3.1 - 3.4 Neoplasia Flashcards
1
Q
What are the three basic features of a neoplasm?
A
- Unregulated
- Irreversible
- Monoclonal
2
Q
What is the marker to determine if a growth is monoclonal? How does this work?
A
G6PD
If 1:1 ratio is disrupted, then monoclonal expansion, since one cell would have only one isotype
3
Q
How is the clonality of B cell determined?
A
Via Kappa or lambda Ig light chain secretions– if 3:1, this is polyclonal if normal. If this ratio disrupted, then Monoclonal lymphoma.
4
Q
Are benign tumor monoclonal? Malignant?
A
Both are monoclonal
5
Q
What, generally, are papillomas?
A
Outpouching of epithelial tissue, with a central fibrovascular core
6
Q
Are tumors that have the potential to metastasize called benign or malignant?
A
Malignant
7
Q
Benign Tumors derived from glands = ?
A
Adenomas
8
Q
Benign Tumors derived from epithelial tissues (not glands) = ?
A
Papilloma
9
Q
Malignant Tumors derived from glands = ?
A
Adenocarcinoma
10
Q
Malignant Tumors derived from epithelial tissues (not glands) = ?
A
Papillary carcinoma
11
Q
Benign moles are called what? Malignant?
A
Nevus
Melanoma
12
Q
What is the malignant form of lipomas?
A
Liposarcoma
13
Q
When is the -sarcoma suffix added?
A
To describe malignant mesenchymal tissue
14
Q
When is the -oma suffix added?
A
Benign epithelial tissue
15
Q
What is the name for a benign growth of lymphocytes?
A
Does not exist–always lymphoma/leukemia, which are malignant
16
Q
What is the second leading cause of death in both children and adults?
A
CA
17
Q
What are the three most common forms of CA by incidence?
A
- Breast/prostate
- Lung
- Colorectal
18
Q
What are the three most common forms of CA by mortality?
A
- Lung
- Breast/prostate
- Colorectal
19
Q
Does lung CA have a screening test?
A
Not really
20
Q
How many cell divisions occur before CA symptoms arise?
A
30 divisions
21
Q
What happens to the number of mutation with each division of CA cells? What is the consequence of this?
A
Increased– more malignant
22
Q
What is the difference between dysplasia and CA?
A
Dysplasia is reversible, whilst cancer is not.
23
Q
Where in the prostate does CA grow?
A
Posterior, peripheral part
24
Q
What is the PAP smear screening for?
A
HPV 16 and 18
25
What does PSA and DRE screen for?
Prostate CA
26
Where are aflatoxins found, and what CA are they associated with?
Aspergillus on grains
Hepatocellular CA
27
Where are alkylating agents used, and what is the CA associated with them?
Used for chemotherapy
Leukemia/lymphoma associated
28
What are the CAs associated with EtOH use? (3)
- Squamous cell carcinoma of the oropharynx
- Pancreatic carcinoma
- Hepatocellular carcinoma
29
Where is arsenic found, and what CA is it associated with? (3)
-Present in cigarette smoke
- Squamous cell carcinoma of the skin
- Lung CA
- Angiosarcoma of the liver
30
What CAs are associated with asbestos?
**Squamous cell carcinoma** and mesothelioma
31
What CAs are associated with cigarette smoke?
Carcinoma of oropharynx
- esophagus
- lung
- kidney
- bladder
32
What is the chemical found in cigarette smoke that is particularly carcinogenic?
Polycyclic hydrocarbons
33
Where are nitrosamines found, and what CA are they associated with?
- Smoked foods
| - Intestinal type of stomach carcinoma
34
Where is naphthylamine found, and what CA are they associated with?
Derived from cigarette smoke
Urothelial carcinoma of the bladder
35
Where is vinyl chloride found, and what CA is it associated with?
- Making PVC
| - Angiosarcoma of the liver
36
What are the two types of people who classically develop Nasopharyngeal carcinoma?
- African male
| - Young chinese male
37
What are the CAs caused by EBV? (3)
- Nasopharyngeal carcinoma
- Burkitt's lymphoma
- CNS lymphoma
38
What is the CA associated with HHV-8?
Kaposi sarcoma
39
What is the CA associated with HBV and HCV?
Hepatocellular carcinoma
40
What are the CAs associated with HTLV-1?
Adult T cell leukemia/lymphoma
41
What are the high risk HPV virus strains? What CAs do they cause?
16, 18, 31, 33
Squamous cell carcinoma of the vulva, vagina, anus, cervix
42
Ionizing radiation produces what carcinogenic agents? What CAs is this associated with (3)?
Hydroxyl free radical generation
- AML
- CML
- papillary carcinoma of the thyroid
43
Non-ionizing radiation produces what? What is the most common source of this? What CAs is this associated with?
-Pyrimidine dimers
-UVB sunlight
-Basal cell carcinoma
Squamous cell carcinoma
Melanoma of the skin
44
What are the three systems (gene types) that can be disrupted by carcinogenic agents to cause a tumor?
1. Protooncogenes
2. Tumor suppressor genes
3. Regulator of apoptosis
45
What are proto oncogenes?
genes that are essential for cell growth and differentiation, but can be mutated into oncogenes
46
What are the four categories of oncogenes?
1. Growth factors
2. Growth factor receptors
3. Signal transducers
4. Cell cycle regulators
47
What is the MOA of growth factors (i.e. what happens when it binds to a receptor)?
Binds to receptor, stimulates signal transducer, to start Cell cycle
48
What is the protein that drives the formation of an astrocytoma? How?
Overexpression of PDGFB by cell causes an (via an autocrine-like mechanism) increase in cell growth
49
ERBB2[HER2/Neu] is what? what happens to cause CA, and what specific CA does it cause?
- Epidermal GF receptor
| - Amplification causes breast CA by increasing the receptor density and thus the response to normal amounts of GF
50
RET is what? What happens to cause CA, and what specific CA does it cause?
- Neural GF inhibitor
- Point mutation causes MEN2A/B receptor upregulation
specifically medullary carcinoma of the thyroid
51
KIT is what? what happens to cause CA, and what specific CA does it cause?
- Stem cell GF receptor
| - Point mutation causes GI stromal tumor
52
Ras family gene is what? What happens to cause CA, and what specific CAs does it cause (3)?
- GTP binding protein (cell signalling molecule)
- Point mutation increases expression of nuclear proteins, to cause:
- carcinoma
- melanomas
- lymphomas
53
ABL is what? what happens to cause CA, and what specific CA does it cause?
- Y kinase signal transducers
| - t(9:22) with BCR causes CML (and some ALL)
54
c-Myc is what? What translocation happens to cause CA, and what specific CA does it cause?
- transcription factor (nuclear regulator)
| - t(8,14) causes Burkitt's lymphoma
55
N-Myc is what? what happens to cause CA, and what specific CA does it cause?
Transcription factor
| Amplification causes neuroblastoma
56
L-Myc is what? what happens to cause CA, and what specific CA does it cause?
Transcription factor
| Amplification causes lung carcinoma
57
CCND1 (cyclin D1) is what? What translocation happens to cause CA, and what specific CA does it cause?
- Cyclin D1
| - t(11;14) involving IgH causes mantle cell lymphoma
58
CDK4 is what? what happens to cause CA, and what specific CA does it cause?
- Cyclin dependent kinase
| - Amplification causes Melanoma
59
What is the Philadelphia chromosome? What CA is it associated with?
t(9;22) with BCR.
CML and some types of ALL
60
What is the MOA behind burkitt's lymphoma?
t(8;14) causes change of IgH gene with Myc gene in B cells, causing the overproduction of c-Myc
61
What is the MOA behind Mantle cell lymphoma?
Cyclin D1 (CCND1) gene on chr 8 is translated to chr 14 (IgH chain) in B cells, causing overexpression of CCND1
62
What is the function of Cyclin D1?
Allows cells to go from G1 to S phase
63
What are the two major tumor suppressor genes?
p53 and Rb
64
What is the function of p53?
"traffic cop" for cell between G1 and S phase--checks to make sure DNA is in order
65
What is the molecule that p53 calls in if there is DNA damage? What does this do?
BAX, which destroys BCL2 (this causes apoptosis)
66
p53 follows what model of DNA damage?
Two hit model
67
What is Li-Fraumeni syndrome
Germline mutation in one of the p53 genes, causing an increased propensity for developing carcinomas and sarcomas
68
What is the function of E2F? What is this protein bound to usually?
Allows for progression from G1 to S phase
usually bound and inhibited by Rb
69
What is the function of Rb?
Inhibits E2F protein, thereby inhibiting transition from G1 to S phase
70
Bilateral Rb is more likely caused by what (germline mutation or sporadic)? Unilateral?
```
Bilateral = Germline
Unilateral = Sporadic
```
71
What is the function of Bcl2?
Stabilizes the mito membrane, so that cyt-c cannot be released
72
Bcl2 is overexpressed in what cancer? What translocations allows for this?
Follicular lymphoma t(14;18) moves Bcl2 to Ig heavy chain (14), resulting in increased Bcl2
73
What is the function of telomerase?
Preserves telomeres in CA cells
74
What are the two angiogenic factors that are upregulated in tumors to promote angiogenesis?
FGF
| VEGF
75
Tumors create a lot of antigenic proteins. How do they avoid detection by the immune system?
Downregulate MHC I
76
True or false: immunodeficiency has no effect on the probability of getting CA
False--increases the risk
77
What is the function of E-cadherin? What is its role in CA?
Protein that attaches cells together.
Downregulation of this allows cell to metastasize
78
What are the two major proteins that comprise the basement membrane?
Collagen IV and laminin
79
What is the function of laminin in CA?
Allows tumors to attach to BM and destroy it via collagenases
80
Once in the ECM, tumors attach to what protein to migrate locally?
Fibronectin
81
What type of CA tends to spread via lymphatics?
Carcinomas
82
Hematogenous spread is characteristic of what type of CA?
Sarcomas
83
What are the four *carcinomas* that spread via *hematogenous* route?
- RCC
- Hepatocellular carcinoma
- Follicular carcinoma
- Choriocarcinoma
84
Seeding of body cavities is characteristic of what particular CA?
Ovarian CA (omental caking)
85
What is "omental caking"?
Local spread of ovarian CA into the omentum
86
What are the top three causes of death in adults?
1. CV disease
2. CA
3. Cerebrovascular disease
87
What are the top three causes of death in children?
1. Accidents
2. Cancer
3. Congenital defects
88
Who is classically affected with HHV-8 Kaposi's sarcoma?
1. Older eastern european males (skin)
2. AIDS pts
3. Transplant patients
89
What is the MOA and use of trastuzumab?
Antibody against the ERB2/Neu receptor on breast cancer
90
How does Ras become activated? Deactivated?
Binds to GTP
GAP cleaves the phosphate off of GTP
91
What is the treatment for CML?
Imatinib
92
What is the classic histological characteristics of Burkitt's lymphomas?
starry sky with tingible body macrophages
93
What are the two regions that surround a follicle of a lymph node?
Mantle
| Margin
94
Rb mutations increase the risk for what cancers?
Retinoblastomas, and osteosarcomas
95
Malignant or benign feature: slow growing
Benign
96
Malignant or benign feature: rapid growth
Malignant
97
Malignant or benign feature: poorly circumscribed
Malignant
98
Malignant or benign feature: infiltrative
Malignant
99
Malignant or benign feature: well circumscribed
Benign
100
Malignant or benign feature: mobile
Benign
101
Malignant or benign feature: fixed to surrounding tissues
Malignant
102
What is the only way to determine if a mass is cancer?
Bx
103
Malignant or benign feature: organized growth
Benign
104
Malignant or benign feature: uniform nuclei
Benign
105
Malignant or benign feature: minimal mitotic activity
Benign
106
Malignant or benign feature: nuclear pleomorphism
Malignant
107
How does the nuclear: cytoplasmic ratio compare between malignant and benign tumors?
Malignant has high nuclear: cytoplasmic ratio, whereas the reverse is true for benign
108
What is the hyperchromasia that is characteristic of malignant cells?
Dark staining nuclei
109
What is the absolute distinguishing feature between malignant and benign tumors?
Metastatic potential
110
Keratin is found in what type of tissue?
Epithelium
111
Vimentin is found in what type of tissue?
Mesenchyme
112
Desmin is found in what type of tissue?
Muscle
113
GFAP is found in what type of tissue?
Neuroglial cells
114
Neurofilament is found in what type of tissue?
Neurons
115
PSA is found in what type of tissue?
Prostate
116
Estrogen receptors are found in what type of tissue?
Breasts
117
Thyroglobulin is found in what type of tissue?
Thyroid follicular cells
118
S100 is found in what type of tissue?
Melanoma
119
Chromogranin is found in what type of tissue?
Neuroendocrine cells
120
What are the three general uses of serum tumors markers?
- screening
- monitoring response to treatment
- Monitoring recurrence
121
What is involved in grading a tumor?
Looking at architectural and nuclear features to determine if well or poorly differentiated
122
What, generally, is staging?
Size and spread of the cancer
123
Which is more important: cancer grade, or stage
Stage
124
What are the components of the TNM staging? Which of these is the most important?
- Tumor size or depth of invasion
- N = nodes
- M = *mets*
