5.10 Paths of Spread

Question 1

Pathways of spread

Answer 1

local invasion, seeding of body cavities, lymphatic metastasis, hematogenous metastasis

Question 2

seeding of body cavities

Answer 2

occurs in ovarian and abdominal tumors_.things of spreading seeds everywhere and the tumors growing

Question 3

lymphatic metastasis is used to

Answer 3

stage the tumor. In breast tumors they are usually in the upper outer quadrant and drained by the axillary LN, so if you have a positive biopsy you want to evaluate the LN and see if you do or don’t need adjuvant threrapy

Question 4

after distant metastasis

Answer 4

surgery is not an option and all you have left is chemotherapy

Question 5

of patients with lung cancer

Answer 5

95% are smokers

Question 6

percent of smokers that develop lung cancer

Answer 6

20%…..but with emphysema and additional problmes there is an additional 40% occurance of cancer

Question 7

helpful diagnostic lesions in the liver

Answer 7

coin lesions_.they could be granulomas so you ned to biopsy, see lots of seeding though

Question 8

histological diagnosis of malignancy

Answer 8

there is no single parameter which allows one to diagnose a malignant neoplasm. However a pattern of invasiveness, histologic or cytologic anaplasia, and evidence for metastasis are the criteria which are most generally useful

Question 9

for primary diagnosis look at

Answer 9

HE stain

Question 10

benign neoplasms

Answer 10

remain localized to tissue of oritin, encapsulated (pusing borders), lack of invasiveness, slow or arrested growth, well differentiated (resembles normal tissues)

Question 11

encapsulation

Answer 11

seen in benign tumors as the grow, pusing against surrounding tissue, resulting in formation of a fibrous cap

Question 12

leiomyomas

Answer 12

smooth muscle tumors - benign - seen in uterine fibroids - will look like normal smooth muscle but with a little more density in nuclei

Question 13

danger of benign neoplasms

Answer 13

depends on location

Question 14

sypmptoms of uterine fibroids

Answer 14

inability to become pregnant, pain

Question 15

benign neoplasms lack

Answer 15

metastases

Question 16

do benign neoplasms result in death

Answer 16

not usually, but it depends on location

Question 17

benign neoplasm that causes problmes

Answer 17

meningioma - if it grows fast and big enough it will kill you by mass effect (not metastasis, endocrine tumors can over secrete things like insuline resulting in death

Question 18

benign neoplasms can often be cured by

Answer 18

simple surgical excision

Question 19

malignant neoplasms and surgery

Answer 19

cannot always perform surger, tumors are usually not fully treatable by surgery, often need chemo too

Question 20

anaplasia

Answer 20

lac of differentiation

Question 21

anaplastic cells are seen in

Answer 21

malignant neoplasms

Question 22

anaplastic cells generally lack

Answer 22

cytoplasmic features of differentiation

Question 23

an anaplastic skeletal muscle tumor can lose

Answer 23

muscle differentiation

Question 24

an anaplastic secretory cell can lose

Answer 24

secretory product

Question 25

morphologically anaplastic cells have

Answer 25

higher nuclear to cytoplasmic ratios, nuclear hyperchromasia, clumped chromatin, prominent nucleoli

Question 26

nuclear hyperchromasia

Answer 26

dark staining nucleus

Question 27

clumped chromatin

Answer 27

this is seen in anaplastic cells bc cells are rapidly actively dividing and making things

Question 28

anaplastic tumors often exhibit

Answer 28

pleomorphism (nuclear and cytoplasmic), frequent and sometimes abnormal mitosis, tumor giant cells

Question 29

pleomorphism

Answer 29

different shape - seen in malignant cells

Question 30

tumor giant cells

Answer 30

these are NOT fused like when macs fuse, instead these cells are just messed up bc they grow multiple nuclei without being lined up with mitosis

Question 31

suspect malignancy if yous see

Answer 31

tissue that is not supposed to be there

Question 32

where should you see lung glands?

Answer 32

in the submucosal glands of the large bronchi, so if you see them in the periphery, or paranchyma of the lung_.you know they shouldn_t be there

Question 33

cell features you need to pay attention to

Answer 33

shapes of nuclei, sizes of cells

Question 34

squamous cell metaplasia happens in

Answer 34

heavy smokers, marker of damage, will lead to squamous cell carinomma

Question 35

diff btw a leiomyosarcoma and Leiomyoma

Answer 35

a leioymyosarcoma will have a larger nucleus to cell ratio

Question 36

stain showing invasion of lymphatics predicts

Answer 36

high number of draining LN that will stain positive

Question 37

perineural invasion indicates

Answer 37

malignancy

Question 38

Dysplasia

Answer 38

abnormal growth