oncology revision and cytology cases

what does hitology examine

• organisation of tissue structure

• degree of cellularity

• nuclear to cytoplasmi ratio

• nuclear morphology

• necrosis

• mitotic index

• individualisation of cells

• invasivness of cells

for benign tumours describe

• differentitation

• growth rate

• local invasion

• metastasis

• host consequences

• well differentiated, similar to tissue of origin

• slow, progressive

• no invasion, caspsule

• none

• none, space ocupying lesion effects

for malignant tumours describe

• differentitation

• growth rate

• local invasion

• metastasis

• host consequences

• lack of differentiation, atypical structures

• slow to rapid growth

• local invasio, infiltrative, no capsule

• frequent mets

• life threatening

for bening tumours describe these cytological features

• cellular morphology

• nuclear to cytoplasmic ratio

• nuclear morphology

• mitotic count

• necrosis

• invasion of surrounding tissue

• minimal variation in size and shape of cells (anisocytosis/ pleomorphism)

• normal to reduced

• minimal variation in size and shape of nuclei (anisokaryosis)

• low mitotic rate, rare mitotic figures

• none

• none

for malignant tumours describe these cytological features

• cellular morphology

• nuclear to cytoplasmic ratio

• nuclear morphology

• mitotic count

• necrosis

• invasion of surrounding tissue

• marked anisocytosis/ cellulr pleomorphism

• increased (big nuclei)

• marked anisokaryosis, multiple nuclei

• high mitotic rate, lots of mitotic figures and abnormal

• present

• invasion, incl bv and lymphatics

what are the cytological features for criteria of malignancy

• pleomorphism/ anisocytosis

• anisokaryosis

• muliple, bizarre shape nuclei

• macrocytosis, macrokaryosis, macronuclei

• anisonuceliosis

• increased N:C ratio: less cytoplasm, more nuclei

• nuclear molding (huggin nuclei)

• coarse chromatin

• abnormal mitotic figures

what is neoplasia

diesease characterised by abnormal cell growth

result of imbalance in mechs that regulate cell proliferation

what contributes to neoplastic growth

• genetic and epigenetic alterations of somatic cell dna

  • multiple alterations are required

  • gain of functions in genes that promote cell proliferations (oncogenes)

  • loss of function in genes that oppose cell proliferation (tumour supressor genes)

§How you might expect neoplasia to present in our patients

• see the lump

• palpate the lump → reactive?

• abnormal body functions → depends where the cancer is

• 
  

How will you diagnose it?

• fna

• imaging

• incisional and excisional biopsy→ histopathology

what is grading

Derived from histopathologic analysis of biopsy

May be predictive of behaviour, depending on tumour type

Helps answer the question of “what”

what is staging

Describes the extent of a tumour, often accounting for tumour size and presence of local and distant metastasis

Helps answer the question of “where”

for sarcomas

• tissue of origin

• most common route of metastasis

• most common metastasis site

• intial staging diagnostic

• Mesenchymal

• Haematogenous

• lungs

• thoracic radiography

for carcinomas

• tissue of origin

• most common route of metastasis

• most common metastasis site

• intial staging diagnostic

• epithelial

• lymphatic, haematogenous

• regional LN, lungs, liver, spleen

• regional/draining LN aspirate, thoracic xray, abd US

for round cell

• tissue of origin

• most common route of metastasis

• most common metastasis site

• intial staging diagnostic

• immune system cells

• lymphatic

• regional LN, liver, spleen

• regional/draining LN aspirate, abd US with liver/ spleen aspirate

list some round cell tumours

mast cell tumour, lymphoma, plasma cell tumour, histocytic tumour

what genes prevent cancer?

tumour suppressor genes

what genes promote cancer

oncogenes

What type of cell is this?

describe its appearance

Round cell
mortar lines

What type of cell is this?
describe its appearance

epithelial cell
- exfoliative
- clump together

What type of cell is this?
describe its appearance

mesenchymal
- spindle shaped

what cell type is this ?

mesenchymal

what cell type is this ?

epithelial

what cell type is this ?

round