Block 1 Lab Dx of Neoplasia Flashcards
Local clinical signs of neoplasia
Asymmetry, fixation, firmness of tissue, compression, inflammation
Systemic signs of neoplasia
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
Local complications of neoplasia
Obstruction, infection, destruction of critical structure, hemorrhage, ulceration, infarction
Paraneoplastic syndrome
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
Paraneoplastic syndrome examples
Cushing syndrome, hypercalcemia, DIC, carcinoid syndrome, polycythemia, SIADH, etc.
Benign vs. malignant: growth rate, differentiation, & nucleus
Benign: slow GR, well diff, normal nuc
Malig: high GR, poorly diff, hyperchromatic nuc
Benign vs. malignant: invasion, metastases, direction of growth
Benign: no invasion, no metastases, exophytic growth
Malig: invasion, metastases, endophytic growth
Benign vs. malignant: border, necrosis
Benign: circumscribed, rare necrosis
Malig: ill-defined, frequent necrosis
Adenoma vs. papilloma
A: benign tumor arising from glandular or secretory epithelium
P: benign tumor arising from non-secretory epithelium
Carcinoma vs. sarcoma
C: malignant epithelial neoplasm
S: malignant mesenchymal neoplasm
Leiomyoma vs. rhabdomyoma
L: SM origin
R: sk mm origin
Teratoma
Neoplasm with components of all three germ cell layers
Dysplasia
Disorderly growth of epithelium with pleomorphism and loss of architectural orientation
Carcinoma in-situ
Full thickness change in epithelium
CIN-1 (Pap smear)
Mild dysplasia; mild increase in NC ratio, hyperchromasia, abnormal chromatin pattern
CIN-3 (Pap smear)
Severe dysplasia; basal type cells with high NC ratio, marked hyperchromasia & chromatin abnormality; mitotic figures near surface
Tumor shapes: sessile, fungating, pedunculated polyp
S: raised, flat
F: growing in all directions, above and below original plane
PP: like a lollipop
Tumor shapes: ulcerated, papillary, annular
U: raised edges with depressed middle
P: finger-like projections
A: enclosing the lumen
Nuclear morphology of cancer
Pleomorphism (variation in shape, size), increased NC ratio, hyperchromasia (increased nuclear chromatin), atypical mitoses, nuclear position
Histopathologic dx of cancer
Pleomorphism, increased mitoses, degree of differentiation/anaplasia, invasion (past BM), metastases, necrosis
Grade vs. stage
G: degree of differentiation; determined based on histopathology
S: size, dissemination of tumor; determined based on imaging studies
Grading of tumor
Low grade (1,2) = well differentiated Int grade (2,3) = moderately diff High grade (3,4) = poorly diff High grade (4) = anaplastic, undifferentiated
Staging criteria
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)
Pathologic prognosis
Type of neoplasm, benign vs. malig, grade, invasion, margins, pathologic stage
Prognostic features
Grade, stage, tumor markers, DNA content, cell cycle analysis, karyotypic changes, gene rearrangement, molecular signature
