8 Disturbances II (Starts at Malignant neoplasms) Flashcards
What are the 4 gross characteristics of a malignant neoplasm?
- poorly circumscribed
- infiltrative
- destructive invasion
- heterogenous
What are the 4 microscopic characteristics of malignant neoplasms?
- cellular variability
- necrosis
- destructive invasion
- desmoplasia
What is the growth of fibrous or connective tissues marked by proliferation of fibroblasts?
desmoplasia
What is puckering?
The infiltrative (destructive) growth pattern of a malignant neoplasm
Ulceration is an example of what characteristic of malignant neoplasia?
Destructive growth/invasion
Why would destruction of bowel wall by carcinoma be rock hard?
desmoplasia
T-F–malignant neoplasms have variable differentiation but steady growth rate?
False—variable differentiation and variable growth rate
T-F– Malignant neoplasms are not capable of metastasis?
False, they are capable of
What is defined as the resemblance to cell of origin?
Differentiation
What is defined as the lack of differentiation?
Anaplasia
What is defined as having a dark nucleus?
hyperchromasia
What is defined as having variable size and shape?
pleomorphism
T-F–malignant tumors have excess numbers of atypical mitotic figures?
True
T-F—malignant tumors have a high cytoplasmic:nuclear ratio?
False–high nuclear:cytoplasmic
What is the stromal reaction to invasive epithelial malignancies?
desmoplasia
What is a key microscopic finding in a well differentiated squamous carcinoma?
well formed keratin pearl
[however, the basal layer is not oriented correctly and cells are not maturing completely]
A malignant neoplasm of epithelial origin is called a?
carcinoma
A malignant neoplasm of mesenchymal origin is called a?
sarcoma
What are the 2 malignant neoplasms of hematopoietic origin?
Blood- Leukemia
Lymph Node- Lymphoma
Does tumor mean malignancy?
No- tumor means swelling but is now often implied to mean neoplasm
Is a mass always neoplasm?
No- its a space occupying lesion but can be neoplastic in nature
T-F–cancer encompasses all types of malignant neoplasms?
True
Does the term cancer separate primary from metastasis?
Not necessarily
Does cancer convey the heterogeneity of type and behavior of cancers?
No
What pathway of metastasis is found in the lung and the ovary?
growth within or seeding of body cavities
What pathway of metastasis is exemplified by breast and colon cancers?
lymphatic spread
What pathway of metastasis is exemplified by kidney and colon cancer?
hematogenous spread
What pathway of metastasis is exemplified by perineural invasion?
prostate
What occurs when proximal lymphatics are obstructed by neoplasm?
lymphedema
What is a proliferation of epithelial cells with cellular morphology of malignancy, but still confined within the epithelium?
carcinoma in situ
T-F—carcinoma in situ is a pre-invasive process with a high risk of metastasis?
False- no risk
What is the difference in cytology of normal squamous cells and carcinoma in situ cells?
CIS cells have very high nuclear:cytoplasm ratio
The clinical behavior of malignancy is multi-factorial–what 3 things are noted as being the multifactorial part?
- location of primary
- histology and grade of primary
- stage of primary
In general, what is the most important predictor of behavior?
Stage
The prognosis of malignancy is estimated by 6 factors mentioned in lecture, what are they? [May just review this]
- Stage
- Grade
- Metastasis to nodes or distant site
- Histologic type
- Organ of origin
- Response to therapy
What 3 main things determine stage of cancer?
- Size of primary tumor (T)
- Involvement of lymph nodes (N)
- Hematogenous metastases (M)
Review the following life threatening complications of malignancy?
cachexia infection local mass effect coagulopathy neuromayopathic syndromes paraneoplastic syndromes therapeutic toxicity
What is cachexia?
wasting
What are the major etiology of neoplasm 5?
genetic physical agents chemical agents microbiological agents iatrogenic
What are the 2 physical agents of malignancy mentioned?
ionizing radiation
ultraviolet radiation
What type of malignancy is caused by asbestos?
mesothelioma
What type of malignancy is caused by arsenic?
skin cancer
what type of malignancy is caused by aniline dye?
urinary bladder cancer
What type of malignancies are caused by tobacco products?
oral, laryngeal and lung cancers
What type of malignancy is caused by unopposed estrogen?
endometrial
The epstein barr virus causes what 2 malignancies?
Burkitt’s Lymphoma
Nasopharyngeal carcinoma
What malignancy is caused by helicobacter pylori?
gastric lymphoma
what malignancy is caused by human papilloma virus?
cervix carcinoma, oropharyngeal carcinoma
What type of malignancy is caused by hepatitis virus B or C?
hepatocellular carcinoma
What are the 3 iatrogenic ways of leading to malignancy?
immunosuppression
chemotherapy
thymic radiation
Can some malignancies be due to more than one etiology?
YES
