Notes in 1- Tumour Pathology

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Published	02/10/2024	{{c1::Pathology}} is the study of disease, the language of disease.It describes disease mechanisms and how they correlate to clinical medicine (C…
Published	02/10/2024	Three disease behaviours:1- {{c1::Acute self-limiting}}2- {{c1::Chronic}}3- {{c1::Progressive}}
Published	02/10/2024	In terms of understanding disease:{{c1::Aetiology}} - what causes disease.{{c1::Pathogenesis}} - how does a disease develop and progress (macro/m…
Published	02/10/2024	Aetiology is what causes the disease, it can either be:1- {{c1::genetic}} factors.2- {{c1::environmental}} factors.e.g. Diet, Toxins, Micro-organisms
Published	02/10/2024	Pathogenesis is how an individual disease develops and progressesBasic pathological mechanisms:1- {{c1::Inflammation}}• Acute• Chronic2- {{c1::Neoplas…
Published	02/10/2024	{{c1::Clinico-pathological correlation}} describes the integration of clinical features and pathological findings.
Published	02/10/2024	{{c1::Diagnostic Pathology}} is the diagnosis of disease based on macroscopic, microscopic and molecular examination and analysis of tissue …
Published	02/10/2024	• A {{c1::tumour or neoplasm}} is an abnormal growing mass of tissue.Malignant (cancer) or BenignCharacteristics: - uncoordinated growt…
Published	02/10/2024	{{c1::Cancer}} is a pathological condition characterised by the ability to invade into adjacent tissue and to metastasise and grow at other sites with…
Published	02/10/2024	What are the common types of cancer in males and females?
Published	02/10/2024	Survival rate after diagnosis by 5-Year Survival Rate method. (open up)
Published	02/10/2024	Classification of Tumours * To understand their behaviour & determine prognosis and select therapy.[1] Based on {{c1::tissue of origin}}- Epi…
Published	02/10/2024	Nomenclature of Epithelial TumoursPrefix is the Epithelium in which the tumour is arisingAny benign tissue in Epithelium is called with the suffix {{c…
Published	02/10/2024	Nomenclature Of Connective Tissue TumoursPrefix is the Connective Tissue in which the tumour is arisinge.g. Osteo & Lipo & FibroAny benig…
Published	02/10/2024	Nomenclature Of Blood Cell TumoursNo benign tumours in Blood CellsAny malignant tissue in White blood cells is called {{c1::Leukaemia}}
Published	02/10/2024	Nomenclature Of Lymphoid Tissue TumoursNo benign tumours in Lymphoid TissueAny malignant tissue in Lymphoid Tissue is called {{c1:…
Published	02/10/2024	Nomenclature Of Melanocyte TumoursAny benign tissue in Melanocyte is called {{c1::Naevus}}Any malignant tissue in Melanocyte …
Published	02/10/2024	Nomenclature Of Neural Tissue TumoursCNS → e.g. {{c1::Astrocytoma}}PNS → e.g. {{c1::Schwannoma}}There are more, these are the common ones
Published	02/10/2024	Nomenclature Of Germ Cell TumoursGerm cell Tumours are called {{c1::Teratomas}} they are composed of various tissues & develop in ovary/testi…
Published	02/10/2024	Features of Benign and Malignant Tumours:• Growth pattern  • Presence of capsule • Invasion  • Presence of metastases•&n…
Published	02/10/2024	Features of Benign Tumours:• Non-invasive growth pattern • Usually encapsulated  • No evidence of invasion • No metastases•&…
Published	02/10/2024	Features Of Malignant Tumours• Invasive growth pattern • No capsule or capsule breached by tumour cells• Cells abnormal • Can…
Published	02/10/2024	Benign vs Malignant TumoursWhat are the differences?
Published	02/10/2024	Properties Of Cancer Cells  • Loss of {{c1::tumour suppressor genes}} - genes that regulate cell growth. - Adenomatous polyposis (…
Published	02/10/2024	Tumour suppressor genes vs Oncogenes.What are the differences?
Published	02/10/2024	How is cellular function affected in cancer?
Published	02/10/2024	{{c1::Tumour biomarkers}} are biological molecules that suggest the presence of cancer in a patient, they may also be us…
Published	02/10/2024	Clinical Utility of Tumour Biomarkers• {{c1::Screening}}– looking for disease in asymptomatic patients • {{c1::Diagnosis}}– assistance in identificati…
Published	02/10/2024	Clinical Uses Of Tumour Biomarkers (for Diagnosis & other uses)• Alpha-fetoprotein – Teratoma of testes – Hepatocellular carcinoma …
Published	02/10/2024	Clinically Useful Predictive Tumour BiomarkersKras (oncogene) → drugs affect Kras pathway in Colorectal cancerBRAF → drugs affect Braf pathwayEGFR → d…
Published	02/10/2024	Morphology of Cancer Cells:• Cellular and nuclear {{c1::pleomorphism}}→ Marked variation in size and shape• presence of {{c1::abnormal mitoses}}
Published	02/10/2024	{{c1::Tumour growth}} is the balance between cell growth and cell death.Maintenance by two factors ({{c2::Angiogenesis}} & {{c2::Ap…
Published	02/10/2024	{{c1::Tumour Angiogenesis}} is new blood vessel formation by tumours to sustain growth.It also provides route for release of tumour cells into circula…
Published	02/10/2024	{{c1::Apoptosis}} is the mechanism of programmed single cell death.It is an active cell process that regulates tumour growth.Clinically - involved in …
Published	02/10/2024	Spread of Cancer is a fundamental property of cancer that is divided into {{c1::invasion}} and {{c1::metastasis}}
Published	02/10/2024	Major clinical problem of cancer is formation of {{c1::metastatic (secondary) tumours}}Prognosis depends on extent of cancer spread at diagnosis
Published	02/10/2024	Invasion and Metastasis is a multi-step process characterized by:1- Increased {{c1::matrix degradation}} by proteolytic enzymes 2- Altered cell-t…
Published	02/10/2024	Modes Of Spread Of Cancer• {{c1::Local spread}} - moving into nearby normal tissue • {{c1::Lymphatic spread}} - tumor spread&…
Published	02/10/2024	Tumour Invasion steps: 1- Malignant tumour2- Invasion into {{c1::connective tissue}}3- Invasion into {{c1::lymph/blood vessels}}
Published	02/10/2024	Tumour Metastasis Via Lymphatics1- Adherence of tumour cells to lymph vessels2- Invasion from lymphatics3- Invasion into lymph node4-&n…
Published	02/10/2024	What are the steps of tumour metastasis via Lymphatics?
Published	02/10/2024	Tumour Metastasis Via Blood1- Adherence of tumour cells to blood vessels2- Invasion from blood vessels3- Invasion into tissue4- Fo…
Published	02/10/2024	What are the steps of Tumour Metastasis Via Blood?
Published	02/10/2024	{{c1::Trans-coelomic Spread}} is a special form of local spread, where tumours spread across body cavities e.g. pleural or peritoneal cavities.•&…
Published	02/10/2024	Why are the sites of metastasis not directly related to tissue blood flow?
Published	02/10/2024	{{c1::Metastatic niche}} is an environment or a microenvironment in which tumour cells can colonize and grow and form metastasis.
Published	02/10/2024	Common sites of Metastasis:• Liver • Lung • Brain • Bone – Axial skeleton • Adrenal gland • Omentum / peritoneum
Published	02/10/2024	Uncommon Sites Of Metastasis:• {{c1::Spleen}} • {{c1::Kidney}} • {{c1::Skeletal muscle}} • {{c1::Heart}}
Published	02/10/2024	Tumours Which Commonly Metastasise To Specific Sites:Tumour         TissueBreast      →  {{c1::Bone}…
Published	02/10/2024	Local Effects Of Benign Tumours– {{c1::Pressure}} - exerted on adjacent anatomical structures – {{c1::Obstruction}} - blockage of flow e.g. intes…
Published	02/10/2024	Local Effects Of Malignant Tumours• {{c1::Pressure}} • {{c1::Obstruction}} • {{c1::Tissue destruction}} which results from: – Ulceration / infect…
Published	02/10/2024	Systemic Effects Of Malignant Tumours• Weight loss-cancer {{c1::cachexia}}- secretion of growth factors that promote weight loss (unpla…
Published	02/10/2024	Hormone Production By Tumours 1- {{c1::Normal}} - hormones produced by tumours of endocrine organ* but abnormal control of hormone production/sec…
Published	02/10/2024	{{c1::Paraneoplastic syndromes}} are a group of rare disorders that are triggered by an abnormal immune system response to a cancerous tumor.They…
Published	02/10/2024	Why is it important to detect cancer early?e.g. Detection at pre-invasive stage – Identification of dysplasia/intraepithelial neoplasia
Published	02/10/2024	{{c1::Dysplasia}} is the pre-malignant change, it is the earliest change in the process of malignancy that can be visualised.It's generally identified…
Published	02/10/2024	Early Detection Of Cancer → requirement of effective tests (sensitive/specific + acceptable){{c1::Cervical cancer screening}} is an established&n…
Published	02/10/2024	How does cell division occur?
Published	02/10/2024	{{c1::Cell Cycle}} is an ordered series of events leading to division and replication of cell type in which a cell's chromosomes are divided between t…
Published	02/10/2024	The human genome is stored on {{c1::23}} chromosome pairs.{{c1::22}} are autosomal chromosome pairs & {{c1::one}} pair is sex-determining
Published	02/10/2024	What are the key features of Cell Cycle Control?
Published	02/10/2024	Key features of Cell Cycle Control1- {{c1::Sequence}}→ Cycle phases must be in correct sequence → DNA synthesis and mitosis must occur …
Published	02/10/2024	{{c1::G1/S transition}} is a rate-limiting step in the cell cycle and is also known as {{c2::restriction point}}; cells that progress through thi…
Published	02/10/2024	Several checkpoints are used to control and regulate the Cell Cycle → They prevent progression into the next phase if the requirements have not b…
Published	02/10/2024	Factors that regulate the Cell Cycle:• External factors→ {{c1::hormones}} & {{c1::growth factors}} & {{c1::cytokines}}• Intrinsic factors→ cri…
Published	02/10/2024	Two key classes of regulatory molecules determine a cell's progress through the cell cycle:1- {{c1::cyclins}} → regulatory subunits that have no catal…
Published	02/10/2024	What is the role of Cyclins and Cyclin-dependent kinases (CDKs) in the Cell Cycle?
Published	02/10/2024	{{c1::Cell Cycle Inhibitors}} are molecules that slow or stop cell cycle progression through various mechanisms.e.g.CDK inhibitors → bind to…
Published	02/10/2024	What's the role of the Retinoblastoma gene in regulating the cell cycle?
Published	02/10/2024	{{c1::Carcinogenesis}} is the failure of cell cycle control, when the balance between proliferation and apoptosis is disrupted.• Mutations in genes re…
Published	02/10/2024	Protein {{c1::p53}} maintains the integrity of the genome by G1 arrest to repair damaged DNA.When it is mutated or lost, genetically damaged cell…
Published	02/10/2024	• Virtually all cancers are {{c1::dysregulated}} at G1-S checkpoint The following are normally anti-oncogenes,but they are mutated in the majorit…
Published	02/10/2024	{{c1::Two-hit hypothesis}} is the hypothesis that most tumor suppressor genes require both alleles to be inactivated, either through mutations or thro…
Published	02/10/2024	Why does inherited retinoblastoma occur at an earlier age than sporadic retinoblastoma?
Published	02/10/2024	{{c1::Tumour suppressor genes (anti-oncogenes)}} are genes that protect a cell from forming cancers, by restraining inappropriate cell growth and divi…
Published	02/10/2024	{{c1::Retinoblastoma gene}} is a tumour suppressor gene that inhibits the cell cycle when it is hypophosphorylated (pRb) hypophosphorylated Rb&nb…
Published	02/10/2024	Approximately 5-10% of all cancers are hereditary, known as {{c1::inherited cancer syndromes}}, which means that mutations in specific genes are passe…
Published	02/10/2024	Inherited predisposition to cancer
Published	02/10/2024	Inherited mutations of tumour-suppressor genes
Published	02/10/2024	{{c1::Proto-oncogene}} is a normal gene which, when altered by mutation, becomes an oncogeneThey are normal genes coding for normal growth r…
Published	02/10/2024	{{c1::Oncogenes}} are cancer causing genes that are derived from proto-oncogenes.Activated by:• Alteration of proto-oncogene structure  - point m…
Published	02/10/2024	{{c1::Chemical carcinogenesis}} occurs when purine and pyrimidine bases in DNA are critically damaged by oxidizing and alkylating agents. • Chemi…
Published	02/10/2024	{{c1::Radiation carcinogenesis}} occurs when purine and pyrimidine bases in DNA are damaged by high-energy radiation in sufficient doses.– ultraviolet…
Published	02/10/2024	{{c1::Viral carcinogenesis (Oncoviruses)}} is cancer caused by viruses.– Virus genome inserts near a host proto-oncogene • viral promoter causes prot…
Published	02/10/2024	{{c1::Multistep Carcinogenesis}} is the activation of several oncogenes and loss of two or more anti-oncogenes.• All sporadic cancers harbour multiple…
Published	02/10/2024	{{c1::Ageing}} is a fundamental risk factor for the development of cancer. The incidence of cancer rises dramatically with age due to a build up …
Published	02/10/2024	Colorectal Adenoma - Carcinoma sequence showing accumulation of mutations.Normal → Benign → Malignant
Published	02/10/2024	Summary & important points:
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