8/14+15 - Neoplasia Flashcards
what means new growth
neoplasia
what is the study of neoplasms
oncology
what is a genetic disorder of cell growth that is triggered by acquired or less commonly inherited mutations affecting a single cell and its clonal progeny
neoplasm
neoplasm mutations alter the function of what
certain genes and give neoplastic cells a survival and growth advantage
what are the basic components of neoplasm
- tumor parenchyma
- reactive stroma
what neoplasm component are transformed or neoplastic cells
tumor parenchyma
what neoplasm component is composed of CT, blood vessels, and variable number of cells of adaptive and innate immune system
reactive stroma
classification of tumors and their biological behavior are primarily based on___
parenchymal components
growth and spread of tumors are dependent on ___
stroma
what tumor remains localized at site of origin and are generally amenable to surgical removal
benign tumors
Do pt generally survive benign tumor
yes
what benign tumor may cause significant morbidity and are sometimes fatal
tumors in brain
how to name benign tumor of mesenchymal cells
“oma” is attached to name of cell type from which tumor arises (E.g., chondroma, adenoma, papilloma)
what tumor can invade and destroy adjacent structures and spread to distant size (metastasize)
malignant tumors
what is collectively called a “cancer”
malignant tumor
since not all cancers are deadly, what can be done to cancers discovered at early stages
surgical excision, systemically administered drugs, or therpeutics antibodies
what are malignant tumors arising in epithelial cell origin called
carinoma
what are malignant tumors arising in solid mesenchymal tissues called
sarcoma
what are malignant tumors arising in blood-forming cells called
leukemia
what is a cancer that begins in the cells that line alveoli and make substances such as mucus and is the most commone type of lung cancer
adenocarcinoma
what is a cancer that begins in squamous cells, which are thin, flat cells that look like fish scales
squamous cell carinoma
what is cancer that may begin in several types of large cells and look abnormal when viewed under microscope
large cell carcinoma
what is cancer of smooth muscle
leiomyosarcoma
what is cancer of ARMS or ERMS sksletal muscle
rhabdomyosarcoma
T/F: in most neoplasms, all parenchyma cells closely resemble one another, but in some types of tumors more than one line of differentiation is evident, creating subpopulation of cells
TRUE
what is mixed tumor of saliary glands (pleomorphic adenoma), which contains epithelial components scattered within myxoid stroma that may contain islands of cartilage and bone and example of
mixed tumors (create distinct subpopulation of cells)
benign and malignant names of:
CT and derivatives
B: fibroma, lipoma, chondroma, osteoma
M: fibrosarcoma, liposarcoma, chondrosarcoma, osteocarcoma
benign and malignant names of:
blood vessels
B: hemangioma
M: angiosarcoma
benign and malignant names of:
lymph vessels
B: lymphangioma
M: lymphangiosarcoma
benign and malignant names of:
mesothelium
B: benign fibrous tumor
M: mesothelioma
benign and malignant names of:
brain covering
B: meningioma
M: invasive meningioma
benign and malignant names of:
hematopoietic cells
B: NONE
M: leukemia
benign and malignant names of:
lymphoid tissue
B: NONE
M: lymphoma
benign and malignant names of:
smooth muscle
B: leiomyoma
M: leiomyosarcoma
benign and malignant names of:
striated muscle
B: rhabomyoma
M: rhabdomyosarcoma
benign and malignant names of:
stratified squamous
B: squamous cell papilloma
M: squamous cell carcinoma
benign and malignant names of:
basal cells of skin or adnexa
B: NONE
M: basal cell carinoma
benign and malignant names of:
melanocytes
B: nevus
M: malignant melanoma
benign and malignant names of:
epithelial lining of glands and ducts
B: adenoma, papilloma, cystadenoma
M: adenocarcinoma, papillary carcinoma, cystadenocarcinoma
benign and malignant names of:
respiratory passage
B: bronchial adenoma
ML bronchogenic carcinoma
benign and malignant names of:
renal epithelium
B: rental tubular adenoma
M: renal cell carinoma
benign and malignant names of:
liver cells
B: hepatic adenoma
M: hepatocellular carcinoma
benign and malignant names of:
urinary tract epi
B: transitional cell papilloma
M: transitional cell carcinoma
benign and malignant names of:
placenta epi
B: hydatiform mole
M: choriocarcinoma
benign and malignant names of:
testicular epi
B: NONE
M: seminoma, embryonal carcinoma
benign and malignant names of:
salivary glands
B: pleomorphic adenoma (mixed tumor of salivary glands)
M: malignant mix tumor of salivary gland
benign and malignant names of:
renal anlage
B: NONE
M: Wilms tumor
benign and malignant names of:
totipotent cells on gonads or in embryonic rests
B: mature teratoma, Dermoid cyst
M: immature teratoma, teratocarcinoma
mixed tumors are usually derived from how many germ layers
ONE
mixed tumors usually derived from more than one germ layer is called what
more than one germ layer - teratogenous layer
describe differentiation/anaplasia in benign tumors
well differentiated structure sometimes typical of tissue of origin
describe differentiation/aplasia of malignant tumors
some lack differentiation (anaplasia); structure often atypical
describe rate of growth of benign tumors
usually progressive and slow; may come to a standstill or regress; mitotic figures are rare and normal
describe rate of growth of malignant tumors
erratic, may be slow to rapid; mitotic figures may be numerous and abnormal
describe local invasion charac. of benign tumors
usually cohesive, expansile, well-demarcated masses that do not invade of infiltrate surrounding normal tissues
describe local invation charac. of malignant tumors
locally invasive, infiltrating surrounding tissues; sometimes may be misleadingly cohesive and expansile
describe metastasis of benign tumors
ABSENT
describe metasis of malignant tumros
frequent; more likely with large undifferentiated primary tumors
___ refers to the extent to which neoplastic
parenchymal cells resemble the corresponding normal
parenchymal cells, both morphologically and functionally
Differentiation
__ is the lack of differentiation
anaplasia
___ is the replacement of one type of cell
with another
type; nearly always found in association
with tissue damage, repair, and regeneration; often the
replacing cell type is better suited to some alterations
in the local environment
Metaplasia
In ___, gastroesophageal reflux damages the
squamous epithelium of the esophagus, leading to its
replacement by glandular epithelium better suited to an acidic
background; unfortunately, the metaplastic epithelium is
prone
to malignant transformation
Barrett esophagus
___ literally means ‘disordered growth’; it is
encountered principally in epithelial cells and is
recognized based on several morphological changes
Dysplasia
what cells exhibit considerable pleomorphism
dysplastic cells
what cells exhibit:
- consierable pleomorphism
- Often contain large hyperchromatic nuclei with a high nuclear cytoplasm ratio
- Abundant mitotic figures throughout dysplastic epithelium, rather than being confined to the basal layer
- Architectural disarray
- Loss of orderly differentiation
dysplastic cells
___: when dysplasia is severe and
involves the full thickness of the epithelium, but the
lesion DOES NOT penetrate the basement
membrane
Carcinoma in situ
where is Carcinoma in situ often seen
skin, breast, bladder, and urine cervix
what cancer, unless treated, has a high probability to progress to invasive cancers
Carcinoma in situ
Growth of ___ is accompanied by progressive
invasion, destruction of surrounding tissues, and
eventually systemic spread
cancer
next to development of metastasis, ___ is the most reliable discriminator of malignant and benign tumros
invasiveness
Nearly all ___ tumors are cohesive, expansile masses that remain localized to their site of origin and lack the capacity to invade to metastasize to distant sites
benign
___ is the spread of tumor to sites that are
physically discontinuous with the primary tumor
Metastasis
what is an event the unquivocally marks a tumor as malignant
Metastasis
dissemination of metastsis occurs from what paths of spread
- direct seeding
- lymphatic spread
- hematogenous spread
___ of body cavities or surfaces: when a malignant
neoplasm penetrates a natural ‘open space’ lacking physical
barriers; characteristic in ovarian carcinomas
Direct seeding
___: most common pathway for initial
dissemination of carcinomas
Lymphatic spread
___: typical of sarcomas, but is also seen in
carcinomas
Hematogenous spread
The incidence of cancer varies with ___
geography, age, race,
and genetic background
cancer is most common in who
adults older than 55 years but occur in all ages and in children and infants
Important ___ implicated in
carcinogenesis include infectious agents, smoking, alcohol,
diet, obesity, reproductive history, and exposures to
environmental carcinogens
environmental factors
Risk is increased by ___ caused
by chronic inflammation or tissue injury, certain forms of
hyperplasia or immunodeficiency
reparative proliferations
___: normal cellular genes whose
products promote cellular proliferation
Proto-oncogenes
___: mutated or overexpressed version on
proto-oncogenes that function autonomously, having lost
dependence on normal growth-promoting signals
Oncogene
___: protein encoded by oncogene that derives
increased cancer cell proliferation, which may result from
a
variety of aberrations)
Oncoprotein
___: whereas oncogenes derive
the proliferation of cells, the product of most ___ apply brakes to cell proliferation, and
abnormalities in these genes lead to failure of growth
inhibition, another fundamental hallmark of carcinogenesis
Tumor suppressor genes; Tumor suppressor genes
___ such as RB and p53 recognize genotoxic stress from any source and respond by shutting
down proliferation
Tumor suppressor proteins such as RB and p53 recognize
genotoxic stress from any source and respond by shutting
down proliferation
Loss of function ___ mutations are associated with
retinoblastomas and osteosarcoma
retinoblastoma
Loss of function mutations of ___ is found in more than 50% of
cancers
p53
___: formation of new blood vessels
Angiogenesis
Even if a solid tumor
possesses all the genetic aberrations
that are required for malignant transformation, it cannot
enlarge beyond ___ mm in diameter unless it has the
capacity to induce angiogenesis
1-2 mm
what is essential for angiogenesis growth? what is it controlled by
Vascularization is essential for their growth and is controlled by the balance between angiogenic and anti-angiogenic factors that are produced by tumor stromal cells
what triggers angiogenesis
hypoxia
angiogenesis is a multi-factorial process and is induced by
- specific receptors on or near cell that are directly related to angiogenesis
- glucose metablism and hypoxia
1 and #2 hallmark of malignancy
- metastasis
- invasion
what are the steps of tissue invasion in malignancy
- loosening of cell-cell contact
- degeneration of extracellular matrix
- attachment to novel extracellular matrix components
- migration of tumor cells
T/F: The metastatic site of many tumors can be predicted by the location of the primary tumor
TRUE
___: normal function of the immune system to constantly scan the body for emerging malignant cells and destroy them
Immune surveillance
antitumor activity is mediated by predominantly what?
cell-mediated mechanisms (T-cell)
do immune suppressed people have an increased or decreased risk of developing cancer
INCREASED
what can alter DNA
- chemical carcinogens
- radiant energy
- tumor viruses
is carcinogenesis a multistep process
YES
! multistep process of chemical carcinogenesis
- initiation
- promotion
- progression
what step of carcinogenesis:
(1) exposure of cells to a sufficient dose of a
carcinogenic agent; it causes permanent DNA damage
(mutations)
initiation
what step of carcinogenesis:
(2) promoters
can induce tumor to arise from
initiated cells, but they are not tumorigenic by themselves;
application of promoters leads to proliferation and clonal
expansion of initiated (mutated) cells
promotion
what step of carcinogenesis:
(3) driven to proliferate, subclones of the
initiated cells suffer various additional mutations, and
eventually a cancerous clone with all the hallmarks
characteristics emerges
progression
what are major chemical carcinogens
- alkylating agents
- natural plants and microbial products
- others
___, in the form of the UV rays of sunlight or as ionizing electromagnetic and particulate radiation, is mutagenic and carcinogenic
Radiation energy
A common theme in the pathogenesis of ___ is that the infection triggers cell proliferation, which is initially polyclonal but with time becomes monoclonal by acquisition of driver mutations in rapidly dividing cells
microbial carcinogenesis
! what are oncogenic RNA viruses
HTLV-1
what is a retrovirus that is endemic in Japan, Caribbean, and parts of South America and Africa, that causes adult T-cell leukemia/lymphoma
HTLV-1
! what are oncogenic DNA viruses
- HPV
- EBV
- Hep B and C
what is an important cause of benign warts, cervical cancer, and oropharyngeal cancer; low-risk cause benign papilloma; high-risks HPVs have been implicated in this cancer and can be prevented by vaccination
HPV
what is a member of the herpesvirus family implicated in the pathogenesis of Burkitt lymphoma, nasopharyngeal carcinoma and several other cancers
EBV - Epstein-Barr
what causes 70-80% of hepatocellular carcinoma worlwide
Hep B and C
which hepatitis are chronic
B, C, D
which hepatitis are acute
A and E
which hepatitis cause liver cancer
B and C
! what are the high risk HPV types
16 and 18
! what are the low risk HPV types
6 and 11
! what are cancers, viruses or lesions that can cause EBV
- diffuse large B cell lymphoma
- Hodgkin lymphoma
- smooth muscle sarcoma
- gastric carcinoma
- nasopharyngeal carcinoma
- extra-nodal T/NK cell lymphoma
- Burkitt lymphoma
what is the first bacterium to be classified as a carcinogen?
helicobacter pylori
what bacterium is implicated in gastric adenocarcinoma and MALToma
helicobacter pylori
what is a progressive loss of body fat and lean body mass, accompanied by profound weakness, anorexia, and anemia that is caused by release of factors by tumor or host immune cells
cachexia
what are symptom complexes in individuals with cancer that cannot be explained by tumor spread of release of hormones that are indigenous to the tumor “cell of origin”
paraneoplastic syndromes
endocrinopathies (Cushing syndrome), skin disorders, skeletal and joint abnormalities, and neuropathic syndromes are examples of what
paraneoplastic syndromes
