• Damage to vessel wall allows LDL cholesterol deposition and phagocytosis of LDLs to form foam cells
• Invasion of fatty streak by smooth muscle cells, fibrous cap formation (fibro-fatty plaques)
• Formation of complicated lesions - contain macrophages, T cells, necrotic lipid core, tissue factor and increased plaque vulnerability/thrombogenecity

• Epitethelial - renal (oncocytoma vs renal cell carcinoma), glandular (adenoma vs adenocarcinoma), squamous (squamous cell papilloma vs squanous cell carcinoma), uroepithelium (uroepithelial cell papilloma vs carcinoma), liver (hepatoma vs hepatic cell carcinoma)
• Connective tissue tumours - fat cell (lipoma vs liposarcoma), bone (osteoma vs osteosarcoma), cartilage (chondroma vs chondrosarcoma), smooth muscle (leiomyoma vs leiomyosarcoma, skeletal muscle (rhabdomyoma vs rhabdomyosarcoma
• Germ cell - testis (mature teratoma vs seminoma)
• Lymphoid - lymphocytes (lymphoma), plasma cells (plasmacytoma vs multiple myeloma)

Properties of a malignant tumour

(terms and definitions)

• Invasion - spread of tumour to healthy tissues immediately surrounding the tumour 
• Metastasis - spread of the tumoiur to distant locations via blood supply
• Progression - Increased growth speed and invasiveness of tumour cells (acquisition of greater malignant potential)
• Pleomorphism - variability of size and shape of cells and cell nuclei
• Anaplasia - poor cellular differentiation, loss of morphological charecteristics

Routes of metastasis

(types and common examples)

• Transceolomic - spread across body cavity by penetration of peritoneal, pleural, pericardiac or subarachnoid spaces - e.g. ovarian tumours spreading transperitoneally to liver
• Lymphatic - transport of tumour cells through lymph nodes - most common route for carcinomas but not for sarcomas
• Haematogenous spread - typical spread for sarcoma and some carcinomas (kidney)  - usually through vein due to thinner walls 
• Transplantation or implantation

• Paraneoplastic - cachexia through cytokine release, release of hormomes (e.g. ADH from lung cancer), expression of neoantigens to trigger immune response and autoimme coniditon, hypercoagulability 
• Local effects - tissue damage, local compression, obstruction of hollow tubes, haemorrhage

Oncogene classification

(category, example, gene functions)

• Growth factors (c-Sis) - usually secreted by cells to induce self proliferation, nearby proliferation of distant proliferation. Unusual secretion can induce uncontrolled proliferation and production of growth hormones
• Receptor tyrosine kinases (EGFR, PDGFR, VEGFR) - add phosphate groups to inhibit/activate. Receptor kinases add phosphate to receptor proteins add thus can induce receptor signalling for growth and differentiation without signal
• Cytplasmic tyrosine kinases (Src, Syk-ZAP-70, BTK, Abl gene) - mediate response to activation of tyrosine kinase receptors allowing proliferation, migration, differentiation and survival
• Cytoplasmic serine/threonine kinases and regulatory subinits (Raf kinase, CDKs) - involved in development, cell cycle regulation, cell proliferation, differentiation and survival
• Regulatory GTPase (Ras) - involved in signalling in cell proliferation pathways
• Transcription factors (myc) - regulation of genes that induce cell differentiation

Tumour suppressor genes

(functions)

• Repression of genes that are essential for continuing cell cycle
• Couple the cell couple to DNA damage
• Initiation of apoptosis in cells with damage to DNA
• Proteins involved in cell adhesion, blocking loss of contact inhibition and therefore metastatic inhibition
• DNA repair proteins (HNPCC, MEN1, BRCA)