3.1 Neoplasia

Question 1

How to determine clonality, original method

Answer 1

Look at G6PD isoforms. (glucose 6 phosphate DH)

• in females, should see 1:1 ratio of isoforms in normal tissue.
• Only one isoform present in neoplasia

Question 2

How to determine clonality of B lymphocytes

Answer 2

Look at light chain ratio. Should be 3:1 for kappa to lambda light chain ratio. If you get, say, 20:1 ratio, there is neoplasia, meaning you have lymphoma

Question 3

Enlarged lymph nodes: Differential diagnosis

Answer 3

1. Metastatic cancer
2. Reactive hyperplasia (from infection)–this is polyclonal
3. Lymphoma–this is monoclonal (eg 20:1 light chain ratio in B cells)

Question 4

Adenoma

Answer 4

Epithelium, benign

Question 5

Adenocarcinoma

Answer 5

Epithelium, malignant

Question 6

Approx how many divisions occur before the earliest clinical symptoms arise in cancer?

Answer 6

Approx 30

Question 7

Pap smear, detects what?

Answer 7

detect Cervical Dysplasia (CIN) before it becomes carcinoma

Question 8

Mammography, detects what?

Answer 8

detects:

• in situ breast cancer before it invades (eg DCIS–Ductal carcinoma in situ)
• invasive carcinoma before it is clinically palpable

Question 9

PSA and Digital rectal exam tests, detect what?

Answer 9

Prostate Specific Antigen.

-detect prostate carcinoma before it spreads

Question 10

Hemoccult test, Colonoscopy, detect what?

Answer 10

Detect:

• colonic adenoma before it becomes carcinoma
• carcinoma before it spreads