Cancer & Benign Tumors Chap 491 -507 Flashcards
1
Q
AR: Anaphylaxis
A
Cyclophosphamide Ifosfamide L - asparaginasa Cisplatin Carboplatin
2
Q
AR: Hemorrhagic cystitis
A
Cyclophosphamide
Ifosfamide
3
Q
AR: Cardiac toxicity
A
Doxorubicin
Ifosfamide
4
Q
AR: SIADH
A
Vincristine
Cyclophosphamide
Ifosfamide
5
Q
AR: Raynaud Phenomenon
A
Bleomycin
6
Q
AR: Ototoxicity, Hemolytic Uremic Syndrome
A
Carboplatin
Cisplatin
7
Q
AR: Pseudomotor cerebri
A
Tretinoin
8
Q
Tumor lysis syndrome
A
Hyperuricemia
Hyperphosphatemia
Hyperkalemia
9
Q
Prophylaxis for Pneumocystis jiroveci
A
TMP-SMX
10
Q
MC malignant neoplasm in childhood
A
Leukemia
11
Q
Initial chemotherapy to eradicate leukemic cells from the bone marrow
A
Remission induction
12
Q
<5% blasts in the marrow post initial chemo
A
Remission
13
Q
> 25% lymphoblasts
A
ALL
14
Q
> 20% blasts cells in early differentiation states of yhe myeloid-monocyte-megakaryocyte series
A
AML
15
Q
Subcutaneous nodules or blueberry muffin lesions in addition to marrow failure
A
AML
15
Q
Subcutaneous nodules or blueberry muffin lesions in addition to marrow failure
A
AML
16
Q
Disseminated Vascular Coagulation
A
Acute Promyelocytic Leukemia
17
Q
Chloromas or granulocytic sarcomas (discrete masses) that may occur in the absence of apparent bone marrow involvement
A
AML
18
Q
Philadelphia chromosome - translocation (9;22)
BCR-ABL
A
CML
19
Q
Younger than 2 years old
Rashes, lymphadenopathy, splenomegaly, hemorrhagic manifestations
PBS: increased monocytes, anemia with erythroblasts
A
JMML
20
Q
Before 1 year of age
Hyperleukocytosis, organomegaly, subcutaneois nodules (leukemia cutis)
Large irregular lymphoblasts
Negative for CD10
A
Infant ALL
21
Q
MC cancer in adolescents
A
Lymphoma
22
Q
Virus associated with 4x risk in developing Hodgkin’s lymphoma
A
Ebstein-Barr virus
23
Q
Pathognomonic feature of Hodgkin Lymphoma
A
Reed-Sternberg cell
- large cell with multiple nuclei
24
Presents with painless, nontender, firm, ruberry, cervical or supraclavicular lymphadenopathy
Unexplained fever >38, weight loss >10%, night sweats
Hodgkin Lymphoma
25
B symptoms important in staging
Unexplained fever >38
weight loss >10%
night sweats
26
Staging classification for Hodgkin Lymphoma
Ann Arbor staging
27
Staging classification for Hodgkin Lymphoma
Ann Arbor staging
28
SINGLE lymph node involvement or single extralymphatic site
Stage I
29
TWO or MORE lymph nodes on the SAME side of diaphragm or localized involvement of extralymphatic organ or site
Stage II
30
Involvement of lymph nodes on BOTH sides of the diaphragm
| May be accompanied by spleen involvement
Stage III
31
DIFFUSE or disseminated involvement of 1 or more extralymphatic organs
Stage IV
32
Non Hodgkin Lymphoma subtype that manifests as an..
Intrathoracic or mediastinal supradiaphragmatic mass
With predilection of spreading to bone marrow and CNS
Lymphoblastic Lymphoma
32
Non Hodgkin Lymphoma subtype that manifests as an..
Intrathoracic or mediastinal supradiaphragmatic mass
With predilection of spreading to bone marrow and CNS
Lymphoblastic Lymphoma
33
Non Hodgkin Lymphoma subtype that manifests as an..
Abdominal (sporadic) or head & neck (endemic) mass
With predilection of spreading to bone marrow or CNS
Burkitt Lymphoma
34
Non Hodgkin Lymphoma subtype that manifests as an..
Abdominal (sporadic) or head & neck (endemic) mass
With predilection of spreading to bone marrow or CNS
Burkitt Lymphoma
35
Non Hodgkin Lymphoma subtype that manifests as an..
Abdominal or mediastinal mass
Rarely metastasize to bone marrow and CNS
Diffuse Large B Cell Lymphoma
36
Non Hodgkin Lymphoma subtype that manifests as a..
Cutaneous or systemic disease
With predilection of spreading to liver, spleen, lungs or mediastinum
Rare bone marrow or CNS disease
Anaplastic Large Cell Lymphoma
37
Premature hand preference
Supratentorial tumor
38
Triad of headache, nausea, vomiting with papilledema
Midline or infratentorial tumors
39
Torticollis
Cerebellar tonsil herniation
40
Failure to thrive, emaciation despite normal caloric intake, inappropriately happy affect
Diencephalic syndrome
41
Upward gaze paresis, pupils reactive to accommodation but NOT TO LIGHT, nystagmus to convergence or retraction, eyelid retraction
Parinaud syndrome
42
T/F: In newly diagnosed hydrocephalus secondary to CSF flow obstruction, Lumbar puncture is contraindicated
True
43
T/F: In newly diagnosed INFRATENTORIAL tumors with signs of INCREASED ICP, Lumbar puncture is contraindicated
True
44
MC astrocytoma in children
Pilocytic Astrocytoma
45
Classically presents in the CEREBELLUM
Appears as a contrast medium-enhancibg module within the wall of a cystic mass
In microscopy: biphasic appearance of bundles of compact fibrillary tissue with lose, microcystic, spongy areas
(+) ROSENTHAL FIBERS (condensed masses of glial filaments)
Pilocytic Astrocytoma
46
Pilocytic Astrocytoma of the optic nerve is associated with
Neurofibromatosis type 1
47
Dense cellularity, high mitotic index, microvascular proliferation, FOCI of TUMOR NECROSIS
Glioblastoma Multiforme
48
Cerebral cortex mass arising from the white matter consisting of rounded cells with little cytoplasm and microcalcifications
(+) seizure
CT: Calcified cortical mass
Ologodendrioglioma
49
Brain tumor associated with Li-Fraumeni syndrome
Choroid plexus tumors
50
Immunopositive for TRANSTHYRETIN (prealbumin)
Choroid plexus carcinoma
51
MC group of malignant CNS tumors of childhood
Embryonal tumors
52
CT: solid homogenous contrast enhancing mass in the posterior fossa, with noted fourth ventricular obstruction and hydrocephalus
Histo: monomorphic sheet of undifferentiated cells (small, blue, round cells), (+) Homer Wright rosettes
Most commonly seen at the CEREBELLAR VERMIS
Male, 5-7 yrs
Immunopositive for synaptophysin
Medulloblastoma
53
Alpha feto protein
| Beta HCG
Germ cell tumor
54
MC extracranial solid tumor in children
Neuroblastoma
55
Bluish subcutaneous nodules, orbital proptosis, and periorbital ecchymoses
Neuroblastoma
56
Homovallinic acid and vanillylmandelic acid elevated in urine
Small round blue tumor cells in biopsy
Neuroblastoma
57
Confined and completely resected Neuroblastoma
Stage 1
58
Neuroblastoma that extend beyond the organ but do not cross midline
Stage 2
* 2A - without lymph node involvement
* 2B - with ipsilateral lymph node involvement
59
Neuroblastoma tumor that extend beyond midline
Stage 3
60
Neuroblastoma tumor that is disseminated or with metastases
Stage 4
61
MC primary malignant renal tumor
Wilms tumor
62
Asymptomatic abdominal mass
Hypertensiom
Abdominal pain, painless gross hematuria, fever
Wilms tumor
63
MC solid renal tumor diagnosed in neonatal period
Mesoblastic Nephroma
64
MC pedia soft tissue sarcoma
Rhabdomyosarcoma
65
3 histologic subtypes of Rhabdomyosarcoma
1. Embryonal (60%) - MC
2. Alveolar - worst prognosis
3. Pleomorphic - adult form, rare
66
Rhabdomyosarcoma that is seen as a bunch of grapes
Botroid type (variant of embryonal)
67
Rhabdomyosarcoma tumir cells that grow in NESTS that often have cleft-like spaces
MC in trunk & extremities
Alveolar
68
T/F: Absence of anaplasia in histologic findings of Wilms tumor givea a favorable pronosis
True
69
MC primary malignant bone tumor in children and adolescents
Osteosarcoma
70
```
SPINDLE cell producing Osteoid
METAPHYSES of long bone
SUNBURST appearance in Xray
SCLEROTIC destruction of bones
History of INJURY
Invasion of the MEDULLARY cavity of long bones
```
Osteosarcoma
71
Sites of metastasis for Osteosarcoma and Ewing Sarcoma
Lungs
| Bone
72
Undifferentiated small round cell tumor
DIAPHYSES of long bones (Shaft)
ONION - SKINNING in Xray
Lytic, multilaminar periosteal reaction
Ewing sarcoma
73
Bone neoplasm associated with Retinoblastoma
Osteosarcoma
74
A low-grade, well differentiated tumor variant of Osteosarcoma that DOES NOT INVADE the medullary cavity and is usually found in the posterior aspect of the distal femur
Surgical resection is CURATIVE
Pareosteal Osteosarcoma
75
Reactive to muscle markers desmin and actin
Rhabdomyosarcoma
76
Pain, swelling, limitation of motion and tenderness over the affected bone WITH SYSTEMIC manifestations of fever and weight loss
Ewing sarcoma
77
T/F: Pelvic tumors have poor prognosis
True
78
Bone xray: stalks or broad based projections from the surface of the bone, away from adjacent joint
Asymptomatic, Enlarges with the child
Bony, non painful mass
Osteochondroma (exostosis)
*routine removal is not performed
79
Benign lesion of hyaline cartilage
Asymptomatic
Pathologic fractures
Xray: radiolucent, sharply marginated lesion in the medullary canal, punctate or stippled calcification may be present
Endochondroma
80
Multifocal endochondromas that result in short stature, limb length inequality and joint deformity
*high rate of malignant transformation
Ollier disease
*surgery may be necessary to correct/prevent deformity
81
Myltiple endochondromas associated with angiomas of the soft tissue
*high rate of malignant transformation
Maffucci syndrome
82
Small benign bone tumor
Male predominance
Unremitting and gradually increasing pain often worst at night, RELIEVED BY ASPIRIN
Common at the proximal femur and tibia
Osteoid Osteoma
*surgery
83
MC intraocula tumor in children
Retinoblastoma
84
Leukocoria (white pupillary reflex)
Retinoblastoma
85
Bilateral retinoblastoma plus pineal area tumor
Trilateral Retinoblastoma
*universally fatal
86
Syndrome that is at increased risk for mediastinal Germ Cell Tumor
Klinefelter Syndrome
87
T/F: The risk for testicular cancer in patients with Cryptorchidism is REDUCED BUT NOT ELIMINATED if orchipexy is performed before 13 years old
True
88
Tumor markers for GCT
Serum AFP
| Serum Beta HCG
89
MC site for teratomas
Sacrococcygeal region
90
Tumor marker negative massess of the gonads despite being malignant
Germinomas
* Dysgerminoma - ovary
* Seminoma - testis
91
Treatment for intracranial germ cell tumors
Rafiatiom and chemotherapy
92
Most predictive factor of survival for extragonadal GCTS
Age
*>12 years old have 4x higher risk of death
93
T/F: Prematurity & LBW have increased incidence of hepatoblastoma
True
94
More favorable histology subtype in hepatoblastoma
Pure histology
95
Hepatoblastoma arises more often in what lobe
Right lobe
96
Tumor marker for hepatoblastoma to be used in diagnosis and monitoring
Serum AFP
97
Chemotherapy used for hepatoblastoma
Cisplatin
Vincristine
5-FU or Doxorubicin
98
Carcinoma associated with Hepatitis
Hepatocellular carcinoma
99
Multicentric, invasive tumor consisting of large pleomorphic cells of epithelial origin of the liver
Hepatocellular carcinoma
100
Metastatic spread of liver tumors
Regional lymph nodes and lungs
101
MC benign tumor of infancy
Hemangioma
102
Primary site of of visceral involvement for hemangioma
Liver
103
Xommon complication of hemangioma
Ulceration
104
Rapidly enlarging vascilar lesion, thrombocytopenia, microangipathic hemolytic anemia, and coagulopathy
Kasabach-Merritt Syndrome
105
Second most common benign vascular tumors in children
Lymphangiomas
106
Effective sclerosing agent for Cystic Hygroma
Bleomycin
