Cancer Work-Up

Question 1

______ -> histopathological scoring by pathologist

______ -> extent of body affected, determined by clinician with diagnostic tests

Answer 1

Grade -> histopathological scoring by pathologist

Stage -> extent of body affected, determined by clinician with diagnostic tests

Question 2

3 disadvantages of cytology

Answer 2

1) Cannot determine histological grade
2) False positive = reactive tissue
3) False negative = appear benign cytologically but aggresive biological behavior

Question 3

Term used for transposing tumor cells to new areas

Answer 3

Tumor seeding

Question 4

Goal of Aspiration technique

Answer 4

Monolayer of cells

Question 5

4 Indications for incisional biopsy

Answer 5

1) Type
2) Extent
3) Planning
4) Owner’s decision to treat

Question 6

Size of pulmonary nodules needed for detection under CT scan

Answer 6

Needs to be bigger than 1-2mm

Question 7

4 Characteristics of biological behavior predicted by cells of origin diagnosis

Answer 7

1) Growth rate
2) Invasiveness
3) Sites of metastasis
4) Paraneoplastic syndromes

Question 8

Size of pulmonary nodules needed for detection with thoracic radiographs

Answer 8

Bigger than 5mm

Question 9

Cytology scan on high power

• if non-inflammatory, determine if _______ vs _______
• if neoplastic, determine which of 3 cell types,
  1) ___ 2) ___ 3) ___

Answer 9

• if non-inflammatory, determine if normal/hyperplastic vs neoplastic
• if neoplastic, determine which of 3 cell types
  1) sarcoma
  2) carcinoma
  3) round cell

Question 10

Difference betwen incisional vs excisional biopsy

Answer 10

Incisional biopsy -> selected portion of a lesion

Excisional biopsy -> removal of a mass primarily for diagnostic purposes, usually equivalent to “narrow excision”

Question 11

3 things needed to develop cancer

Answer 11

1) Initiation -> allows a single mutated cell limitless replicative potential
2) Promotion -> additional mutations required to allow continued growth
3) Progression -> more mutations to allow tissue invasion and mets

Question 12

5 common features in tumor grading schemes

Answer 12

1) Cellular differentiation (well to poorly differentiated)
2) Degree of necrosis
3) Mitotic index (mitoses seen/10 HPFs)
4) Degree of invasion
5) Degree of stromal tissue reaction

Question 13

5 Types of Round cell tumors

Answer 13

1) Plasma cell tumor
2) Histiocytoma
3) Mast cell tumor
4) Lymphoma
5) TVT (transmissible veneral tumor)

Question 14

Definitive diagnosis for cancer

Answer 14

Biopsy and histopathology