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1 Path Unit > 9 Laboratory Diagnosis of Neoplasia > Flashcards

9 Laboratory Diagnosis of Neoplasia Flashcards

1
Q

What are some examples of morphologic based tests?

A

cytology, histology, immunohistochemistry

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2
Q

what are the applications for serologic tumor markers?

A

screening, diagnosis, prognosis, and monitoring treatment response

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3
Q

T/F: Tumor markers are serologic markers that are only present in people with cancer.

A

F; tumor markers may be expressed in diseases other than cancer

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4
Q

What type of antigens are commonly used as serologic markers?

A

oncofetal antigens, expressed in fetal tissue but not typically in adults

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5
Q

what are the two best known serologic tumor markers?

A

CEA (carcinoembryonic antigen) and AFP (alpha-fetoprotein)

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6
Q

For what type of cancers is CEA the most widely used marker? what other types of cancers may it be used for?

A

Most widely used for gastrointestinal cancers, also used for some breast, liver, and lung cancers

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7
Q

Why isn’t CEA used for screening in asymptomatic patients?

A

It has low positive predictive value and has limited value in screening asymptomatic patients.

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8
Q

Why is CEA used to follow patients in whom it was elevated pre-operatively?

A

rising postoperative levels can be evidence of recurrence

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9
Q

What other condition can lead to an elevation in CEA, and could therefore create a false positive?

A

elevations in serum CEA may be due to liver disease

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10
Q

T/F: highly elevated CEA prior to surgery may be associated with metastases and a worse prognosis

A

T

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11
Q

Where is AFP synthesized in the embryo and fetus?

A

yolk sac and hepatocytes

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12
Q

What is AFP most useful in diagnosing when elevated in adults?

A

hepatocellular carcinoma and germ cell tumors that have yolk sac like differentiation (endodermal sinus tumor in the ovary and yolk sac tumor in the testes)

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13
Q

In what cancers is CA 125 elevated?

A

CA 125 is high in >75% of epithelial ovarian carcinomas, and can also be elevated in benign and malignant uterine tumors.

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14
Q

T/F: A decline in CA 125 during treatment of ovarian carcinoma means the cancer is being successfully treated.

A

F; CA 125 can show a false decline during therapy of ovarian carcinoma.

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15
Q

In what cancers is CA 19-9 elevated?

A

pancreatic, colorectal carcinoma, and gastric carcinoma

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16
Q

T/F: CA 19-9 is related to Lewis blood group substances.

A

T

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17
Q

Where is PSA produced? What is it used to screen for?

A

produced in the epithelial cells of the prostate gland; it is used to screen for prostate carcinoma and is also used in post surgical followup

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18
Q

Which is greater, the sensitivity or specificity of PSA as a screen for prostate carcinoma? why?

A

The sensitivity is better. PSA may also be elevated in infection, hyperplasia, or other benign processes.

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19
Q

what are normal levels of PSA in the blood?

A

0-4 ng/ml

20
Q

what does a detectable level of PSA following a total prostatectomy indicate?

A

Metastasis or recurrence

21
Q

name the 5 major categories of malignancy

A

carcinoma, hematopoietic neoplasia, sarcoma, melanoma, and neuroepithelial

22
Q

What is a malignancy of epithelial-derived tissues called?

A

carcinoma

23
Q

Breast, colon, lung, and ovary cancers are usually what type of malignancy?

A

carcinomas

24
Q

What is a malignancy of blood element-derived tissues called?

A

hematopoietic neoplasia

25
Q

What is a malignancy of mesenchymal tissues called? what are mesenchymal tissues?

A

sarcoma; bone, muscle, vessels

26
Q

What is a malignancy of CNS or PNS tissues called?

A

neuroepithelial tissues

27
Q

What is cytology?

A

a morphologic based test that relies on individual cells or small clusters of cells with little or no reliance on the microscopic architecture of the lesion

28
Q

T/F: Nuclear:cytoplasmic ratio is decreased in malignancy

A

F, it is increased

29
Q

Are body fluids examined using exfoliative or aspiration cytology?

A

exfoliative

30
Q

what type of cytology is a pap smear (exfoliative or aspiration)?

A

exfoliative

31
Q

T/F: FNA of deep-seated lesions can be performed using CT or ultrasound guidance

A

T

32
Q

What are some of the drawbacks of using cytology in diagnosis of malignancies?

A

1) Some malignancies cannot be conclusively diagnosed with cytology
2) cytology cannot give a complete prognosis
3) it cannot determine the extent of the carcinoma in some situations

33
Q

What are some of the histologic features of adenocarcinomas?

A

cohesive cells that form glands

34
Q

What are some of the histologic features of squamous carcinomas?

A

cohesive cells with intercellular bridges and keratinization

35
Q

What are some of the general histologic features of hematopoietic tumors?

A

discohesive cells with no intercellular bridges or gland formation

36
Q

What are some of the histologic features of leukemias?

A

may have cell features of immature myeloid cells of marrow, all of one type and stage of maturation

37
Q

What are some of the histologic features of sarcomas?

A

often have spindle cells, and often cohesive without intracellular bridges

38
Q

what is a smooth muscle malignancy called?

A

leiomyosarcoma

39
Q

what is a myofibroblast malignancy called?

A

fibrosarcoma

40
Q

what is a peripheral nerve malignancy called?

A

neurofibrosarcoma

41
Q

what is a skeletal muscle malignancy called?

A

rhabdomyosarcoma

42
Q

what type of malignancy is pigmented and contains a mixed cellular appearance with large epithelioid cells and bizarre nuclei?

A

melanoma

43
Q

what is immunohistochemistry?

A

a technique that allows use of specific antibodies to be reacted on tissue slides to identify markers of interest

44
Q

T/F: immunohistochemistry alone is insufficient for diagnosis of a malignancy.

A

T, must be used in conjunction with histology or cytology

45
Q

what are some of the major uses of immunohistochemistry?

A

1) Categorization of tumors
2) Classification of malignant neoplasms, particularly lymphoma
3) Determination of origin of metastatic tumors
4) Detection of molecules for therapeutic significance

1 Path Unit (16 decks)

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