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01 Pathology > 9 Principles of Neoplasia > Flashcards

9 Principles of Neoplasia Flashcards

1
Q

Leading cause of death in US

A 
Heart diseases
Cancer
Cerebrovascular diseases
Chronic lower respiratory diseases (COPD)
Accidents (unintentional injuries)
Diabetes mellitus
Pneumonia and influenza
Alzheimer disease
 Nephritis, nephrotic syndrome and nephrosis
Septicemia
Suicide
Cirrhosis and chronic liver disease
Hypertension and hypertensive renal disease
Homicide (assault)
Parkinson disease
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2
Q

Leading cause of death in children

A 
Accidents
Cancer 
Congenital anomalies
Homicide
Heart disease
Suicide 
Pneumonia and influenza
Septicemia
In situ/Benign/Unknown neoplasms
Chronic lower respiratory disease
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3
Q

Leading cancer mortality in males

A 
Lung and bronchus
Prostate
Colon and rectum
Pancreas
Leukemia 
Esophagus
Liver & intrahepatic bile ducts
Non-Hodgkin lymphoma
Kidney
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4
Q

Leading cancer mortality in females

A 
Lung and bronchus
Breast
Colon and rectum
Ovary 
Pancreas 
Leukemia 
Non-Hodgkin lymphoma
Uterine corpus
Brain & nervous system
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5
Q

What is HBV relation with HCC

A

HBV by itself (without cirrhosis) increase chance of HCC by 100%

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6
Q

Geographic differences in Breast and Prostate cancer

A

Breast cancer: United States more than Japan

Prostate cancer: African American more than Caucasian

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7
Q

What is the most common cancer in children

A

Leukemia

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8
Q

What is the most common cancer find in males 15-35y

A

Testicular cancer

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9
Q

What is the most common cancer in elderlies

A

Colorectal carcinomas

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10
Q

What cancers are predisposed by Neurofibromatosis

A

Meningiomas

Pheochromocytomas

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11
Q

What cancer is predisposed by Prenicious anemia

A

Gastric cancer

Chronic atrophic gastritis: ↑Macrophages> ↑Mitogenic molecules

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12
Q

Generally carcinogens divide into what categories

A

Initiators: Direct-acting, Indirect-acting(procarcinogens)
Promotors: Cause cellular proliferation

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13
Q

Which cancer associated with Nitrosamines

A

Gastric cancer > Pickled vegetables

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14
Q

Which cancer associated with Cigarette smoke

A

multiple malignancies > 60 carcinogens

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15
Q

Which cancer associated with Polycylic aromatic hydrocarbons

A

bronchogenic carcinoma > benzopyrene in cigarette smoke

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16
Q

Which cancer associated with Asbestos

A

bronchogenic carcinoma, mesothelioma

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17
Q

Which cancer associated with Chromium and nickel

A

bronchogenic carcinoma

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18
Q

Which cancer associated with Arsenic

A

squamous cell carcinomas of skin and lung, Angiosarcoma of liver

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19
Q

Which cancer associated with Vinyl chloride

A

Angiosarcoma of liver

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20
Q

Which cancer associated with Aromatic amines and azo dyes

A

hepatocellular carcinoma

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21
Q

Which cancer associated with Alkalating agents

A

leukemia, lymphoma, other cancers

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22
Q

Which cancer associated with Benezene

A

leukemia

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23
Q

Which cancer associated with Napthylamine

A

bladder cancer

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24
Q

What diseases are related to defect in DNA repair

pattern of inheritance

A

Xeroderma pimentosum: Autosomal recessive

Hereditary non polyposis colorectal cancer

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25
Q

Effects of Ultraviolet radiation

which radiation is damaging

A

UVB sunlight is the most carcinogenic

Produces pyrimidine dimers in DNA leading to transcriptional errors and mutations of onogenes and tumor suppressor genes

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26
Q

Effects of Ionizing radiation

What Phases they involve

A

Causes cross-linking and chain breaks in nucleic acids

Mitosis or the G2 phase

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27
Q

what cancers are prevalent in Atomic bomb survivors and

Uranium miners

A

leukemias, thyroid cancer, other cancers

lung cancer

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28
Q

name Oncogenic viruses

A

RNA: HTLV-l causes adult T-cell leukemia/lymphoma
DNA: Hepatitis B virus
EBV, HPV Types 16, 18, 31, 33
HHV8 causes Kaposi sarcoma

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29
Q

What malignancies associated with Epstein-Barr virus

A

Burkitt lymphoma, B-cell lymphomas in immunsuppressed patients, Nasopharyngeal carcinoma

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30
Q

What is the mechanism of HPV virus to produce malignancies

A

Elongation factors
E6: binds to p53 which prevent mutated cell to enter cycle
E7: binds to Rb gene which regulates growth arrest

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31
Q

How does oncogenes produced

A

Oncogenes are derived from proto-oncogenes
by a change in the gene sequence, resulting in a new gene product (oncoprotein)
Loss of gene regulation resulting in overexpression

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32
Q

What are mechanisms of oncogene activation

A

Point mutations
Chromosomal translocations
Gene amplification
Insertional mutagenesis

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33
Q

Name some Growth factors oncogenes

A

hst-1 and int-2: Cancer of the stomach, breast, bladder, and melanoma
sis: Astrocytoma

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34
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from hst-1 and int-2 Oncogene

A

Cancer of the stomach, breast, bladder, and melanoma
Fibroblast growth factor
Overexpression

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35
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from sis Oncogene

A

Astrocytoma
Platelet-derived growth factor
Overexpression

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36
Q

Name some Growth factor receptors oncogenes

A

erb-B1: SCC of lung
erb-B2 (HER-2): Breast, ovary, lung
erb-B3: Breast
ret: MEN II & III, thyroid (medullary) cancer

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37
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from erb-B1 Oncogene

A

SCC of lung
Epidermal growth factor receptor
Overexpression

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38
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from erb-B2 Oncogene

A

HER2: Breast, ovary, lung
Epidermal growth factor receptor
Amplification

39
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from erb-B3 Oncogene

A

Breast
Epidermal growth factor receptor
Overexpression

40
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from ret Oncogene

A

MEN II & III, thyroid (medullary) cancer
familial Glial neurotrophic factor receptor
Point mutation

41
Q

Name some Signal Transduction Proteins oncogenes

A 
abl: CML,ALL
Ki-ras: Lung, pancreas, and colon
c-myc: Burkitt lymphoma
L-myc: Small cell lung carcinoma
N-myc: Neuroblastoma
42
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from abl Oncogene

A

CML,ALL
bcr-abl fusion protein with tyrosine kinase activity
Translocation t(9;22)

43
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from Ki-ras Oncogene

A

Lung, pancreas, and colon
GTP binding protein
Point mutation

44
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from c-myc Oncogene

A

Burkitt lymphoma
Nuclear regulatory protein
Translocation t(8;14)

45
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from L-myc Oncogene

A

Small cell lung carcinoma
Nuclear regulatory protein
Amplification

46
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from N-myc Oncogene

A

Neuroblastoma
Nuclear regulatory protein
Amplification

47
Q

Name some Cell cycle regulatory proteins oncogenes

A

bcl-1: Mantle cell lymphoma

CDK4: Melanoma, GBM

48
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from bcl-1 Oncogene

A

Mantle cell lymphoma
Cyclin D protein
Translocation t(11;14)

49
Q

What are the Tumor, Gene Product, Mechanism of Activation derived from CDK4 Oncogene

A

Melanoma, GBM
Cyclin dependent kinase
Amplification

50
Q

Which tumors and chromosomes are related with tumor suppressor gene VHL

A

3p25

von Hippel-Lindau disease, renal cell carcinoma

51
Q

Which tumors and chromosomes are related with tumor suppressor gene WT-1

A

11p13

Wilm tumor

52
Q

Which tumors and chromosomes are related with tumor suppressor gene WT-2

A

11p15

Wilm tumor

53
Q

Which tumors and chromosomes are related with tumor suppressor gene Rb
What is familital retinoblastoma

A

13q14
Retinoblastoma, osteosarcoma
Rb prevents the cell from entering S-phase until the appropriate growth signals are present

Germ-line mutation of Rb on chromosome 13 > higher rates of those malignancies

54
Q

Which tumors and chromosomes are related with tumor suppressor gene P53
what syndrome does it cause in case of inheritance

A

17q13
Lung, breast, colon, etc
p53 prevents a cell with damaged DNA from entering S-phase

Li-Fraumini syndrome: Germ-line mutation of p53 on chromosome 17, High rate of many types of tumors

55
Q

Which tumors and chromosomes are related with tumor suppressor gene BRCA-1

A

17q12-21

Hereditary breast and ovary cancer

56
Q

Which tumors and chromosomes are related with tumor suppressor gene BRCA-2

A

13q12-13

Hereditary breast cancer

57
Q

Which tumors and chromosomes are related with tumor suppressor gene APC

A

5q21

Adenomatous polyps and colon cancer

58
Q

Which tumors and chromosomes are related with tumor suppressor gene DCC

A

18q21

Colon cancer

59
Q

Which tumors and chromosomes are related with tumor suppressor gene NF-1

A

17q11.2

Neurofibromas

60
Q

Which tumors and chromosomes are related with tumor suppressor gene NF-2

A

22q12

Acoustic neuromas, meningiomas

61
Q

What is the mechanism of action of NF family as tumor suppressors

A

Suppress transduction of cell signals by binding to GTP binding protein or RAS proto-oncogenes

62
Q

name some gene that work in Regulation of apoptosis

A

bcl-2
bax, bad, bcl-xS, bid
c-myc

63
Q

What cancer is produced by bcl-2 gen and what is the mechanism

A

Overexpressed in follicular lymphomas t(14:18)
• Chromosome 14: immunoglobulin heavy chain gene
• Chromosome 18: bcl-2

64
Q

How does c-my control apoptosis

A

Promotes cellular proliferation
When associated with p53 leads to apoptosis
When associated with bcl-2 inhibits apoptosis

65
Q

how does p53 promotes apoptosis

A

p53 Promotes apoptosis in mutated cells by stimulating bax synthesis

66
Q

Gross and microscopic features of benign tumors

A

Small size
Slow growing
Encapsulated or well-demarcated borders
Expansile growth with well-circumscribed borders
Tend to be well differentiated
Resemble the normal tissue counterpart from which they arise
Noninvasive and never metastasize

67
Q

Gross and microscopic features of malignant tumors

A

Larger in size
Rapid growth
Necrosis and hemorrhage are commonly seen
Poorly demarcated
Vary from well to poorly (anaplastic)differentiated
Tumor cells vary in size and shape (pleomorphism)
Increased nuclear to cytoplasmic ratios > aneuploidy
Nuclear hyperchromasia and prominent nucleoli
High mitotic activity with abnormal mitotic figures
Invasive growth pattern
Has potential to metastasize

68
Q

How can we diagnose a cancer

A 
Histologic diagnosis
Complete excision
Biopsy
Fine needle aspiration
Cytologic smears (Pap smear)
69
Q

what monoclnal antibody can we use to recognize thyroid cancers

A

Thyroglobulin

70
Q

what monoclnal antibody can we use to recognize melanoma

A

S100

100% soluble in persulfate

71
Q

what monoclnal antibody can we use to recognize neural tumors

A

S100

100% soluble in persulfate

72
Q

what monoclnal antibody can we use to recognize smooth and skeletal muscle

A

Actin

Intermediate filaments: Desmin

73
Q

what monoclnal antibody can we use to recognize lymphomas/leukemias

A

CD markers

74
Q

what monoclnal antibody can we use to recognize breast cancer

A

Estrogen receptors

75
Q

what monoclnal antibody can we use to recognize Epithelial cell Carcinomas

A

Intermediate filaments: Keratin

76
Q

what monoclnal antibody can we use to recognize Mesenchymal cell Sarcomas

A

Intermediate filaments: Vimentin

77
Q

what monoclnal antibody can we use to recognize Pheochromocytoma

A

Intermediate filaments: Neurofilament

78
Q

what monoclnal antibody can we use to recognize Neuroblastoma

A

Intermediate filaments: Neurofilament

79
Q

what monoclnal antibody can we use to recognize Astrocytomas

A

Intermediate filaments: Glial fibrillary acidic protein (GFAP)

80
Q

what monoclnal antibody can we use to recognize Ependymomas

A

Intermediate filaments: Glial fibrillary acidic protein (GFAP)

81
Q

In which tumors levels of Alpha fetoprotein will rise

A

HCC, nonseminomatous testicular germ-cell tumors > Yolc sac

82
Q

In which tumors levels of Beta human chorionic gonadotropin will rise

A

Trophoblastic tumors, choriocarcinoma

83
Q

In which tumors levels of Calcitonin will rise

A

medullary carcinoma of the thyroid

84
Q

In which tumors levels of Carcinoembryonic antigen will rise

in which normal conditions

A

carcinomas of the lung, pancreas, stomach, breast, and colon

Emphysema, Gastritis, Smoking, ulcerative colitis

85
Q

In which tumors levels of CA-125 will rise

in which normal conditions

A

ovarian cancer

Tuboovarian abscess, Endometriosis

86
Q

In which tumors levels of CA19-9 will rise

in which normal conditions

A

pancreatic cancer

Pancreatitis

87
Q

In which tumors levels of Placental alkaline phosphatase will rise

A

seminoma

88
Q

In which tumors levels of PSA will rise

in which normal conditions

A

prostate cancer

Prostitis, BPH, prostate infarction

89
Q

What is grading and what is staging in tumors

A

Grade: Histologic estimate: Degree of differentiation, Number of mitosis
Stage: TNM

90
Q

Which well differentiated Tumor is very aggressive and metastasize pretty soon

A

Follicular carcinoma of thyroid

91
Q

which tumors use lymphatic spread as initial route of spreading

A

Epithelial carcinomas

92
Q

which tumors use Hematogenous spread as initial route of spreading

A 
Most sarcomas
Renal cell carcinoma
Hepatocellular carcinoma.
Follicular carcinoma of the thyroid
Choriocarcinoma
93
Q

which tumors use Seeding spread as initial route of spreading

A

Ovarian carcinoma

94
Q

which tumors can be Transplanted via mechanical manipulation (e.g., surgical incision, needle tracts)

A

Although Very rare

May be seen in osteogenic sarcoma

01 Pathology (2 decks)

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