the basal layer, normal N/C ratio.
Nucleus: at the lower pole of the cell

Hyperplasia and Metaplasia

Hyperplasia: Increased cell number due to increased cell proliferation. Physiological or pathological; reversible.
Metaplasia: Change of adult cell type to different adult cell type. Reversible change where one cell type is replaced by another.

Dysplasia

Dysplasia: Disorderly growth of cells in tissues (Loss of uniformity of individual cells, architectural orientation).
Architecture: Disorderly arrangement in epithelium, loss of maturation.
Cells: Pleomorphic (variation in size and shape), lost polarity.
Nuclei: Variation in size and shape, nuclear enlargement, hyperchromatic nuclei, increased N/C ratio, mitosis not confined to the basal layer.

Dysplastic Cells vs. Normal Cells

Arrangement: Dysplastic - disordered; Normal - arranged
Size and shape: Dysplastic - variations; Normal - uniform
Maturation: Dysplastic - loss; Normal - preserved
Polarity: Dysplastic - loss; Normal - preserved
Nuclear size & shape: Dysplastic - enlargement, irregularity; Normal - uniform
Chromatin: Dysplastic - hyperchromatic; Normal - normochromatic
N/C ratio: Dysplastic - increased; Normal - normal
Mitosis: Dysplastic - not confined to basal layer; Normal - confined to basal layer.

Dysplasia Progression

Reversible: Low-grade dysplasia may regress if the persistent injury is removed.
Progressive: High-grade dysplasia may progress to carcinoma in situ, followed by invasive carcinoma.

What is a Neoplasm?

Neoplasia means "new growth."
Neoplasms are characterized by purposeless and autonomous cell growth.
Differentiate benign/malignant tumors based on their gross and microscopic examination.

Benign vs. Malignant Neoplasms (Gross Features)

Benign Tumors: Slow growth, well-defined edges/margins, encapsulated, no invasion, do not spread to distant sites.
Malignant Tumors: Rapid growth, irregular edges/margins, not encapsulated, invasive, spread to distant sites.

Classification and Nomenclature of Benign and Malignant Neoplasms

Neoplasms are named on the basis of their cell/tissue of origin.
- Epithelial, connective tissue, lymphoid/hematological, mixed tissue.
Specific terms are used (e.g. suffix "-oma" for benign epithelial tumors).

Main Classifications: Benign and Malignant Tumors

Benign: Epithelial, connective tissue, fat/lipid, cartilage, bone, muscle
Malignant: Carcinoma(Epithelial). Sarcoma(Connective tissue), Lipomas, Adenocarcinoma.

Other Tumors

Lymphoid/Hematopoietic: Lymphomas, leukemia
Melanocytes: Melanoma (malignant), Nevus (benign)
Embryonic Tissue: Teratomas (malignant)

Teratomas of the Ovary

Benign tumors composed of mixed tissues (e.g., skin, hair, bone, cartilage).
Other common sites (e.g., testis) but testicular teratomas are malignant.

Pathological Changes in Tumors

Gross (Macroscopic): Describes physical characteristics (size, shape, color, number, location)
Microscopic: Examines the cells and tissue structures at high magnification

How to Describe Gross Pathological Changes

Shape of lesion (e.g., ulcer, nodule, mass, polyp)
Number of lesions (e.g., single, multiple, 2,3 etc)
Location of lesion
Shape of lesion (e.g., rounded, oval ...etc)
Size of lesion
Color of lesion
Surface of lesion (e.g., intact, smooth, ulcerated)
Outline/Border (e.g., regular/irregular, well demarcated/poorly demarcated)
Relationship to surrounding structures.

A Pathological Lesion of the Uterus

Well-Circumscribed Masses: Multiple, rounded, white, regular well-demarcated masses, pushing the surrounding structure without invasion.

Is it Benign or Malignant?

Benign: Leiomyoma of the uterus

Adenoma of Colon

Lesion: Polyps
Location: Above mucosa
Shape: Rounded Mass with a neck
Size: ~ 2 x 2 cm
Color: Brown/Reddish
Outline/ Border: regular well demarcated
Relation to surrounding structure: above surface with no invasion

Benign Tumors

Well differentiated: Tumors resemble their tissue of origin
Examples of benign tumors: - Adenoma - Lipoma
- Leiomyoma

Malignant Tumors

Grades: 4 grades of differentiation (well-differentiated, moderately differentiated, poorly differentiated, anaplastic)

Microscopic Pathological Changes of Tumors

(A) Parenchyma: Arrangement (tubules, glands, sheets, cords, papillae), Cell size and shape (uniform or pleomorphic), nuclei (shape, chromatin, N/C ratio), mitosis (rare, frequent, normal or abnormal).
(B) Stroma: Connective tissue, blood vessels, and host-derived inflammatory cells.

Invasive vs. Non-Invasive Cells

Benign: Cells remain confined to their areas
Malignant: Cells invade surrounding tissues

Metastasis (Spread) of Malignant Tumors

Process: Neoplastic cells from primary tumors spread to distant sites.
Steps: Invasion into surrounding tissues; detachment within vessels; transport in emboli; extravasation (movement from vessel to tissue) and growth at new sites.
Routes: Blood vessels, lymphatics, and transcoelomic spread. (across body cavities e.g. spread of malignant cells from gastric carcinoma too the ovaries through peritoneal cavity)

Metastatic Malignant Tumors in the Liver

Liver containing multiple metastases, noted with central necrosis within nodules.

Grading of Adenocarcinoma of Colon

4 grades of differentiation: well-differentiated, moderately-differentiated, poorly-differentiated, and undifferentiated (anaplastic).

Squamous Cell Carcinoma

Gross Appearance: Ulcer with raised everted edges, irregular outline; red necrotic floor
Microscopic features: Keratin pearls, malignant sheet, malignant cells

Transitional Cell Carcinoma of the Kidney

Gross: friable, necrotic tumor mass, in renal pelvis
Microscopically: transitional cell carcinoma

Adenocarcinoma of the Colon

Lesion appearance: ulcerative mass with irregular outline
Edge: raised everted edges
Floor: red necrotic floor

Endometrial Carcinoma, Uterus

Type: Grade 1 adenocarcinoma
Characteristics are described in the slides

Breast Carcinoma

Describe gross and microscopic features

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Description

Test your knowledge on key concepts related to neoplasia and dysplasia in pathology. This quiz covers definitions, characteristics, and classifications of various types of tumors and cellular abnormalities. Perfect for students in medical or health sciences courses.