Benign and Malignant Tumors Flashcards
What are the four properties of cancer?
uncontrolled growth
invasion and metastasis
clonal dominance/monoclonality (common ancestor cell)
Loss of differentiation (forgets what it is and what it should be doing)
What are found at the stromal side?
lymphatic vessels and blood vessels
if you have disease that is on the epithelial side and hasnt broken through the basemement membrane, what does this tell you?
It hasn’t metastasized and you can get that sucker out
Desmoids are difficult to identify has metastasized or not, Why?
because they dont have a basement membrane
Where do carcinomas travel?
Where do sarcomas travel?
lymphatics
blood
What are the three routes of malignant neoplasm metastasis?
lymphatic spread (regional lymph nodes usually affected first) Hematogenous spred (lung, liver, brain, bone marrow and adrenals) Transcoelomic spread (seeding of body cavities, often seen in periotoneal, pleural, pericardial and subarachnoid spaces)
What is the importance of grading and staging of cancer?
estimating aggressiveness
planning therapy
How is grading done? What are the grades? what does it describe?
microscope
I-IV,
well, moderately, poorly differentiated and undifferentiated
What is staging?
What does it utilize?
anatomic extent of tumor
TNM (Tumor, lymph Node, Metatases)
AJC
Describe the TNM
T(tumor)0-3 little to biggest
N (nodes) 0-2 1=1 2=3
M (metastases) 0, 1 (possible), X (has)
The kinetics of tumor growth involves what?
doubling time, growth fraction, cell production and loss(apoptois)
What are the clinical implications of tumor growth?
susceptibility to chemotherapy
latent period before detection
tumor progression and heterogenity (cells in cancer come from common ancestor but express differntly and are at different stage of cell cycle)
(blank) are heterogeneous with respect to invasiveness, metastatic ablility, antigenicity and responsiveness to chemotherapy.
What do we classify this as?
Mutant subclones
Tumor Progression and heterogenity
What are host factors that affect tumor growth?
angiogenesis (necessary for tumor growth beyond 1 to 2 mm and aids metastaes)
hormones (breast and prostate tumors need these)
What are mechanisms of invasion and metastasis?
1)cells must become less cohesive (cadherins reduced)
2)Attachment to matrix components (lamin and fibronectin)
3)Degredation of ECM (metalloproteinases- 4)collagenases and plasmin)
Migration ( cytokins and cleavage products of ECM)
Vascular dissemination and homing of tumor cells is done how?
Can form emboli with leukocytes and platlets or circulate as single cells
Eventual site of metastases- “Organ tropism” or “poor soil”
Likes to infect lung and liver and NOT kidney and spleen
Cancer is a largely a disease of (blank)
aging
Most cancers occur after the age
of (blank). So there is no evolutionary selection pressure that has equipped us to deal with this disease and Cancer is a disease of our (blank)
procreation
own cells
Li Fraumeni syndrome
Inherit one mutant TP53 (or RB)
Marked increased risk of multiple types of malignancies
Requires mutation of second normal allele
Inherited retinoblastoma gene
Adenomatous polyposis coli
One defective APC gene inherited
Loss of the second APC leads to hundreds of colon adenomas (polyps) by age 20
Very high risk of adenocarcinoma of colon
additional mutations required
inherited cancers.
