Mechanisms Of Disease: Definitions

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TMN

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Tumour, node and metastasis = universal staging for malignant tumours. T1 = <2cm, T2 = 2-5cm, T3 = skin &/or chest wall. N0 = no nodes, N1 = local nodes, M0 = no metastasis, M1 = deomstrabole metastasis

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Ann Arbor staging

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Used to stage Hodgkin's and non-Hodgkin's lymphoma. Combines pathological staging with clinical findings. I = one group of nodes involved, II = 2 separate groups same side of diaphragm, III = nodes involved both sides of diaphragm, IV = bone marrow, lung, other sites. A = no symptoms, B = fever, weight loss, night sweats. Xs = spleen. XE = extranodal

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Annexin-A1

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Anti-inflammatory molecule that can activate leukocytes and send them to the site of infection directly, inhibiting neutrophil extravasation and down-regulating the magnitude of the inflammatory response

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Aplasia

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Failure of organ to grow

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Apoptosis

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A distinct reaction pathway that represents programmed cell death with internal control and no cell leakage - usually single cells involved

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Arteriolosclerosis

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Arteriosclerosis associated with hypertension and due to hypertrophy and fibrosis of arterioles

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Arteriosclerosis

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Thickening and loss of elasticity of arterial wall

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Ataxia telangectasia

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Genetic condition where there is defective DNA repair, predisposing the patient to lung, gastic and lymphoid tumours)

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Atherosclerosis

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A chronic arterial disease process characterised by the intimal accumulation of lipid, inflammatory cells, vascular smooth muscle cells and ECM resulting in a narrowing of the arterial lumen and a weakening of the wall, leading to sudden arterial thrombus formation

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Atrophy

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Shrinkage of cell siz by loss of cell substance involving autophagy or organelles

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Autocrine

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To self

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Autopsy

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Examination of a body after death

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Benign

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Cells grow as a compact mass and remain at their site of origin

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Cadherins

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Calcium dependent glycoproteins present at the cell membrane which interact between and within cells through catekins to maintain polarity

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Cancer

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A malignant growth

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Carcinogen

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Environmental agent participating in the causation of tumours

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Carcinogenesis

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Process that results in the transformation of normal cells to neoplastic cells by causing permanent genetic alterations

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Caseous necrosis

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Accumulation of amorphous debris within an area of necrosis

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Chemotaxis

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Directional movement of phagocytic cells towards areas of injury, necrotic tissue and bacterial invasion

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Chronic granulomatous disease

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X-lined recessive inherited disorder of acute inflammation where neutrophils are unable to kill through oxidative burst,leading to foci or persistant infection and secondary macrophage response

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Coagulative necrosis

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Cells have died but basic shape and architecture of the tissue endures

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Duke's staging

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Staging for neoplasms of the rectum. A = not extending completely through the muscularis propria, B = extending completely through muscularis propria, C = lymph nodes involves

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Dysgenesis

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Failure of organ to develop normal structure

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Dyskaryosis

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Abnormal cell nuclei - sign of malignancy

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Dysplasia

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Premalignant condition with increased cell growth, cellular atypia and altered differentiation. High grade dysplasia = carcinoma in situ

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Embolism

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A mass which travels through the vascular tree and becomes lodged so as to obstruct blood flow

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Endocrine

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By blood to distant sites

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Epigenetic

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Change in the phenotype without changing the underlying genotype

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Exudate

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Extravascular inflammatory fluid with a high protein concentration. May be fibrinous or purulent

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Fat necrosis

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Action of lipases released into adipose tissue causes FFA accumulation and precipitation as calcium soaps

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Frammengen's score

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Index used to calculate the risk of developing atherosclerosis, using medical and social criteria

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Gangrene

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Necrosis that is advanced and visible grossly. Dry gangrene = coagulation necrosis. Wet gangrene = liquefactive necrosis

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Gliosis

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Proliferation of astroglia and microglia to form a waxy scar in brain tissue

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Gohn Focus

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Small granuloma seen in TB, typified by caseous necrosis surrounded by fibrous tissue

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Grade

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The degree of differentiation of a tumour - how closely does it resemble the tissue it comes from? Low grade = well differentiated

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Haemostasis

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The physiological process of maintaining blood in a fluid, clot-free state in a normal vessel, and inducing a rapid and localised haemostatic plug at the site of injury

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Heat shock response genes

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Large group of genes whose expression is upregulated in the presence of stressors and whose products protect the cell from stress-related damage

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Histopathology

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Study of the microscopic structure of diseased tissue

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Hydrocoele

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Fluid in the cavity of the tunica vaginalis - may be caused by infection, testicular torsion, patent processus vaginalis, trauma or tumour

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Hyperplasia

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Increase in the number of cells of a tissue

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Hypertrophy

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Increase in cell size

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Hypoplasia

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Reduced cell mass causing organ to fail to grow to full size developmentally (but otherwise normal)

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In situ carcinoma

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Carcinoma that has broken out of the basement membrane but has not yet metastasised to another site

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Infarction

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An area of ischaemic necrosis in a tissue or organ

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Inflammation

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The mechanism by which the body deals with injury or insult

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Initiation

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Genetic alteration

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Integrins

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Cell surface glycoproteins composed of 2 subunits which are receptors for different components of the basement membrane e.g. fibronectin

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Invasion

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Ability of cells to break through the basement membrane into surrounding tissues

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Keloid

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Hyperplastic scar formation due to high proliferation of fibrous tissue

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Labile cells

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Normal state cells regularly turnover using local stem cells e.g. skin, oral mucosa

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Latency

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Period between exposure and tumour development

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Lines of Zahn

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Alternating pale and dark layers of a thrombus corresponding to platelets and fibrin with entrapped RBCs

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Liquefactive necrosis

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Complete dissolution of necrotic tissues usually due to massive infiltration of neutrophils or high lysosomal content of cells

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Magination

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Displacement of cells from central axial flow to the periphery due to more chaotic flow

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Malignant

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Growth of cells is uncontrolled and cells spread into surrounding tissues and distant sites

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Matrix metalloproteases

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Speacialist enzymes which cleave fibrillary collagen and depend on zinc ions to work. Secreted in a procollagenase form which is activated by free radicals released during inflammation

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Metaplasia

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Reversible change from one adult cell type to another adult cell type

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Metastasis

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Ability of malignant cells to invade into blood vessels, lymphatics and cavities and spread to distant (non-contiguous) sites (local invasion is NOT metastasis)

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Monckeberg arteriosclerosis

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Arteriosclerosis due to calcification of tunica media in medium sized arteries, so no dilation or constriction but falsely high BP

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Myeloma

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Tumour formed from B cells. Plasma cells produced will be monoclonal and will all have kappa or lambda light chains

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Myofibroblasts

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Modified fibroblast cells containing desmin and smooth muscle fibres that allow contraction of scars

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Necrosis

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Pathological cell death due to impairment of key cellular systems resulting in cell contents leaking into the surroundings - usually multiple cells involved

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Neoplasm

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Abnormal growth of cells which persists after initiating stimulus has been removed

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Nottingham prognostic index

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Stratification of patients with breast cancer into survival groups based on size x 0/2, stage and grade

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Nuclear factor kappa B

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Rapid acting primary transcription factor found in the signalling pathways of TLRs on neutrophils and macrophages. Activates ~200 genes involved in inflammatory response, cell proliferation and cell survival pathways

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Oedema

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Accumulation of excess extravascular fluid

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Oncogene

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Alteration of an oncogene involved in normal growth and differentiation

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Orchitis

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Inflammation of the testes

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Oxidative burst

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Method of neutrophil killing by producing oxygen metabolites = hydrogen peroxide and superoxide ions, which destroy the phagocytosed molecule

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Paracrine

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To neighbours

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Paraneoplastic effects

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Unexplained effects caused by cancer i.e. not caused as a result of local effect, metastases or an indigenous hormone

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Permanent cells

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Unable to divide or regenerate e.g. brain tissue

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Phagocytosis

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Process of engulfment of foreign agents or necrotic tissue

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Phlegmasia alba dolens

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Partial venous blockage

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Phlegmasia cerulae dolens

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Total venous blockage

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Pleomorphic

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Nuclei of varying shape and size

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PMN

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Polymorphonuclear neutrophils

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Post Phelmbotic Syndrome

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Risk of ulceration years following a DVT

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Primary intention

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Edges of the wounds are opposed and fixed and sutres are later removed

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Primary metastasis

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Carcinoma at the site where the malignant neoplasm has arisen

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Procidentia

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Complete prolapse so that bladder and uterus completely external

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Progression

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Process culminating in malignant behaviour e.g. invasion and metastasis

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Promotion

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Proliferation and clonal expansion

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Proto-oncogenes

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Genes present in all normal cells involved in normal growth and differentiation

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Regeneration

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Replacement of functional differentiated cells

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Repair

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Production of a collagenous fibrous scar

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Resolution

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Complete restoration of normal conditions after acute inflammation

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Secondary intention

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Wound left open and initially contracts due to action of fibroblasts as the edges, with granulation tissue forming underneath the scab

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Secondary metastasis

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Carcinoma that has spread to another organ

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Stable cells

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Not normally dividing but can regenerate e.g. hepatocytes

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Stage

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How far tumour has spread

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Suppuration

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The formation of morbific matter in an abscess or a vesicle and the discharge of pus due to a relatively persistant organism

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Thrombocytosis

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Excessive platelets

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Thrombophilia

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Inherited or acquired coagulopathy predisposing to thrombus (usually venous)

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Thrombus

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Pathological solid mass of blood constituents formed within the vascular system during life

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Transudate

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Extravascular fluid with a low protein content caused by alteration in hydrostatic or oncotic pressure in the vessels

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Tumour

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A swelling

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Tumour markers

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Products liberated from tumour into blood stream

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Tumour supressor genes

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Genes which in normal cells suppress growth

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Varicocoele

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Pampiniform plexus becomes varicose

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v-onc

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Oncogene formed following viral infectin

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Wallerian degeneration

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Process where a nerve fibre is cut or crushed

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Xeroderma pigmentosa

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Genetic condition where there is defective DNA repair, so that small amounts of UV radiation may cause malignant melanoma and squamous cell carcinoma