P1-ORAL PATH 2 SAS 2 and PPT

Neoplasm

This is defined as ceaseless, purposeless, uncoordinated and uncontrolled growth of the tissue resulting from multiplication of its cells.

Anaplasia

Loss of the cell's normal morphologic and functional characteristics.

Primitive cells

What does anaplastic cells resemble more of?

Atrophy

Decrease in the size of tissue or organ

Differetiation

Degree of resemblance of the cells or tissues to cell or tissue of origin

Dysplasia

Potentially pre-neoplastic change, increased mitosis, atypical morphology and abnormal maturation may be present. It may be reversible but only in the early stages.

Hamartoma

Congenital tumor like lesions whose growth is coordinated with body growth.

Hyperplasia

Is an increase in the number of cells causing a corresponding increase in tissue mass.

Hypertrophy

Is an enlargement in individual cell size causing a corresponding increase in tissue mass. Cellular proliferation is controlled

Hypoplasia

Failure of attainment of normal size or shape of an organ.

Metaplasia

Is the replacement of one adult tissue type by another and usually the replacement is simpler in form

Neoplasia

Is the autonomous proliferation of cells without response to the normal control mechanisms governing their growth. Neoplasia may be benign or malignant.

Tumor

Literally, any swelling, including an inflammatory mass but the term has become a synonym for neoplasm to the point of being equated often with the term cancer.

Quiscent cells

In control of cell proliferation, Growth factors recruit what type of cells into mitosis?

-P53

-P16

-pRb control proliferation

Example of growth inhibitors

-Apoptosis inhibitors

-Apoptosis inducers

What components determine the fate of post-mitotic cells

-Insulin

-Growth factors

in disorders of growth control, Fetal growth is regulated by?

-Reduced growth hormone

-Growth hormone receptors

-Thyroid hormone

Reduced postnatal growth can be due to what?

Excess growth hormones

What causes gigantism before puberty acromegaly in adults

Malignant neopalsm

Epidemiology of neoplasia, around 25% of individuals will develop what?

True

Epidemiology of neoplasia, True or false: Risk of malignent neoplasia increases with age

Usually slow

What is rate of growht in benign neoplasms?

Usually rapid

WHat is thre rate of growth in malignant?

-Circumscribed/ encapsulated

What is the border of benign

-irregular and poorly defined

What is the border of malignant

Good

What is differentiation is benign

Variable, often poor

What is differentiation of malignant

-Low, normal appearance

WHat is mitotic activity of benign

-High, often abnormal

What is mitotic activity of malignant

Normal

Nuclear features of benign

-Hyperchromatic

-Pleomorphic

-contain nucleoli

Nuclear features of malignant

Benign neoplasms

IN classification of neoplasms, These are non-invasive, slow growing and well differentiated

Malignant neoplasms

These are invasive, capable of distant metasis, grow rapidly and show variable differentiation

Carcinoma

This is the most frequent malignant neoplasm and tends to occur mostly in those over 50 years of age.

Epithelium

In carcinoma, where does it arise?

Connective tissue

in sacroma, where does it arise

Uncontrolled and disorganized growth

What does cancer cells experience

-Hemorrhage

-Infection

For cancer cells, inavade through tissus and cause?

-Loss of function

-Pain

-Paresthesia/ palsy

In clinical effects of tumors, Destruction of adjacent tissue may cause what?

Obstruction to ducts

In clinical effects of tumors, What happens to the ducts if there is pressure on adjacent tissues

Acute or chronic blood loss

If hemorrhage may happne in ulcerated surfaces, what may it lead to?

Localized damage

Secondary deposits (metastatic tumors) may cause that may lead to cachexia (wasting of the body)

Metabolic processing

In carcinogenesis, chhemical carcinogens often require what to activate to active form

-UV light

-Ionizing radiation

In carcinogesis, what are the radiation inducers?

-Epstein barr virus

-Human papillomavirus (16 and 18)

-Hepatitis B and C

-Human herpevirus 8

-Human T-lymphotrophic

List the oncogenic viruses in man

Invasion

In invasion in malignant neoplasia, What is a key feature in diagnosis of malignancy

-Dense planes

-Some organ capsules

In invasion in malignant neoplasia, invasion is limited by what?

Blood vessels, transcoelomic and implantation

In metastitic spread, The routes would be lymphatic through

-Anatomy

-Tumor type

-growth advantages

In metastiatc spread, Distribution of metastases is influenced by what?

neoplasia

refer to abnormal masses of tissue, the growth is virtually autonomous and exceeds the normal tissues

benign

localized lesion w/o spread to other sites and amenable to surgical resection

malignant

aggressive behavior including invasion and destruction of adjacent tissues and spread to other sites

malignant tumors

-carcinoma

-sarcoma

-mixed tumors

-teratomas

these are examples of what type of tumor?

differentiation

refers to how closely tumor cells histologically resemble their normal cells counterparts

Anaplasia

lack of differentiation

benign

well differentiated

malignant

well differentiated to undifferentiated

pleomorphism

variation in the shape and size of cells and/or nuclei

Dysplasia

loss of cellular uniformity and architectural organization

-can occur next to a frank malignancy and antedates development of cancer

true

True or false:

DYSPLASIA do not equate to malignancy and this dyplastic cells do not necessarily progress to cancer

carcinoma-in-situ

when dysplastic changes are marked and involve the entire thickness of an epithelium it is referred to as?

-this lesion can be a forerunner to INVASIVE CARCINOMA

high cell turnover

fast growing tumors can have a _________ if rates of proliferation and apoptosis are both high

growth fraction

the portion of tumor cells that is actively proliferating

inversely correlates

in general, not always, the growth rate of tumors ________ _______ with the level of differentiation (better differentiated tumors grow more slowly)

metastasis

invasion of lymphatics, blood vessels or body cavities by tumor

-followed by transport and growth of secondary tumor passes discontinuous from the primary tumor

transport and growth of secondary tumor masses discontinuous from the primary tumor

most important feature distinguishing benign from malignant

-lymphatic spread (lymph nodes) -hematogenous spread (blood) -transcoelomic spread (peritoneal cavity e.g. ovarian cancer) -implantation (wounds)

recognized metastatic routes

proliferation

regenerative, metaplastic, hyperplastic or dysplastic all increase the risk of developing malignancy

carcinogenesis

proliferating cells hat accumulated the genetic lesions are necessary for what process?

chronic inflammation

increases the pool of stem cells that can be subject to the effects of mutagens

chronic inflammation

produces cytokines and growth factors to drive cell survival and proliferation

chronic inflammation

promotes genomic instability by the production of reactive oxygen species

clonal progeny

tumors develop as _____ _____ of a single genetically damaged progenitor cell

monoclonal

tumors begin as ______ proliferations but when they are clinically evident they are extremely HETEROGENOUS

-growth promoting proto-oncogenes

-growth inhibiting tumor-suppressor genes

-genes that regulate apoptosis

-genes that regulate DNA repair

4 classes of normal regulatory genes that are the targets of genetic damage:

oncogenes

promote autonomous cell growth in cancer

proto-oncogenes

unmutated normal counterparts

oncoproteins

products of oncogenes

-tumor antigens

-antitumor effector mechanisms

-immune surveillance and escape

host defense against tumors

grading

based primarily on the degree of differentiation (how well the tumor resembles its normal counterpart), architectural features/number of mitoses

staging

based on size of the primary tumor and the extent of local and distant spread

laboratory diagnosis

-histologic and cytologic method

-immunohistochemistry

-flow cytometry

-molecular diagnosis