7.1 Benign vs Malignant Flashcards
Which of the following is true of the nomenclature of benign tumors generally, and most often tumors of mesenchymal cells?
A. Based on cell origin
B. Based on microscopic features
C. Based on macroscopic architecture
D. Cell type is given the suffix -oma
D. Cell type is given the suffix -oma
NOTE: A-C are true of benign tumors of epithelial cells
ex. of mesenchymal cells
- fibroma, chondroma, etc
What is the name of epithelial neoplasms that are derived from glands or from glandular structures?
A. Papillomas
B. Adenomatous polyps
C. Papillary cytadenomas
D. Adenomas
E. Polyps
Adenomas
What is the name of epithelial neoplasms that produce microscopic or macroscopic finger-like projections from the epithelial surface?
A. Papillomas
B. Adenomatous polyps
C. Papillary cytadenomas
D. Adenomas
E. Polyps
Papillomas
Epithelial neoplasm that form cytic massess are called?
A. Papillomas
B. Adenomatous polyps
C. Papillary cytadenomas
D. Adenomas
E. Polyps
F. None of the above
None of the above
NOTE: they’re called cystadenomas
Tunors that produce papillary patterns that protrude into cystic spaces are called?
A. Papillomas
B. Adenomatous polyps
C. Papillary cystadenomas
D. Adenomas
E. Polyps
F. None of the above
Papillary cystadenomas
A malignant or benign epithelial neoplasm that produces visible macroscopic projections that project above the mucosal surface are called what?
A. Papillomas
B. Adenomatous polyps
C. Papillary cytadenomas
D. Adenomas
E. Polyps
F. None of the above
Polyps
All neoplasms, whether benign or malignant, are called ______ if they produce a macroscopically visible projection that goes through the mucosa and contains glandular tissue.
A. Papillomas
B. Adenomatous polyps
C. Papillary cytadenomas
D. Adenomas
E. Polyps
F. None of the above
B. Adenomatous polyps
NOTE: whether the prjecting tumor contains glandular tissue or not determines if its an adenomatous polyp or not
A tumor is derived from renal tubular cellls that produce glandular cell clusters that are microscopically visible. What should this benign tissue be called?
A. Papillomas
B. Adenomatous polyps
C. Papillary cytadenomas
D. Adenomas
Adenoma
All tumors have two basic components: Parenchymal and Stromal
Which component is associated with the biological behavior and classification of the tumor cells?
Which component is associated with the growth and mobility of the tumor cells?
Which component is associated with the biological behavior and classification of the tumor cells?
parenchymal
Which component is associated with the growth and mobility of the tumor cells?
stromal
NOTE: stromal refers to the blood vessels, connective tissue, and immune cells involved
Malignant tumors arising in solid mesenchymal tissue are usually called what? What’s an example?
A. Carcinomas
B. Sarcomas
C. Leukemias or Lymphomas
D. None of the above
Sarcomas
Fibrosarcomas and Chondrosarcomas
Malignant tumors arising from epithelial cells, which can be derived from any of the 3 germ layers are termed?
A. Carcinomas
B. Sarcomas
C. Leukemias or Lymphomas
D. None of the above
Carcinomas
NOTE: carcinomas can be further classified based on the epithelial cell the carcinoma resembles
ex. squamous cell carcinoma
NOTE: It can be even further classified based on tissue or organ origin
ex. bronchogenic squamous cell carcinoma
Malignant tumors that arise in hematopoitic cells are called?
A. Carcinomas
B. Sarcomas
C. Leukemias or Lymphomas
D. None of the above
C. Leukemias or Lymphomas
What is the name of a tumor, that arises from a salivary gland, and contains epithelial and myoepithelial cells thus allowing it to have epithelial components amongts myxoid stroma?
A. Adenoma
B. Carcinoma
C. Pleomorphic adenoma
D. Cystadenomas
C. Pleomorphic adenoma
NOTE: This is a mixed tumor
Normally mixed tumors, while containing mixed elements, usually are made up of cells derived from 1 germ line. An exception to the mixed tumor rule, is a teratoma which originates from totipotent germ cells. A common example of a teratoma is the Ovarian Cystic teratoma. Which of the following correctly describes the ovarian cystic teratoma?
A. Composed of epithelial components scattered within a myxoid stroma containing bone and cartilage
B. Neoplasms differentiate along the mesodermal line to create a cystic tumor lined with skin, sebacceous glands, and teeth
C. Tumor cells differentiate along the endodermal line to create a cystic tumor lined with skin, sebacceous glands, and teeth
D. Neoplasms differentiate along the ectodermal line to create a cystic tumor lined with skin, sebacceous glands, and teeth
D. Neoplasms differentiate along the ectodermal line to create a cystic tumor lined with skin, sebacceous glands, and teeth
To say “ecto” you have to use your teeth, just like that ovarian cystic teratoma
Name the 4 examples of malignant tumors that were given benign sounding terminologies. Hints included below
- Malignant tumor of lymphoid tissue:
- MAlignant tumor of melanocytes:
- Maligenant tumor of mesothelium:
- Malignant tumor of testicular epithelium:
- Malignant tumor of lymphoid tissue: lymphoma
- MAlignant tumor of melanocytes: melanoma
- Maligenant tumor of mesothelium: mesothelioma
- Malignant tumor of testicular epithelium: seminoma
Poorly named malignant tumors Lyft Me Spirits Mistakenly
All of the following are useful discriminators when trying to distinguish between benign and malignant tumors, EXCEPT?
A. Anatomical features
B. Growth rate
C. Histological features
D. All the above are good discriminators
B. Growth rate
Why are benign tumors are usually considered well differentiated?
What clues are available to help distinguish benign tumors?
The parenchymal cells of benign tumors tend to have little microscopic difference than their normal counterparts
Some clues can be found in the growth of the cells into masses
NOTE: In well-differentiated benign tumors mitoses are rare and cell divisions are of normal configuration
Which of the following is a hallmark of malignancy?
A. Partial differentiation
B. Reversal of differentation
C. Complete differentiation
D. Lack of differentiation
E. All of the above
F. All except C
All except C
NOTE: D is the definition of anaplasia, and B is a direct translation of anaplasia
Which of the following nuceli to cytoplasm ratios is characteristic of malignant anaplastic neoplasms?
A. 1:6
B. 1:5
C. 1:4
D. 1:1
D. 1:1
Thats right, the nuclei are often LARGEEEE, as well as often darkly stained
Which of the following does mitoses absolutely indicate in a cell?
A. Malignancy
B. Rapid cell growth
C. Benign nature
D. All of the above
B. Rapid cell growth
Which of the following is an important morphological figure of malignancy?
A. Mitoses
B. Atypical mitotic figures
C. Cells with tripolar, quadripolar, or multipolar spindles
D. All but A
E. None of the above
All but A
Dysplasia means “disordered growth” and normally is encountered in what cell type?
Dysplasia includes a constellation of changes that include loss of what 2 things?
Epithelial cells
Loss of uniformity
Loss of architectural orientation
Which of the following correctly characterizes the evolution of dysplasia in squamous epithelium?
A. Replacement of squamous epithelium with a stratified squamous that is more suited for the rough environment
B. Tall cells from the basal layer become flattened squames over time with an abundance of mitotic figures seen at the basal level
C. Tall cells with hypochromatic nuceli populate the surface with an abundance of mitotic figures seen at all cell levels
D. Tall cells with hyperchromatic nuclei populate the surface with an abundance of mitotic figures seen at all cell levels
D. Tall cells with hyperchromatic nuclei populate the surface with an abundance of mitotic figures seen at all cell levels
NOTE:
A is referring to metaplasia
B is refering to normal squamous epithelial growth
Which of the following descriptions correctly describes Carcinoma In Situ?
A. The tumor has not yet breached the basement membrane but dysplastic changes can be seen in all layers of the epithelium
B. The tumor has breached the basement membrane and dysplastic changes can be seen in all layers of the epithelium
C. The tumor has not yet breached the basement membrane, and dysplastic changes can only be seen in the majority of the epithelial layers
D. Regardless of the level of dysplastic changes in the epithelial layers, the tumor has not yet invaded through the basement membrane
A. The tumor has not yet breached the basement membrane but dysplastic changes can be seen in all layers of the epithelium
NOTE: the left figure depicts a carcinoma in situ which is also called a pre-invasive neoplasm
T/F: Like that of long time smokers and people with Barrets Esophagus, dysplasia often predates the appearance of cancer
True
NOTE: although dysplasia is a precursor to malignant transformation, it does not always progress to cancer
T/F: All dysplasia often occurs in metaplastic epithelium, but not all metaplastic epithelium is dysplastic
True
Due to the slow growth of benign tumors, as a response to pressure and hypoxia, the tumors stromal cells release extracell matrix that encapsulates the growth in a fibrous capsule. All of the following are true of the affects of this capsule EXCEPT?
A. Makes the tumor palpable
B. Makes the tumor easy to remove surgically
C. Makes the tumor mobile locally
D. PRevents the tumor from growing further
D. Prevents the tumor from growing further
NOTE: the exception to these influences is seen in hemangiomas, which are uncapsulated
Histologically, pseudocapsulated masses always show a row of cell penetrating the margin and infiltrating adjacent structures in a crab-like growth pattern. Which of the following cells are we most likely to see pseudocapsulated masses?
A. Rapidly growing benign tumors
B. Rapidly growing malignant tumors
C. Slow growing benign tumors
D. Slow growing malignant tumors
D. Slow growing malignant tumors
Next to metastases, what is the most reliable feature that differentiates cancers from benign tumors, and yields to the reason resection of malignant tumors are damn near impossible?
Invasivness
In general, though there are many exceptions, the likilihood of metastes correlates with what 4 things?
Anaplasia (lack of differentiation)
Agreesive invasion
Rapid Growth
Large Size
Metasteses are like a good basketball player. “If he’s big, fast, an agressive penetrator, and not like other normal atheletes, then he’s going places”
About 30% of solid tumors present with metastases, with the exception of what class of solid tumors?
What is the exception that is highly metastatic in that class of solid tumors?
Skin cancers
Melanoma
What are the 3 potential pathways utilized by disseminated cancers?
Which one is the most common pathway for initial dissemination of carcinomas?
Which one is it more typical for sarcomas to use than carcinomas?
What are the 3 potential pathways utilized by disseminated cancers?
Open space/cavities, Lymphatics, Blood vessels
Which one is the most common pathway for initial dissemination of carcinomas?
Lymphatics
Which one is it more typical for sarcomas to use than carcinomas?
Blood vessels
Which of the following is true regardinf hematogenous spread of disseminated cancers?
A. Arteries are more often penetrated vs. veins
B. Venous spread only occurs if the tumor can pass through the pulmonary capillary beds
C. Venous flow we often see the tumor cells rest at the first capillary bed they encounter
D. Liver and lungs are the most frequent site of tumor travel destinations
E. All except A
F. C and D
C and D
C. Venous flow we often see the tumor cells rest at the first capillary bed they encounter
D. Liver and lungs are the most frequent site of tumor travel destinations
Cancers of the upper quadrants like breast cancer are most often sent to axillary lymph nodes, while cancers of inner quadrants are sent to which of the following lymph nodes?
A. LN along the internal mammilary arteries
B. Perihilar Trachobronchial LNs
C. Mediastinal LNs
D. All except A
E. A and B
F. B and C
A. LN along the internal mammilary arteries
NOTE: B and C are utilized by cancers of the lungs
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