Block 1 Lab Dx of Neoplasia

Question 1

Local clinical signs of neoplasia

Answer 1

Asymmetry, fixation, firmness of tissue, compression, inflammation

Question 2

Systemic signs of neoplasia

Answer 2

Low grade recurrent fever, pruritis, fatigue/ loss of appetite/ weight loss, anemia, jaundice, cachexia; resp/ liver failure, pathologic fx, cerebral dysfxn, chronic renal failure, immunodeficiency

Question 3

Local complications of neoplasia

Answer 3

Obstruction, infection, destruction of critical structure, hemorrhage, ulceration, infarction

Question 4

Paraneoplastic syndrome

Answer 4

Combination of signs/symptoms in pt with cancer that can’t be attributed to location of primary tumor or meatless or the secretion of hormones indigenous to tissue from which tumor is derived

Question 5

Paraneoplastic syndrome examples

Answer 5

Cushing syndrome, hypercalcemia, DIC, carcinoid syndrome, polycythemia, SIADH, etc.

Question 6

Benign vs. malignant: growth rate, differentiation, & nucleus

Answer 6

Benign: slow GR, well diff, normal nuc
Malig: high GR, poorly diff, hyperchromatic nuc

Question 7

Benign vs. malignant: invasion, metastases, direction of growth

Answer 7

Benign: no invasion, no metastases, exophytic growth
Malig: invasion, metastases, endophytic growth

Question 8

Benign vs. malignant: border, necrosis

Answer 8

Benign: circumscribed, rare necrosis
Malig: ill-defined, frequent necrosis

Question 9

Adenoma vs. papilloma

Answer 9

A: benign tumor arising from glandular or secretory epithelium
P: benign tumor arising from non-secretory epithelium

Question 10

Carcinoma vs. sarcoma

Answer 10

C: malignant epithelial neoplasm
S: malignant mesenchymal neoplasm

Question 11

Leiomyoma vs. rhabdomyoma

Answer 11

L: SM origin
R: sk mm origin

Question 12

Teratoma

Answer 12

Neoplasm with components of all three germ cell layers

Question 13

Dysplasia

Answer 13

Disorderly growth of epithelium with pleomorphism and loss of architectural orientation

Question 14

Carcinoma in-situ

Answer 14

Full thickness change in epithelium

Question 15

CIN-1 (Pap smear)

Answer 15

Mild dysplasia; mild increase in NC ratio, hyperchromasia, abnormal chromatin pattern

Question 16

CIN-3 (Pap smear)

Answer 16

Severe dysplasia; basal type cells with high NC ratio, marked hyperchromasia & chromatin abnormality; mitotic figures near surface

Question 17

Tumor shapes: sessile, fungating, pedunculated polyp

Answer 17

S: raised, flat
F: growing in all directions, above and below original plane
PP: like a lollipop

Question 18

Tumor shapes: ulcerated, papillary, annular

Answer 18

U: raised edges with depressed middle
P: finger-like projections
A: enclosing the lumen

Question 19

Nuclear morphology of cancer

Answer 19

Pleomorphism (variation in shape, size), increased NC ratio, hyperchromasia (increased nuclear chromatin), atypical mitoses, nuclear position

Question 20

Histopathologic dx of cancer

Answer 20

Pleomorphism, increased mitoses, degree of differentiation/anaplasia, invasion (past BM), metastases, necrosis

Question 21

Grade vs. stage

Answer 21

G: degree of differentiation; determined based on histopathology
S: size, dissemination of tumor; determined based on imaging studies

Question 22

Grading of tumor

Answer 22

Low grade (1,2) = well differentiated
Int grade (2,3) = moderately diff
High grade (3,4) = poorly diff
High grade (4) = anaplastic, undifferentiated

Question 23

Staging criteria

Answer 23

Size of primary lesion, # tumor foci (solitary vs. multifocal), local spread (to LN), systemic spread/ metastases, clinical features (e.g. fever)
TNM = tumor size and # (T), spread to nodes (N), metastases (M)

Question 24

Pathologic prognosis

Answer 24

Type of neoplasm, benign vs. malig, grade, invasion, margins, pathologic stage

Question 25

Prognostic features

Answer 25

Grade, stage, tumor markers, DNA content, cell cycle analysis, karyotypic changes, gene rearrangement, molecular signature