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3 Principles of Neoplasia > 3.3 Tumor Progression > Flashcards

3.3 Tumor Progression Flashcards

1
Q

Steps of Tumor Invasion (5)

A
  • see drawing
    1. Loosening of cell–downregulation of E-Cadherin loosens epithelial cell from neighbors
    2. Entrance into basement membrane–cell attaches to laminin in basement membrane
    3. Cell destroys basement membrane with collagenase (type IV collagen)
    4. Local spreading: cell attaches to fibronectin in ECM
    5. Metastasis: cell enters vessels/lymphatics
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2
Q

Generally, what routes do these tumors use to metastasize?

  1. Carcinoma
  2. Sarcoma
A
  1. Carcinoma–lymphatics (eg breast cancer, axillary nodes)

2. Sarcoma–blood

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3
Q

Routes of metastasis (3)

A
  1. lymphatics (most carcinomas)
  2. blood (most sarcomas)
  3. Seeding of body cavities–eg “omental caking” of peritoneum in ovarian carcinoma
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4
Q

Omental caking

A
  • Metastasis of ovarian carcinoma by ‘seeding of body cavity’
  • involves the peritoneum
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5
Q

Clinical characteristics of benign tumors:

  1. growth rate?
  2. well or poorly circumscribed?
  3. distinct or infiltrative/diffuse?
  4. mobile or fixed to surrounding tissues?
A

Benign:

  1. slow growth
  2. well-circumscribed
  3. distinct
  4. mobile
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6
Q

Clinical characteristics of malignant tumors:

  1. growth rate?
  2. well or poorly circumscribed?
  3. distinct or infiltrative/diffuse?
  4. mobile or fixed to surrounding tissues?
A

malignant:

  1. fast growth
  2. poorly circumscried
  3. infiltrative/diffuse. not distinct
  4. fixed
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7
Q

Histologic features of benign tumors:

  1. growth pattern
  2. nuclei
  3. nuclear to cytoplasm ratio
  4. mitotic activity
  5. invasion
A

Benign:

  1. organized growth pattern, no loss of polarity
  2. uniform nuclei
  3. low nuclear:cytoplasm ratio
  4. low mitotic activity
  5. no invasion of surrounding tissue
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8
Q

Histologic features of malignant tumors:

  1. growth pattern
  2. nuclei
  3. nuclear to cytoplasm ratio
  4. mitotic activity
  5. invasion
A

malignant:

  1. disordered growth, loss of polarity
  2. nuclear polymorphism (different sizes) and hyperchromasia (dark)
  3. high ratio (big nuclei, lots of gene expression)
  4. high mitotic activity
  5. yes, invasion of surrounding tissues
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9
Q

Tumor of this shows what on immunohistochemistry stain?

-epithelium (carcinoma)

A

keratin

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10
Q

Tumor of this shows what on immunohistochemistry stain?

-mesenchyme

A

vimentin

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11
Q

Tumor of this shows what on immunohistochemistry stain?

-muscle

A

desmin

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12
Q

Tumor of this shows what on immunohistochemistry stain?

-neuroglia

A

GFAP

glial fibrillary acidic protein

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13
Q

Tumor of this shows what on immunohistochemistry stain?

-neuron

A

neurofilament

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14
Q

Presence of this on immunohistochemistry stain shows what tumor origin?
-keratin

A

epithelium (carcinoma)

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15
Q

Presence of this on immunohistochemistry stain shows what tumor origin?
-vimentin

A

mesenchyme (sarcoma)

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16
Q

Presence of this on immunohistochemistry stain shows what tumor origin?
-desmin

A

muscle

17
Q

Presence of this on immunohistochemistry stain shows what tumor origin?
-GFAP

A

neuroglia

glial fibrillary acidic protein

18
Q

Presence of this on immunohistochemistry stain shows what tumor origin?
-neurofilament

A

neuron

19
Q

Serum tumor markers of what?

  1. PSA
  2. Estrogen receptor
  3. Thyroglobulin
  4. Chromogranin
  5. S-100
A
  1. prostate epithelium
  2. breast epithelium
  3. thyroid follicular cells
  4. neuroendocrine cells
  5. melanoma, schwannoma, Langerhans cells
20
Q

What are the serum markers?

  1. prostate epithelium
  2. breast epithelium
  3. thyroid follicular cells
  4. neuroendocrine cells
  5. melanoma, schwannoma, Langerhans cells
A
  1. PSA
  2. ER - estrogen receptor
  3. Thyroglobulin
  4. Chromogranin
  5. S-100
21
Q

When is biopsy required to diagnose a tumor?

A

Always! even if screening serum test is positive

22
Q

Cancer grading

A
  • how much tumor resembles parent tissue
  • well (low grade) vs poorly differentiated (high grade) cells
  • poorly differentiated cells do not resemble parent tissue. this is considered ‘high grade’ cancer and is bad prognosis
23
Q

Cancer staging

A
  • assess size and spread of tumor
  • determined after surgical resection
  • TNM staging:
    1. Tumor size/depth
    2. Nodes–local spreading?
    3. Metastasis?
24
Q

Cancer staging vs grading: which is more important in prognosis

A
  • Cancer staging is a key prognostic factor.

- TNM staging after surgical resection

3 Principles of Neoplasia (5 decks)

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