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What type of mutations result in malignant tumors
Non-lethal heritable mutations
How do benign tumors cause damage
Compress surrounding tissues and may restrict blood flow, causing atrophy
How do malignant tumors cause damage
Infiltrate nearby tissues, may metastasize
Pleiomorphism
Change in size and shape of cells and nuclei
Histo characteristics of an abnormal nuclei
Hyperchromic due to excessive genetic material
Large nuclei
Prominent nucleoli
Significance of mitotic figures
Indicates that there is increased mitotic activity
Characteristics of a tumor giant cell
Large cell with multiple nuclei
Significance of cellulular polarity
Crucial for epithelial and secretory cells, the loss of polarity may mean they don’t function correctly
Microscopic characteristics of benign neoplastic cells
Well differentiated
Uniform
Normal nuclei and nucleoli
What structure is common in benign neoplasms that helps separate them from normal tissue
Capsule
Gross characteristics of malignant neoplasms
Initially slow growing
Aggressive growth
Infiltrative
No respect for boundaries
What encourages the switch from slow growth to aggressive growth in malignant neoplasms
The immune system will kill all the cells it can, inadvertently selecting for the cells that adapt to survive, resulting in a neoplastic cell population of aggressive subclones
What characteristic always means that a tumor is malignant
Metastasis
Why are malignant tumors less mobile
Not self contained, often very infiltrative
What substance/structure is part of tumors and supports their growth
Stroma
Why are excisional margins so important for malignant tumors
You may not know how far they have infiltrated, and if any of it is left it will lead to recurrence
Cause of central necrosis in tumors
Low nutrients to the center → hypoxia → death → central depressions in tumors
Cytology
Looking at cells
Biopsy/Histopath
Looking at whole tissues
What is described by tumor grading
How bad is the type of tumor
Who grades tumors
Pathologists
What is descried by tumor grading
How far along is the tumor
Who stages tumors
Clinicians
How is a diagnostic cytology sample collected
Fine needle aspirates
Purpose of a diagnostic cytology
Initial determination of tumor type
May allow determination of benign v malignant
Complements biopsy
Types of biopsy
Incisional
Excisional
Incisional biopsy procedure and purpose
Removal of a partial sample of the mass, often done if the tumor is in an unfortunate location to help plan possible treatments
Excisional biopsy procedure and purpose
Complete removal of a mass, done to cure or reduce the tumor burden
Default histopath stain
H & E
Why might special histopath stains be used
To highlight certain characteristics or pathogens
What types of stains are commonly used to diagnose lymphoma
Immunohistochemical stains
Lymphoma characteristics determined by additional testing
T or B cell
Chronic or acute
Monoclonal or polyclonal
Additional testing done for determining mast cell prognosis
Testing for tumor proliferation markers
Why might an excisional biopsy be “painted” with different stains
To visualize if there are any neoplastic cells approaching the margins
Characteristics used to stage a tumor
T: primary tumor size
N: involvement of lymph nodes
M: metastasis to other organ systems
Characteristics used to grade a tumor
Morphologic features that are associated with prognosis
Differentiation
Invasiveness
Cellularity
Mitotic index
