1 Flashcards
1
Q
Abnormal proliferation of cells serving no purpose / function
A
Neoplasm
2
Q
Interchangeably used with the word ‘Tumor”
A
Neoplasm
3
Q
Classification based on biologic behavior or fatality
A
Benign
Intermediate Tumor
Malignant Tumor
4
Q
● Innocent type
● Slow growth rate
● No infiltration
● no metastasis
● High patient survival rate after successful surgery
A
Benign
5
Q
Types of Benign
A
Simple benign tumor
Mixed simple benign tumor
Compound simple benign tumor
6
Q
Simple benign tumor Sub classifications based on origin
A
A. Of epithelial tumor (ectoderm)
B. Of connective tissue origin
7
Q
glands/glandular pattern
A
Adenoma
8
Q
fingerlike projections
A
Papilloma
9
Q
large, cystic masses (ovary)
A
Cystadenoma
10
Q
of connective tissue origin
Muscle tissue
Mesenchymal origin - CT, MT of mesodermal origin
A
Chondroma - cartilage
Hemangioma - blood vessels
Osteoma - bone
Rhabdomyoma - skeletal muscle
Lymphangioma - lymph vessels
Leiomyoma - smooth muscle
Lipoma - adipose tissue
11
Q
● Ending in “oma” but not benign
● Are malignant cancer
A
Melanoma - melanocytes (skin)
Lymphoma - lymph
Hepatoma - liver cells
12
Q
● Ending in “oma” but non-neoplastic lesions, simulating tumors
A
Choristoma
Hamartoma
13
Q
ectopic, sometimes nodulars
A
Choristoma
14
Q
- a mass of disorganized tissue
- indigenous
- to the particular site
A
Hamartoma
15
Q
Involves two cell types arising from the same germ layer that differentiates into more than one parenchymal cell type.
A
Mixed Simple Benign Tumor
16
Q
− epithelial cells
− cartilage-like tissue
− myxiod stroma
A
Mixed salivary gland tumor
17
Q
arise from differentiation of
ductal epithelial cells
A
Myxiod stroma
18
Q
Several cell types arising from the three germ layers
A
Compound Simple Benign Tumor
19
Q
Sub classification of Compound Simple Benign Tumor
A
Dermoid cyst
20
Q
− mature teratoma of the ovary − mature testicular teratoma
A
Dermoid cyst
21
Q
Locally aggressive neoplasm Low-grade malignant neoplasm Borderline neoplasm
A
Intermediate Tumor
22
Q
● Fatal type of neoplasm
● Often referred to as “cancer”
● The term “cancer” –derived from the way in which the tumor grips the surrounding tissue with claw-like extensions like a “crab”
● CANCER - Greek Word “Carcinos”
● Refers to Zodiac Sign ‘CANCER’…the CRAB….with its tendril-like projections…like the 10 legged sea creature.
A
Malignant Tumor
23
Q
Characteristics of Anaplastic or poorly differentiated Tumors: (ANAPLASIA)
A
- Nuclear & Cellular Pleomorphism
- Hyperchromatism
- Nuclear-Cytoplasmic Ratio
- Active mitosis
- Presence of Giant Tumor Cells
24
Q
● wide variations in shape and size of cells and nuclei
A
- Nuclear & Cellular Pleomorphism
25
● darkly stained nuclei that frequently contain prominent nucleoli
2. Hyperchromatism
26
● 1:1 instead of 1:4 indicating enlargement of nuclei
3. Nuclear-Cytoplasmic Ratio
27
● proliferative activity
● mitotic figures may be abnormal
4. Active mitosis
28
● with a single, large polyploid nucleus or multiple nuclei
5. Presence of Giant Tumor Cells
29
Methods of Microscopic Classification
A. Based on microscopic Cellular Reading
B. Broder’s Classification
30
● Tumor invasiveness
● The process of spreading out of the tumor throughout the body
● Involves invasion of the lymphatics, blood vessels and body
cavities by tumor cells, followed by transport and growth of secondary tumor cell masses that are discontinuous with the primary tumor.
● The single most important feature distinguishing benign from malignant tumors.
● Exceptions: brain tumors and basal cell carcinoma of the skin, almost all malignant tumors have the capacity to metastasize.
Invasiveness Factors
Metastasis
31
Invasiveness Factors
Decrease in Cohesiveness
Loss of Contact Inhibition
32
● loss of structural integrity of the juxta-luminal junctional complex
● due to low calcium content, cancers cells detach from the primary neoplasm and are carried to the diff parts of the body.
Decrease in Cohesiveness
33
● neighboring cells no longer exert pressure
● promotes cellular proliferation and cellular enlargement
Loss of Contact Inhibition
34
Routes of Metastasis
Seeding into body cavities
Lymphatic permeation
Hematogenous spread
35
● peritoneal, pleural, pericardial and sub-arachnoid spaces
Seeding into body cavities
36
● tumor cells in lymphatic circulation to other parts of the body
Lymphatic permeation
37
● blood circulation esp. the venous system
Hematogenous spread
38
Spell UICC
United Institute Center for Cancer
39
● Uses the “TNM” system
UICC
40
● where:
– extent of tumor from primary tumor
T
41
- involvement of the regional lymph nodes
N
42
- presence / absence of metastasis
M
43
Classification of Cancer
Based on Histological Characteristics
1. Medullary type
2. Schirrous (Skir-rus)
44
more cellular than stromal
● very soft and very malignant
Medullary type
45
● more stromal (fibrous) than cellular ● cells are entrapped in the stroma
● hard / firm type
● less malignant
2. Schirrous (Skir-rus)
46
● Belief: 4 body humors (body fluids)
● blood/ phlegm / yellow & black bile
● Balanced humors – healthy person
● Unbalanced – cause disease
● Excess Black bile – causes cancer
● Remained unchallenged through the middle ages for over 1300
years
Humoral Theory of Hippocrates
47
● Cancer was composed of fermenting and degenerating lymph,
varying in density, acidity and alkalinity.
2. Lymph Theory of Stahl/Hoffman
48
● Demonstrated that cancer is made up of cells and not lymph.
● Belief: cancer come from abnormal cells. He proposed that
cancer cells developed from budding elements (blastema) between normal tissues.
3. Blastema Theory of Johannes Muller
49
cancer is spread by the spread of malignant cells NOT through some unidentified liquid
4. Chronic Irritation Theory of Rudolf Virchow
50
● Any traumatic events can cause cancer
Trauma theory
51
Cancer was contagious → ‘contagion theory”
6. Infectious Disease Theory
52
chemical structure of DNA by James Watson and Francis Crick
Mid 19th century (1953)
53
a change in the DNA sequence
Mutation
54
Mutation may be due to
a. Proto-oncogenes (normal genes - regulates cell growth )
55
− are the genes that normally control how often a cell
divides and the degree to which it differentiates (or
specializes).
− If altered due to mutation will lead to cancer formation.
Proto - oncogenes
56
● Tumor suppressor genes are normal genes that slow down cell division, repair DNA errors, and tell cells when to die (a process known as apoptosis or programmed cell death). When tumor suppressor genes don’t work properly, cells can grow out of control, which can lead to cancer.
Inactivation of Tumor Suppressor Genes
57
● Correlates with pre-carcinogen, one of the types of chemical carcinogen → initiation stage
● Mutagens
3. Multi-Stage Theory
58
Types of Multi-Stage Theory
Direct acting carcinogen
Pre-carcinogens
Co-carcinogen
59
directly cause formation of neoplastic growth
Direct-acting carcinogen
60
proximate to ultimate carcinogen
Pre-carcinogens (non-active)
61
promoter
Co-carcinogen
62
Etiology of neoplasm
A. Exogenous factors/agents
Biologic Agents
Chemical carcinogens
Acidic Diet
Physical Agents
Endogenous Factors
63
Viral carcinogens – DNA & RNA viruses
Biologic Agents
64
DNA VIRUSES
HPV
EBV
HBV
65
direct-acting agents: cyclophosphamide Busulfan
Alkylating Agents
66
− present in cigarette smoke − lung cancer
Aromatic Hydrocarbons
67
− B-naphthylamine – aniline dyes – rubber industries
− Bladder cancer
Azo dyes
68
− Aflatoxins – produced by Aspergillus flavus − common in grains and nuts
− a hepatocarcinogen
Naturally occuring carcinogens
69
− derived from digested proteins or ingested nitrites − gastric cancer
Nitrosamines and amides
70
− asbestos – sound-proof rooms − vinyl chloride
− metals: nickel
Miscellaneous chemical carcinogens
71
− Food (proteins) that are subjected to high heat creates carcinogenic by -products →heterocyclic amines
● Deep fried food
● Grilled/ barbequed food
● Baked meats
● Red meat and processed meats (bacon, ham, sausages)
● Excessive intake of salt, sugar and oily foods..
Acidic Diet
72
Physical agents example
● UV Rays
● Radiation
73
. Endogenous Factors examples
Age
Race
Heredity
74
Laboratory techniques H&E staining technique
Histotech
75
Pap’s Smear (Papanicolau staining technique)
Cytotech
76
Other examinations
Immunochemmistry
CHA CANCER HUMAN ANTIGEN
77
carcinoma in situ. Early form
Stage 0
78
cancers are localized to one part of the body.
Stage I
79
cancers are early locally advanced.
Stage II
80
cancers are also late locally advanced.
Stage III
81
cancers have often metastasized, or spread to other organs or throughout the body. Metastasized
Stage IV
82
● Measurement of DNA content of tumor cells
Flow Cytometry
83
- absence of atypical / abnormal cells
CLASS I
84
- atypical cytologic picture but not suggestive of
malignancy
Class II
85
- cytologic picture strongly suggestive of malignancy
Class IV
86
- cytologic picture suggestive but not conclusive of malignancy
Class III
87
- cytologic picture suggestive but not conclusive of malignancy
CLASS III
88
cytologic picture conclusive of malignancy
Class V
89
the most common form of human cancer.
Skin Cancer
90
which is in sunlight, is the main cause of skin cancer.
Ultraviolet light,
91
have the longest wavelengths,
UVA RAYS
92
transmitted through the atmosphere
UVB RAYS
93
transmitted through the atmosphere
UVB RAYS
94
● absorbed by the Earth’s ozone layer.
UVC RAYS
95
● absorbed by the Earth’s ozone layer.
UVC RAYS
96
A colorless gas that forms a layer
● It absorbs harmful components of sunlight, the UV B, protecting
living things.
Ozone layer
97
● UV Rays exceed what can be blocked by your level of melanin
Sunburn
98
● Basal Cell Carcinoma + Squamous cell carcinoma
● generally curable.
● The cure rate for this skin cancer could be 100% if
these lesions were brought to a doctor's attention before they had a chance to spread
Nonmelanoma skin cancer
99
● is the most common form of skin cancer and accounts for more than 90% of all skin cancer in the U.S.
● These cancers almost never spread (metastasize) to other parts of the body.
● They cause damage by growing and invading surrounding tissue.
Basal Cell Carcinoma
100
● A basal cell carcinoma usually begins as a small, dome-shaped bump and is often covered by small, superficial blood vessels called
telangiectases
101
● Some basal cell carcinomas
contain————, making them look dark rather than shiny.
melanin pigment
102
● To make a proper diagnosis, doctors usually remove all or part of the growth by performing a biopsy.
Biopsy
103
● This usually involves taking a sample by injecting a local anesthesia and scraping a small piece of skin.
Shave biopsy
104
which are thin, flat cells that look like fish scales under the microscope.
Squamous Cell Carcinomas
105
sometimes referred to as squamous cell carcinoma in situ.
Bowen’s Disease
106
These are genital warts that under the microscope look like Bowen's disease but behave like warts, not like cancers. Caused by strains of HPV
Bowenoid Papulosis
107
Mohs Micrographic Surgery is named after its inventor
Dr. Fredric Mohs
108
is a medical treatment that uses a photosensitizing drug (a drug that becomes activated by light exposure) and a light source to activate the applied drug.
● The result is an activated oxygen molecule that can destroy nearby cells. Precancerous cells and certain types of cancer cells can be treated this way.
Polydynamic Therapy
109
Used for skin pre-cancer conditions, acne, skin cancer, sun damage, cosmetic skin improvement, oily skin, enlarged sebaceous glands, wrinkles, rejuvenation (anti-
aging), warts, psoriasis, and many other skin conditions.
● It is not used to
remove moles or birthmarks
Levulan Stick
110
is a rating system that determines how long a sunscreen protects your skin from the sun's UVB rays.
Sun Protection Factor
111
measures only the level of protection from UVB rays, the ultraviolet rays that cause sunburn, and does not measure levels for the far more dangerous UVA rays, which penetrate the skin more deeply and can cause damage at the cellular level.
SPF
