8 Disturbances II (Starts at Malignant neoplasms)

Question 1

What are the 4 gross characteristics of a malignant neoplasm?

Answer 1

• poorly circumscribed
• infiltrative
• destructive invasion
• heterogenous

Question 2

What are the 4 microscopic characteristics of malignant neoplasms?

Answer 2

• cellular variability
• necrosis
• destructive invasion
• desmoplasia

Question 3

What is the growth of fibrous or connective tissues marked by proliferation of fibroblasts?

Answer 3

desmoplasia

Question 4

What is puckering?

Answer 4

The infiltrative (destructive) growth pattern of a malignant neoplasm

Question 5

Ulceration is an example of what characteristic of malignant neoplasia?

Answer 5

Destructive growth/invasion

Question 6

Why would destruction of bowel wall by carcinoma be rock hard?

Answer 6

desmoplasia

Question 7

T-F–malignant neoplasms have variable differentiation but steady growth rate?

Answer 7

False—variable differentiation and variable growth rate

Question 8

T-F– Malignant neoplasms are not capable of metastasis?

Answer 8

False, they are capable of

Question 9

What is defined as the resemblance to cell of origin?

Answer 9

Differentiation

Question 10

What is defined as the lack of differentiation?

Answer 10

Anaplasia

Question 11

What is defined as having a dark nucleus?

Answer 11

hyperchromasia

Question 12

What is defined as having variable size and shape?

Answer 12

pleomorphism

Question 13

T-F–malignant tumors have excess numbers of atypical mitotic figures?

Answer 13

True

Question 14

T-F—malignant tumors have a high cytoplasmic:nuclear ratio?

Answer 14

False–high nuclear:cytoplasmic

Question 15

What is the stromal reaction to invasive epithelial malignancies?

Answer 15

desmoplasia

Question 16

What is a key microscopic finding in a well differentiated squamous carcinoma?

Answer 16

well formed keratin pearl

[however, the basal layer is not oriented correctly and cells are not maturing completely]

Question 17

A malignant neoplasm of epithelial origin is called a?

Answer 17

carcinoma

Question 18

A malignant neoplasm of mesenchymal origin is called a?

Answer 18

sarcoma

Question 19

What are the 2 malignant neoplasms of hematopoietic origin?

Answer 19

Blood- Leukemia

Lymph Node- Lymphoma

Question 20

Does tumor mean malignancy?

Answer 20

No- tumor means swelling but is now often implied to mean neoplasm

Question 21

Is a mass always neoplasm?

Answer 21

No- its a space occupying lesion but can be neoplastic in nature

Question 22

T-F–cancer encompasses all types of malignant neoplasms?

Answer 22

True

Question 23

Does the term cancer separate primary from metastasis?

Answer 23

Not necessarily

Question 24

Does cancer convey the heterogeneity of type and behavior of cancers?

Answer 24

No

Question 25

What pathway of metastasis is found in the lung and the ovary?

Answer 25

growth within or seeding of body cavities

Question 26

What pathway of metastasis is exemplified by breast and colon cancers?

Answer 26

lymphatic spread

Question 27

What pathway of metastasis is exemplified by kidney and colon cancer?

Answer 27

hematogenous spread

Question 28

What pathway of metastasis is exemplified by perineural invasion?

Answer 28

prostate

Question 29

What occurs when proximal lymphatics are obstructed by neoplasm?

Answer 29

lymphedema

Question 30

What is a proliferation of epithelial cells with cellular morphology of malignancy, but still confined within the epithelium?

Answer 30

carcinoma in situ

Question 31

T-F---carcinoma in situ is a pre-invasive process with a high risk of metastasis?

Answer 31

False- no risk

Question 32

What is the difference in cytology of normal squamous cells and carcinoma in situ cells?

Answer 32

CIS cells have very high nuclear:cytoplasm ratio

Question 33

The clinical behavior of malignancy is multi-factorial--what 3 things are noted as being the multifactorial part?

Answer 33

1. location of primary 2. histology and grade of primary 3. stage of primary

Question 34

In general, what is the most important predictor of behavior?

Answer 34

Stage

Question 35

The prognosis of malignancy is estimated by 6 factors mentioned in lecture, what are they? [May just review this]

Answer 35

1. Stage 2. Grade 3. Metastasis to nodes or distant site 4. Histologic type 5. Organ of origin 6. Response to therapy

Question 36

What 3 main things determine stage of cancer?

Answer 36

1. Size of primary tumor (T) 2. Involvement of lymph nodes (N) 3. Hematogenous metastases (M)

Question 37

Review the following life threatening complications of malignancy?

Answer 37

``` cachexia infection local mass effect coagulopathy neuromayopathic syndromes paraneoplastic syndromes therapeutic toxicity ```

Question 38

What is cachexia?

Answer 38

wasting

Question 39

What are the major etiology of neoplasm 5?

Answer 39

``` genetic physical agents chemical agents microbiological agents iatrogenic ```

Question 40

What are the 2 physical agents of malignancy mentioned?

Answer 40

ionizing radiation | ultraviolet radiation

Question 41

What type of malignancy is caused by asbestos?

Answer 41

mesothelioma

Question 42

What type of malignancy is caused by arsenic?

Answer 42

skin cancer

Question 43

what type of malignancy is caused by aniline dye?

Answer 43

urinary bladder cancer

Question 44

What type of malignancies are caused by tobacco products?

Answer 44

oral, laryngeal and lung cancers

Question 45

What type of malignancy is caused by unopposed estrogen?

Answer 45

endometrial

Question 46

The epstein barr virus causes what 2 malignancies?

Answer 46

Burkitt's Lymphoma | Nasopharyngeal carcinoma

Question 47

What malignancy is caused by helicobacter pylori?

Answer 47

gastric lymphoma

Question 48

what malignancy is caused by human papilloma virus?

Answer 48

cervix carcinoma, oropharyngeal carcinoma

Question 49

What type of malignancy is caused by hepatitis virus B or C?

Answer 49

hepatocellular carcinoma

Question 50

What are the 3 iatrogenic ways of leading to malignancy?

Answer 50

immunosuppression chemotherapy thymic radiation

Question 51

Can some malignancies be due to more than one etiology?

Answer 51

YES