Cancers Flashcards
1
Q
Tumour histology -> keratin production, intracellular bridges (prickles)
A
Squamous cell carcinoma
2
Q
Tumour Histology -> Glandular epithelium
Mucin Secretion
A
Adenocarcinoma
3
Q
Squamous Cell carcinoma of the lung
A
30-50%
Smoking
p53/cmyc
SCC histology
4
Q
Adenocarcinoma of the lung
A
20-30%
Women/Non-smokers
Adenocarcinoma histology
5
Q
Small Cell carcinoma of the lung
A
20-25%
Neuroendocrine cells
Smoking
6
Q
Small Cell Carcinoma of the lung associated syndromes
A
SIADH
ACTH
Lambert-Eaton
7
Q
Large Cell Carcinoma of the lung
A
No scc/adenocarcinoma histology
Large cells with large nuclei
8
Q
Mesothelioma
A
Extensive pleural effusion
Asbestos
9
Q
GI Adenoma epidemiology
A
Adenocarcinoma precursor
50% over 50s in western world
over 3.4cm need surveillance
10
Q
GI adenoma classification
A
Tubular
Tubulovillous
Villous (rare, leak protein and potassium)
11
Q
GI Hamartomatous Polyp
A
Found sporadically in genetic conditions
Seen in juvenile polyposis and Peutz-Jeghers Syndrome
12
Q
Juvenile Polyposis
A
AD
Up to 100 hamartomatous Polyps
Colectomy if risk of haemorrhage
13
Q
Peutz-Jeghers Syndrome
A
AD - LKB1
Polyps, hyperpigmentation, freckles mouth, palm soles
14
Q
Colorectal Cancer Epidemiology
A
2nd most common cause of cancer deaths
98% adenocarcinoma
NSAIDs protective
15
Q
Colorectal Cancer monitoring
A
Carcinoembryonic Antigen marker
16
Q
Colorectal Cancer staging
A
Duke’s
17
Q
Familial Adenomatous Polyposis
A
AD > AR
>100 adenomatous polyps
Will become malignant
18
Q
Gardner’s Syndrome
A
FAP with osteomas, dental cavities
19
Q
Acinar Cell Carcinoma - Pancreas
A
Rare, older adults
Neoplastic epithelial cells with eosinophilic granular cytoplasm
Positive Immunoreactivity for lipase, trypsin, chymotrypsin
20
Q
Ductal adenocarcinoma of the pancreas
A
85% pancreatic malignancies
Head of pancreas
CA 19-9
21
Q
Islet Cell tumours of the pancreas
A
Body/Tail
MEN 1
Present with syndromes due to hormonal excess
22
Q
Islet Cell Tumour Syndromes
A
Insulinoma
Gastrinoma (Zollinger-Ellison)
23
Q
MEN 1
A
PPP
Parathyroid adenoma
Pancreatic Endocrine Tumour
Pituitary Adenoma
24
Q
MEN 2a
A
PP
Parathyroid cancer
Thyroid Cancer
Phaeochromocytoma
25
Men 2b
```
P
Thyroid -> medullary
Phaeochromocytoma
Neuroma
Marfinoid phenotype
```
26
Benign Liver Tumours
Hepatic Adenoma
| Haemangioma
27
Malignant Liver Tumours
```
HCC
Chloangiocarcinoma
Haemangiosarcoma
Hepatoblastoma
Metastases
```
28
Hepatocellular Carcinoma causes
Chronic liver disease (alcohol, viral, haemochromatosis, fatty liver)
29
Hepatocellular Carcinoma investigation
Alpha-fetoprotein
| USS
30
Cholangiocarcinoma causes
PSC, parasites, liver disease
31
Haemangiosarcoma of the liver
Liver vascular epithelium
Highly Invasive
32
Hepatoblastoma
Children
Abdo Mass
Immature liver precursor cells
33
Liver metastases origin
GI
Breast
Bronchus
34
Prostate Cancer
Adenocarcinoma in men over 50
Arise from Prostatic intraepithelial neoplasia
35
Prostate Cancer structure
Firm, neoplastic tissue in the peripheral zone of the gland
36
Prostate cancer grading
Gleason System
37
Prostate Cancer marker
Prostate Specific Antigen
38
Testicular Tumour Types
```
Germ Cell *
Types = Semimoma *
Teratoma
Embryonal
Yolk Sac
Choriocarcinoma
```
39
What do most testicular tumours arise from?
Precursor lesion -> intratubular germ cell neoplasia
40
Benign renal tumours
Papillary Adenoma
Oncocytoma
Angiomyolipoma
41
Papillary Adenoma -> Histology
Epithelial tumour with papillary architecture
Well circumscribed cortical nodules
42
Oncocytoma histology
Renal
Macro -> Mahogany brown
Micro -> sheets of cells, pink cytoplasm, form nests of cells
43
Angiomyolipoma
Renal
Fat, thick blood vessels, spindle cell components
44
Malignant renal tumours
Renal Cell Carcinoma
Nephroblastoma
Transitional Cell Carcinoma
45
Renal cell carcinoma histological subtypes
Clear Cell (70%)
Papillary (15%)
Chromophobe (5%)
46
Clear Cell Renal cell carcinoma histology
Macro -> Golden yellow with haemorrhagic areas
Micro -> nests of epithelium with clear cytoplasm
47
Papillary renal cell carcinoma histology
Macro -> Friable brown tumour
| Micro -> Papillary growth pattern >5mm
48
Chromophobe renal cell carcinoma histology
Macro -> Solid brown tumour
Micro -> Sheets of large cells with distinct cell borders
49
Nephroblastoma Histology
Small very round blue cells
Epithelial component
50
Transitional cell carcinoma subtypes
*Bladder
Non-invasive papillary
Invasive urothelial carcinoma
51
Non-invasive papillary transitional cell carcinoma histology
Frond-like growths projecting from bladder wall
Micro -> Papillary fronds lined by urothelium
Low/High grade
52
Invasive urothelial transitional cell carcinoma
Solid, invasive tumour fixed to tissue
53
Bladder SCC risk factor
Schistosomiasis
54
Most common tumour of female genital tract
Leiomyoma
| benign of smooth muscle origin
55
Leimyoma histology
Macro -> Sharply circumscribed, discrete, round, firm, grey/white
Micro -> Bundles of smooth muscle cells
56
Endometrial Carcinoma Subtypes
Endometroid
| Non-Endometroid
57
Endometrial Cancer staging
FIGO
58
Endometroid endometrial cancer
80%, look like endometrial glands
Adenocarcinomas
Oestrogen Excess
59
Non-endometroid endometrial cancers
Papillary/Serous/Clear Cell
60
Vulval Intraepithelial Neoplasia
HPV16
Epithelial Dysplasia
Warty, basaloid, mixed
61
Vulval Carcinoma
SCC
62
Ovarian Cancer subtypes
Epithelial (70%)
Germ Cell (20%)
Sex Cord/Stroma (10%)
63
Epithelial Ovarian cancer subtypes
Serous Cystadenoma *
Mucinous Cystadenoma
Endometroid
Clear Cell
64
Serous Cystadenoma ovarian cancer
*
Columnar epithelium
Psammoma Bodies (laminated calcifications)
65
Mucinous Cystadenoma ovarian cancer
Mucin-secreting
| No psammoma bodies
66
Mucinous cystadenoma mutation
K-ras in 75%
67
Endometroid ovarian cancer
Tubular glands
| Endometriosis = rf
68
Clear Cell ovarian carcinoma
Clear cytoplasm
Hobnail Appearance
Malignant, poor prognosis
69
Germ cell ovarian cancer subtypes
Dysgerminoma
Teratoma
Choriocarcinoma
70
Sex cord/stroma ovarian cancer subtypes
Fibroma
| Granulosa/Theca cell tumour
71
Dysgerminoma - Ovarian cancer
Female counterpart of testicular semimoma
| *young woman
72
teratoma - ovaries
dermoid = mature
Contains mature tissues, such as teeth and hair
Can be immature
73
Ovarian choriocarcinoma
hCG secreting
| Malignant
74
Ovarian fibroma
No hormone association
| Meig's Syndrome (ascites + pleural effusion)
75
Granulosa-Theca Cell ovarian tumour
E2 producing
76
Oestrogen secreting tumour signs
Irregular menstrual cycle
Breast enlargement
Endometrial/breast cancer
77
Sertoli/Leydig Cell ovarian cancer
Androgen secreting
Defeminisation
Virilisation
78
Krukenberg Tumour
Ovarian malignancy metastasied from gastric/colonic cancer
Signet Ring Cells
79
CIN grading
```
1 = lower 1/3 epithelium
2 = lower 2/3
3 = full thickness, basement membrane intact
```
80
Where is CIN typically found?
Transformation zone
81
Cervical carcinoma epidemiology
2nd * worldwide
30-39 & >70
* SCC
82
What marks the change from CIN to cervical carcinoma
Breaking through the basement membrane
83
Benign breast neoplasms
```
Fibroadenoma
Intraductal Papilloma
Radial Scar
Phyllode's Tumour
Fibrocystic Disease
```
84
Breast fibroadenoma
'Breast Mouse'
| Spherical, mobile, rubbery
85
Breast fibroadenoma histology
Overgrowth of collagenous mesenchyme
Cytology -> Branching sheets of epithelium, bare, bipolar nuclei and stroma
Multinodular mass of expanded intralobular stroma
86
Intraductal papilloma
Bloody discharge
Papillary tumour of ducts
Not seen on mamogram
87
Intraductal papilloma histology
Cytology -> Branching papillary groups of epithelium
Histology -> Papillaery Mass within a dilated duct lined by epithelium
88
Radial Scar
Sclerosing
| Stellate mass on mammography
89
Radial Scar histology
Central, fibrous, stellate area
90
Phyllode's Tumour
Arise from interlobular stroma
Palpable mass
Excised
91
Breast fibrocystic disease
Changes with menstrual cycle
| lumpiness
92
Breast fibrocystic disease histology
Dilated large ducts which may become calcified
93
Proliferative Breast conditions
Usual epithelial hyperplasia
Flat epithelial atypia
In situ lobular neoplasia
94
Usual epithelial hyperplasia
Not typically precancerous
| Glandular/epithelial tissue grows and forms fronds
95
Flat epithelial atypia
4x risk of carcinoma
| Multiple layers of epithelial cells, lumens more regular and round
96
In situ lobular neoplasia
7-12x risk breast cancer
| Histology = solid aplastic proliferation, residue areas with lumen
97
Subtypes of breast carcinoma
```
In situ (30%)
Invasive (80%)
```
98
invasive breast carcinoma
Ductal = Big pleiomorphic cells
Lobular = cells aligned in chains/strands
Tubular = well-formed tubules with low grade nuclei
Mucinous = lots of mucin dissects surrounding stroma
99
Breast carcinoma in situ
Limited by basement membrane
Lobular = incidental
Ductal = microcalfication
100
breast carcinoma in situ histology
ducts filled with atypical epithelial cells
101
Breast cancer mutations and prognoses
EP/PR positive = good, predicts response to tamoxifen
| HER2 = bad
102
Breast basal-like carcinoma histology
Sheets of markedly atypical cells with lymphocytic infiltrate
103
Most common form of brain tumour?
Secondary metastases
* Lung, breast, malignant melanoma
Astrocytomas = most common primary
104
NF2 brain tumour
Meningioma
105
Ventricular brain tumour with hydrocephalus
Ependymoma
106
Indolent, childhood brain tumour
Pilocystic Astrocytoma
107
Soft, gelatinous, calcified brain tumour
Oligodendroma
108
Benign bone tumour x ray
Thick endosteal Reaction
No periosteal reaction
Well developed bone formation
Even, intraosseus calcification
109
Malignant bone tumour x ray
Acute Periosteal reaction
varied bone formation
irregular calcification
110
Periosteal reaction x ray signs
Codman's triangle
Onion Skin
Sunburst
111
Malignant bone tumours
Osteosarcoma
Chondrosarcoma
Ewing's Sarcoma
Giant Cell
112
Osteosarcoma
Young, knee, malignant mesenchymal cells
ALP +ve
Periosteal reaction on x ray
113
Chondrosarcoma
Old, Axial skeleton, malignant chondrocytes,
Fluffy calcification
114
Ewing's Sarcoma
Young
Long bones/Pelvis
Sheets of small, round cells
'Onion Skinning' of periosteum
115
Giant Cell bone cancer
20-40
Knee
Giant cells on background of spindle/ovoid cells
116
Benign bone tumours
```
Osteoid Osteoma
Osteoma
Endochondroma
Osteochondroma
Fibrous Dyspasia
Bone Cyst
Osteoblastoma
```
117
Osteoid Osteoma
Adolescent
| Radiolucent nidus with sclerotic rim 'Bull's Eye'
118
Endochondroma
Middle Aged
Hands
Lots = ollier's
Lots + haemangiomas = maffuci's
Cotton wool calcification
O ring sign
119
Osteoma
Head + Neck
| Gardner's Syndrome
120
Osteochondroma
Long bones near tendons
Histo -> Cartilage capped bony outgrowth
X ray -> bony protuberance, bone mushroom
121
Fibrous dysplasia of the bone
Albright Syndrome
Chinese Letters histology
X ray -> soap bubble osteolysis
Shepherd's Crook deformity
122
Simple Bone cyst
Well defined lytic lesion
| Fluid filled
123
Osteoblastoma
Speckled mineralisation on x ray
124
Seborrhoeic Keratosis
Waxy, rough, stuck on
Histology -> Horn Cysts, orderly proliferation
125
Actinic keratosis
Sandpaper like texture
```
Histology = SPAIN
Solar elastosis
Parakeratosis
Atypia/dysplasia
Inflammation
Not full thickness
```
126
Keratocanthoma
SCC histology
rapidly growing dome, necrotic, crusted centre
Clears spontaneously
127
Bowen's Disease
Flat, red, scaly patches in sun-exposed areas
Basement membrane intact
Full thickness
128
Skin SCC
Bowen's + Ulceration
Histology = Atypia through epidermis, spreads through basement membrane
129
Skin BCC
Rodent Ulcer
Pearly with telangiectasia
Histology -> Mass of basal cells pushing down into dermis
Palisading (nuclei align in outer layer)
130
Melanoma histology
Atypical melanocytes
Radial growth phase -> horizontally into epidermis
Vertical growth phase -> buckshot appearance
131
Melanoma Prognosis
Breslow Thickness
132
Melanoma Subtypes
Lentigo maligna (sun exposed areas, flat, slow)
Superficial spreading (irregular borders, variation in colour)
Nodular malignant (younger)
Acral Lentiginous (palms, soles)
