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Pathology > 3. Neoplasia - BP > Flashcards

3. Neoplasia - BP Flashcards

1
Q

What is the differentiation of a neoplasm?

A

How histologically similar to the normal tissue is the neoplasm - SUBJECTIVE determination made by the pathologist.

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2
Q

What is carcinoma in situ?

A

Full thickness dysplasia of the epithelium.

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3
Q

What is an hamartoma?

A

A disorganized collection of tissue –> tissue composing the mass being tissue that is normally found in the organ in which the mass has occurred –> NOT A NEOPLASM.

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4
Q

What is a choristoma?

A

A mass composed of ectopic tissue –> NOT A NEOPLASM.

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5
Q

What is a polyp?

A

Mass projecting from a mucosal surface –> It is a descriptive term, the mass causing the polyp MAY or MAY NOT be a neoplasm.

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6
Q

Mention some important histologic features of malignancy.

A
  1. Pleomorphism
  2. Abnormal mitotic figures
  3. Hyperchromasia
  4. Hypercellularity
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7
Q

Benign or malignant neoplasms grow faster?

A

Malignant –> rate of growth often corresponds to their degree of anaplasia.

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8
Q

When do most neoplasms have their most rapid growth rate?

A

Prior to detection. By the time of the detection, it is less than 20%.

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9
Q

Mention the 2 malignancies that do not metastasize.

A
  1. Gliomas

2. Basal cell carcinomas

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10
Q

What percentage of malignant solid tumors have metastases at the time they are clinically detected?

A

30%

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11
Q

What is required for eradication of the neoplasm?

A

Removal of the stem cells.

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12
Q

What must neoplastic stem cells have?

A

The BMI1 gene –> Inhibits p16INK4a and p14ARF.

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13
Q

What is the mechanism of action of HTLV-1?

A

TAX gene of HTLV-1 can activate transcription of host cell genes –> c-fos and IL-2 –> Both important in the proliferation and differentiation of T cells.

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14
Q

What neoplasms are associated with EBV?

A
  1. Burkitt
  2. Some HLs
  3. Nasopharyngeal carcinoma
  4. B cell lymphomas in AIDS patients
  5. Post transplantational lymphoproliferative disorder
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15
Q

What is the mechanism of action of EBV?

A

Enters the B cells through CD21 –> Activate the transcription of LMP1 –> which activates NF-kβ + JAK/STAT signaling pathway –> Promotes B cell survival.

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16
Q

What is the mechanism of action of HBV?

A

Through chronic inflammation + HBV protein binds p53.

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17
Q

What neoplasms are associated with HHV-8?

A
  1. Kaposi sarcoma

2. Primary effusion lymphoma

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18
Q

What is cachexia?

A

Loss of body fat and muscle + weakness + anorexia associated with a neoplasm.

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19
Q

What is the mechanism of cachexia?

A

Caused by cytokines produced by the tumor (possibly TNF) + by host response to the tumor.

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20
Q

What is the paraneoplastic syndrome?

A

Side effects of a neoplasm not attributable to functions normally associated with the cell type of origin or by the location of the tumor.

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21
Q

What neoplasms produce PTHrp?

A
  1. SCC of the lung
  2. Breast carcinoma
  3. Renal cell carcinoma
22
Q

What neoplasms produce ACTH?

A
  1. Small cell carcinoma of the lung

2. Pancreatic carcinoma

23
Q

What neoplasms produce ADH, resulting in SIADH?

A
  1. Small cell carcinoma of the lung

2. Cerebral neoplasms

24
Q

What neoplasms produce erythropoietin?

A
  1. Renal cell carcinoma
  2. Hepatocellular carcinoma
  3. Cerebellar hemangioblastoma
25
Q

What neoplasms are associated with persistent regeneration and repair?

A

Hepatocellular carcinomas arising in cirrhosis.

26
Q

What neoplasms are associated with a hyperplastic process?

A

Endometrial carcinoma arising in endometrial hyperplasia.

27
Q

What neoplasms are associated with a dysplastic process?

A
  1. SCC of cervix arising in CIN

2. Colonic adenocarcinoma arising in adenomatous polyp

28
Q

What neoplasms are associated with chronic inflammation?

A
  1. Gastric adenocarcinoma arising in atrophic gastritis.

2. Colonic adenocarcinoma arising in ulcerative colitis.

29
Q

Mention the 4 methods of conversion of proto-oncogene to oncogene.

A
  1. Overexpression of the gene
  2. Amplification of the gene
  3. Point mutation of the gene
  4. Translocation of the gene to another region with resultant overexpression of the gene/ production of protein with oncogenic activity.
30
Q

What are the 5 ways by which oncogenes promote neoplasia?

A
  1. Synthesize growth factors.
  2. Synthesize growth factor receptors.
  3. Synthesize signal-transducing proteins.
  4. Synthesize nuclear transcription factors.
  5. Loss of regulation of cyclins or cyclin-dependent kinases.
31
Q

What neoplasm is associated with aflatoxin?

A

Hepatocellular carcinoma

32
Q

What neoplasm is associated with thorotrast?

A

Angiosarcoma of the liver

33
Q

What neoplasm is associated with vinyl chloride?

A

Angiosarcoma of the liver

34
Q

What neoplasms is associated with asbestos?

A
  1. Mesothelioma

2. Bronchogemic carcinoma

35
Q

What neoplasm is associated with nitrosamines?

A

Gastric adenocarcinoma

36
Q

What neoplasm is associated with polycyclic hydrocarbons?

A

Bronchogenic carcinoma

37
Q

What is the mechanism of action of p53?

A
  1. Arrests the cell cycle by transcription of CDK1 (p21) which inhibits cyclin/CDK complexes and prevents phopshorylation of RB.
  2. Promotes production of GADD45 –> repair the cell.
  3. If cell injury is not repaired –> Bax gene –> apoptosis.
38
Q

What is the normal function of APC protein?

A

Down regulation of β-catenin.

39
Q

What is the effect of APC mutation?

A

Elevated levels of β-catenin result in interaction with TCF –> incr. c-MYC + cyclin D1.

40
Q

Where do we see APC mutation?

A

70-80% of non familial colon carcinomas.

50% of hepatoblastomas and 20% of hepatocellular carcinomas.

41
Q

Where do we see TGF-β mutation?

A

70% of colon cancer.

42
Q

What is the associated mutation with TGF-β mutation?

A

SMAD4 –> seen in 50% of pancreatic adenocarcinomas.

43
Q

What is the normal function of NF-1?

A

Neurofibromin is a GTPase-activating enzyme.

44
Q

What is the effect of NF-1 mutation?

A

RAS is trapped in an active form.

45
Q

What are the associated neoplasms in NF-1 mutation?

A

Neurofibromas + malignant peripheral sheath tumors.

46
Q

What is the normal function of VHL?

A

VHL protein is a ubiquitin ligase whose substrate includes HIF-1 –> regulation of VEGF.

47
Q

Where do we see PTEN mutations?

A

Frequently found in endometrial carcinomas and glioblastomas associated with COWDEN syndrome.

48
Q

What neoplasms are marked by AFP (α-Fetoprotein)?

A

Hepatocellular carcinomas and yolk sac tumors.

49
Q

Mention the 6 mechanisms of production of tumor antigens?

A
  1. Product of mutated oncogene or tumor suppressor gene.
  2. Protein produced by oncogenic virus.
  3. Altered cell surface glycoprotein/glycolipid.
  4. Overexpressed protein.
  5. Oncofetal antigens.
  6. Cell type specific differentiated antigen (such as expression of CD10).
50
Q

Mention the 4 methods of the tumor to evade the detection by the immune system.

A
  1. Growth of antigen negative variant.
  2. Apoptosis of cytotoxic T cells through production of FAS ligand.
  3. Immunosuppression.
  4. Loss of MHC molecule.
51
Q

What stains HMB-45?

A

Melanoma

52
Q

What stains chromogranin A?

A

Small cell carcinoma

Pathology (16 decks)

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