Cancer Flashcards
What is the progression of cancer?
Normal Hyperplasia Dysplasia Carcinoma in situ Invasive carcinoma (E-cadherin inactivated, no cell-cell adhesion) Metastasis
What are the features of anaplasia?
clumping nuclear chromatin high N/C ratio mitotic figures prominent nucleoli more primitive/less mature may see giant cells
T/F Neoplasia means malignancy.
F. may be benign or malignant
What is desmoplasia?
fibrous tissue after a neoplasm
Describe grading and staging a tumor.
grade: 1-4. 1: well differentiated. 4: poorly differentiated.
stage: TNM
tumor size
nodal involvement
metastasis
Which cancers metastasize to the liver?
Cancer Sometimes Penetrates Benign Liver Colon Stomach Pancreas Breast Lung
What is the origin, stain, and spread of carcinoma and sarcoma?
carcinoma–epithelial, spread by lymph, cytokeratin stain
sarcoma-mesenchymal, spread by blood
What are the benign and malignant forms of the following? blood vessels smooth muscle striated muscle CT
blood vessels:
benign: hemangioma; malignant: angiosarcoma
smooth muscle:
benign: leiomyoma; malignant: leiomyosarcoma
striated muscle:
benign: rhabdomyoma; malignant: rhabdomyosarcoma
CT
benign: fibroma; malignant: fibrosarcoma
What is cachexia?
weight loss and loss of fat and lean muscle
b/c of increased basal metabolic rate from release of TNFalpha, IFNgamma, IL-1, IL-6 from chronic disease
What are the paraneoplastic syndromes created by small cell lung cancer?
ACTH-Cushing’s
ADH-SIADH
Lambert Eaton–muscle weakness better w/ use, antibodies to presynaptic Ca++ channels at NMJ
PTHrP
What are the paraneoplastic syndromes created by renal cell carcinoma?
ACTH
PTHrP
EPO
Which cancers can cause increased EPO release and polycythemia?
Potentially Really High HCT Pheochromocytoma Renal Cell Carcinoma Hemangioblastoma Hepatocellular carcinoma leimyomas (fibroids that bleed may not cause anemia b/c also secrete EPO)
When do you see PSaMMOma bodies?
papillary carcinoma thyroid
serous papillary cystadenocarcinoma of ovary
meningioma
malignant mesothelioma
Which tumors give mets to the brain?
Lots of Bad Stuff Kills Glia Lung Breast Skin (melanoma) Kidney (RCC) GI (colon)
Which tumors give mets to the bone?
Permanently Relocated Tumors Like Bone
**genitourinary:
Prostate (blastic)
RCC (lytic)
Thyroid (lytic)
lung (mixed)
Breast (mixed)
What are the following associated w/?
BCR-ABL
BCL-2
BCR-ABL; oncogene
a part of the PHiladelphia chromosome t(9;22) CML, ALL
tyrosine kinase intracellular
BCL-2; oncogene
antiapoptotic
follicular lymphoma
What are the following associated w/?
c-myc
L-myc
N-myc
all oncogenes
c-myc: burkitt lymphoma, transcription factor
L-myc: lung tumor, transcription factor
N-myc: neuroblastoma, transcription factor
What are the following related to?
DCC
DPC4/SMAD4
NF1
NF1
all tumor suppressor genes
DCC: colon cancer
DPC4: pancreatic cancer
NF1: chromosome 17; neurofibromatosis type 1
NF2; chromosome 22; NF2, related to acoustic schwannomas
Describe what Rb does.
Rb regulates transition from G1–>S
binds E2F
released when it is phosphorylated by cyclin-dependent kinase4-cyclin D
when it is mutated, can’t regulate & can predispose to retinoblastoma and osteosarcoma
How many mutant alleles does it take to produce cancer w/ oncogenes? tumor suppressor genes?
Oncogenes-1
tumor suppressor genes-2
What does p53 do?
responsible for half of all cancers
w/ p21 can arrest cell cycle
at G1/S and G2/M checkpoints
if it chooses can upregulat BAX for apoptosis
How does RAS work?
GPCR–>MAP kinase–>cell proliferation
oncogene
Which cancers with these mutations:
K-RAS
H-RAS
N-RAS?
K-RAS: Kolon, lung, pankreatic tumors
H-RAS: hematuria: bladder and kidney tumors
N-RAS: melanoma, hematologic malignancies, follicular thyroid cancer
What is the most common oncogene? Tumor suppressor gene?
oncogene-RAS
tumor suppressor gene–p53
Which cancers are caused by ionizing radiation?
myeloid leukemias: AML, CML
thyroid cancer
Which type of ultraviolet radiation causes skin cancer?
UVB–forms pyrimidine dimers
What is used to treat actinic keratoses so that they don’t transition into squamous cell carcinoma?
5-FU
What are the important features of tuberous sclerosis?
ash leaf spots SIA seizures ID angiofibromas
3 cancers:
- cardiac rhabdomyoma
- renal angiomyolipoma
- astrocytoma
What is a weird thing that HCV can cause?
papillary thyroid cancer
What are the cancers w/ highest incidence and mortality in US among men and women?
Men: Incidence 1. Prostate 2. Lung 3. Colon Mortality: 1. Lung 2. Prostate 3. Colon
Women: Incidence 1. Breast 2. Lung 3. Colon/Uterine
Mortality:
- Lung
- Breast
- Colon
What type of cancer do aromatic amines–such as benzidine and 2-naphthylamine cause?
transitional cell carcinoma
naphthalene found in moth balls
What type of cancer does arsenic cause?
Angiosarcoma-liver
Lung cancer
Squamous cell carcinoma
What type of cancer does carbon tetrachloride cause?
centrilobular necrosis, fatty change of the liver
Nitrosamines (smoked foods) like hotdogs cause what types of cancer?
squamous cell carcinoma of esophagus
gastric cancer
Vinyl chloride, found in refrigeration can cause what type of cancer?
angiosarcoma-liver
Screening for breast cancer, cervical cancer?
Breast: mammogram 50-75 1/2 yrs
Cervical: pap smear 1/3yrs 21-65
Screening for prostate, colon, lung cancer?
prostate: no recommendations
colon: colonscopy 1/10 yrs 50-75
flex sigmoidoscopy 1/5 yrs, fecal occult blood 1/1yr
Lung: annual CT lung 55-80 if 30 pack year hx of smoking and still smoking or quit
Which cancers are patients who are obese at increased risk for?
esophageal adenocarcinoma
renal cell carcinoma
Women: gallbladder, endometrial
men: thyroid, colon
When you have a high fat diet, what are you at increased risk for in terms of cancer?
Butter, Chips, Pringles, stEak
Breast, Colon, Prostate, Endometrial
What are you at increased risk for w/ inactivity?
breast, colon
What do you the following tumor markers correspond to? Alk Phosph AFT CA15-3/CA27-29 CA19-9 CA125 CEA S-100 TRAP
Alk Phosph: bone or liver AFT: hepatocellular carcinoma CA15-3/CA27-29: breast CA19-9: pancreatic CA125: ovarian CEA: pancreatic, colorectal S-100: melanoma, schwannoma TRAP: hairy cell leukemia (CLL)
Which 2 tumor markers are elevated in pancreatic canceR?
CA19-9
CEA
