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Meded Path Lectures > Cancers > Flashcards

Cancers Flashcards

1
Q

Tumour histology -> keratin production, intracellular bridges (prickles)

A

Squamous cell carcinoma

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2
Q

Tumour Histology -> Glandular epithelium

Mucin Secretion

A

Adenocarcinoma

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3
Q

Squamous Cell carcinoma of the lung

A

30-50%
Smoking
p53/cmyc
SCC histology

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4
Q

Adenocarcinoma of the lung

A

20-30%
Women/Non-smokers
Adenocarcinoma histology

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5
Q

Small Cell carcinoma of the lung

A

20-25%
Neuroendocrine cells
Smoking

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6
Q

Small Cell Carcinoma of the lung associated syndromes

A

SIADH
ACTH
Lambert-Eaton

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7
Q

Large Cell Carcinoma of the lung

A

No scc/adenocarcinoma histology

Large cells with large nuclei

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8
Q

Mesothelioma

A

Extensive pleural effusion

Asbestos

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9
Q

GI Adenoma epidemiology

A

Adenocarcinoma precursor

50% over 50s in western world

over 3.4cm need surveillance

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10
Q

GI adenoma classification

A

Tubular
Tubulovillous
Villous (rare, leak protein and potassium)

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11
Q

GI Hamartomatous Polyp

A

Found sporadically in genetic conditions

Seen in juvenile polyposis and Peutz-Jeghers Syndrome

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12
Q

Juvenile Polyposis

A

AD
Up to 100 hamartomatous Polyps
Colectomy if risk of haemorrhage

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13
Q

Peutz-Jeghers Syndrome

A

AD - LKB1

Polyps, hyperpigmentation, freckles mouth, palm soles

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14
Q

Colorectal Cancer Epidemiology

A

2nd most common cause of cancer deaths
98% adenocarcinoma
NSAIDs protective

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15
Q

Colorectal Cancer monitoring

A

Carcinoembryonic Antigen marker

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16
Q

Colorectal Cancer staging

A

Duke’s

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17
Q

Familial Adenomatous Polyposis

A

AD > AR
>100 adenomatous polyps
Will become malignant

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18
Q

Gardner’s Syndrome

A

FAP with osteomas, dental cavities

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19
Q

Acinar Cell Carcinoma - Pancreas

A

Rare, older adults
Neoplastic epithelial cells with eosinophilic granular cytoplasm
Positive Immunoreactivity for lipase, trypsin, chymotrypsin

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20
Q

Ductal adenocarcinoma of the pancreas

A

85% pancreatic malignancies

Head of pancreas

CA 19-9

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21
Q

Islet Cell tumours of the pancreas

A

Body/Tail

MEN 1

Present with syndromes due to hormonal excess

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22
Q

Islet Cell Tumour Syndromes

A

Insulinoma

Gastrinoma (Zollinger-Ellison)

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23
Q

MEN 1

A

PPP
Parathyroid adenoma
Pancreatic Endocrine Tumour
Pituitary Adenoma

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24
Q

MEN 2a

A

PP
Parathyroid cancer
Thyroid Cancer
Phaeochromocytoma

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25
Q

Men 2b

A 
P
Thyroid -> medullary 
Phaeochromocytoma 
Neuroma 
Marfinoid phenotype
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26
Q

Benign Liver Tumours

A

Hepatic Adenoma

Haemangioma

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27
Q

Malignant Liver Tumours

A 
HCC
Chloangiocarcinoma 
Haemangiosarcoma 
Hepatoblastoma 
Metastases
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28
Q

Hepatocellular Carcinoma causes

A

Chronic liver disease (alcohol, viral, haemochromatosis, fatty liver)

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29
Q

Hepatocellular Carcinoma investigation

A

Alpha-fetoprotein

USS

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30
Q

Cholangiocarcinoma causes

A

PSC, parasites, liver disease

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31
Q

Haemangiosarcoma of the liver

A

Liver vascular epithelium

Highly Invasive

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32
Q

Hepatoblastoma

A

Children
Abdo Mass
Immature liver precursor cells

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33
Q

Liver metastases origin

A

GI
Breast
Bronchus

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34
Q

Prostate Cancer

A

Adenocarcinoma in men over 50

Arise from Prostatic intraepithelial neoplasia

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35
Q

Prostate Cancer structure

A

Firm, neoplastic tissue in the peripheral zone of the gland

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36
Q

Prostate cancer grading

A

Gleason System

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37
Q

Prostate Cancer marker

A

Prostate Specific Antigen

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38
Q

Testicular Tumour Types

A 
Germ Cell * 
Types = Semimoma * 
Teratoma 
Embryonal 
Yolk Sac 
Choriocarcinoma
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39
Q

What do most testicular tumours arise from?

A

Precursor lesion -> intratubular germ cell neoplasia

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40
Q

Benign renal tumours

A

Papillary Adenoma
Oncocytoma
Angiomyolipoma

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41
Q

Papillary Adenoma -> Histology

A

Epithelial tumour with papillary architecture

Well circumscribed cortical nodules

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42
Q

Oncocytoma histology

A

Renal

Macro -> Mahogany brown

Micro -> sheets of cells, pink cytoplasm, form nests of cells

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43
Q

Angiomyolipoma

A

Renal

Fat, thick blood vessels, spindle cell components

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44
Q

Malignant renal tumours

A

Renal Cell Carcinoma
Nephroblastoma
Transitional Cell Carcinoma

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45
Q

Renal cell carcinoma histological subtypes

A

Clear Cell (70%)
Papillary (15%)
Chromophobe (5%)

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46
Q

Clear Cell Renal cell carcinoma histology

A

Macro -> Golden yellow with haemorrhagic areas

Micro -> nests of epithelium with clear cytoplasm

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47
Q

Papillary renal cell carcinoma histology

A

Macro -> Friable brown tumour

Micro -> Papillary growth pattern >5mm

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48
Q

Chromophobe renal cell carcinoma histology

A

Macro -> Solid brown tumour

Micro -> Sheets of large cells with distinct cell borders

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49
Q

Nephroblastoma Histology

A

Small very round blue cells

Epithelial component

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50
Q

Transitional cell carcinoma subtypes

A

*Bladder

Non-invasive papillary

Invasive urothelial carcinoma

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51
Q

Non-invasive papillary transitional cell carcinoma histology

A

Frond-like growths projecting from bladder wall

Micro -> Papillary fronds lined by urothelium

Low/High grade

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52
Q

Invasive urothelial transitional cell carcinoma

A

Solid, invasive tumour fixed to tissue

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53
Q

Bladder SCC risk factor

A

Schistosomiasis

54
Q

Most common tumour of female genital tract

A

Leiomyoma

benign of smooth muscle origin

55
Q

Leimyoma histology

A

Macro -> Sharply circumscribed, discrete, round, firm, grey/white

Micro -> Bundles of smooth muscle cells

56
Q

Endometrial Carcinoma Subtypes

A

Endometroid

Non-Endometroid

57
Q

Endometrial Cancer staging

A

FIGO

58
Q

Endometroid endometrial cancer

A

80%, look like endometrial glands
Adenocarcinomas
Oestrogen Excess

59
Q

Non-endometroid endometrial cancers

A

Papillary/Serous/Clear Cell

60
Q

Vulval Intraepithelial Neoplasia

A

HPV16
Epithelial Dysplasia
Warty, basaloid, mixed

61
Q

Vulval Carcinoma

A

SCC

62
Q

Ovarian Cancer subtypes

A

Epithelial (70%)
Germ Cell (20%)
Sex Cord/Stroma (10%)

63
Q

Epithelial Ovarian cancer subtypes

A

Serous Cystadenoma *
Mucinous Cystadenoma
Endometroid
Clear Cell

64
Q

Serous Cystadenoma ovarian cancer

A
  • Columnar epithelium
    Psammoma Bodies (laminated calcifications)
65
Q

Mucinous Cystadenoma ovarian cancer

A

Mucin-secreting

No psammoma bodies

66
Q

Mucinous cystadenoma mutation

A

K-ras in 75%

67
Q

Endometroid ovarian cancer

A

Tubular glands

Endometriosis = rf

68
Q

Clear Cell ovarian carcinoma

A

Clear cytoplasm
Hobnail Appearance
Malignant, poor prognosis

69
Q

Germ cell ovarian cancer subtypes

A

Dysgerminoma
Teratoma
Choriocarcinoma

70
Q

Sex cord/stroma ovarian cancer subtypes

A

Fibroma

Granulosa/Theca cell tumour

71
Q

Dysgerminoma - Ovarian cancer

A

Female counterpart of testicular semimoma

*young woman

72
Q

teratoma - ovaries

A

dermoid = mature
Contains mature tissues, such as teeth and hair

Can be immature

73
Q

Ovarian choriocarcinoma

A

hCG secreting

Malignant

74
Q

Ovarian fibroma

A

No hormone association

Meig’s Syndrome (ascites + pleural effusion)

75
Q

Granulosa-Theca Cell ovarian tumour

A

E2 producing

76
Q

Oestrogen secreting tumour signs

A

Irregular menstrual cycle
Breast enlargement
Endometrial/breast cancer

77
Q

Sertoli/Leydig Cell ovarian cancer

A

Androgen secreting
Defeminisation
Virilisation

78
Q

Krukenberg Tumour

A

Ovarian malignancy metastasied from gastric/colonic cancer

Signet Ring Cells

79
Q

CIN grading

A 
1 = lower 1/3 epithelium 
2 = lower 2/3 
3 = full thickness, basement membrane intact
80
Q

Where is CIN typically found?

A

Transformation zone

81
Q

Cervical carcinoma epidemiology

A

2nd * worldwide
30-39 & >70
* SCC

82
Q

What marks the change from CIN to cervical carcinoma

A

Breaking through the basement membrane

83
Q

Benign breast neoplasms

A 
Fibroadenoma 
Intraductal Papilloma 
Radial Scar
Phyllode's Tumour 
Fibrocystic Disease
84
Q

Breast fibroadenoma

A

‘Breast Mouse’

Spherical, mobile, rubbery

85
Q

Breast fibroadenoma histology

A

Overgrowth of collagenous mesenchyme

Cytology -> Branching sheets of epithelium, bare, bipolar nuclei and stroma

Multinodular mass of expanded intralobular stroma

86
Q

Intraductal papilloma

A

Bloody discharge
Papillary tumour of ducts
Not seen on mamogram

87
Q

Intraductal papilloma histology

A

Cytology -> Branching papillary groups of epithelium

Histology -> Papillaery Mass within a dilated duct lined by epithelium

88
Q

Radial Scar

A

Sclerosing

Stellate mass on mammography

89
Q

Radial Scar histology

A

Central, fibrous, stellate area

90
Q

Phyllode’s Tumour

A

Arise from interlobular stroma
Palpable mass
Excised

91
Q

Breast fibrocystic disease

A

Changes with menstrual cycle

lumpiness

92
Q

Breast fibrocystic disease histology

A

Dilated large ducts which may become calcified

93
Q

Proliferative Breast conditions

A

Usual epithelial hyperplasia

Flat epithelial atypia

In situ lobular neoplasia

94
Q

Usual epithelial hyperplasia

A

Not typically precancerous

Glandular/epithelial tissue grows and forms fronds

95
Q

Flat epithelial atypia

A

4x risk of carcinoma

Multiple layers of epithelial cells, lumens more regular and round

96
Q

In situ lobular neoplasia

A

7-12x risk breast cancer

Histology = solid aplastic proliferation, residue areas with lumen

97
Q

Subtypes of breast carcinoma

A 
In situ (30%)
Invasive (80%)
98
Q

invasive breast carcinoma

A

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
Q

Breast carcinoma in situ

A

Limited by basement membrane
Lobular = incidental
Ductal = microcalfication

100
Q

breast carcinoma in situ histology

A

ducts filled with atypical epithelial cells

101
Q

Breast cancer mutations and prognoses

A

EP/PR positive = good, predicts response to tamoxifen

HER2 = bad

102
Q

Breast basal-like carcinoma histology

A

Sheets of markedly atypical cells with lymphocytic infiltrate

103
Q

Most common form of brain tumour?

A

Secondary metastases
* Lung, breast, malignant melanoma

Astrocytomas = most common primary

104
Q

NF2 brain tumour

A

Meningioma

105
Q

Ventricular brain tumour with hydrocephalus

A

Ependymoma

106
Q

Indolent, childhood brain tumour

A

Pilocystic Astrocytoma

107
Q

Soft, gelatinous, calcified brain tumour

A

Oligodendroma

108
Q

Benign bone tumour x ray

A

Thick endosteal Reaction

No periosteal reaction

Well developed bone formation

Even, intraosseus calcification

109
Q

Malignant bone tumour x ray

A

Acute Periosteal reaction
varied bone formation
irregular calcification

110
Q

Periosteal reaction x ray signs

A

Codman’s triangle
Onion Skin
Sunburst

111
Q

Malignant bone tumours

A

Osteosarcoma
Chondrosarcoma
Ewing’s Sarcoma
Giant Cell

112
Q

Osteosarcoma

A

Young, knee, malignant mesenchymal cells
ALP +ve
Periosteal reaction on x ray

113
Q

Chondrosarcoma

A

Old, Axial skeleton, malignant chondrocytes,

Fluffy calcification

114
Q

Ewing’s Sarcoma

A

Young
Long bones/Pelvis
Sheets of small, round cells
‘Onion Skinning’ of periosteum

115
Q

Giant Cell bone cancer

A

20-40
Knee
Giant cells on background of spindle/ovoid cells

116
Q

Benign bone tumours

A 
Osteoid Osteoma 
Osteoma
Endochondroma 
Osteochondroma 
Fibrous Dyspasia 
Bone Cyst 
Osteoblastoma
117
Q

Osteoid Osteoma

A

Adolescent

Radiolucent nidus with sclerotic rim ‘Bull’s Eye’

118
Q

Endochondroma

A

Middle Aged
Hands
Lots = ollier’s
Lots + haemangiomas = maffuci’s

Cotton wool calcification
O ring sign

119
Q

Osteoma

A

Head + Neck

Gardner’s Syndrome

120
Q

Osteochondroma

A

Long bones near tendons

Histo -> Cartilage capped bony outgrowth

X ray -> bony protuberance, bone mushroom

121
Q

Fibrous dysplasia of the bone

A

Albright Syndrome
Chinese Letters histology

X ray -> soap bubble osteolysis

Shepherd’s Crook deformity

122
Q

Simple Bone cyst

A

Well defined lytic lesion

Fluid filled

123
Q

Osteoblastoma

A

Speckled mineralisation on x ray

124
Q

Seborrhoeic Keratosis

A

Waxy, rough, stuck on

Histology -> Horn Cysts, orderly proliferation

125
Q

Actinic keratosis

A

Sandpaper like texture

Histology = SPAIN
Solar elastosis 
Parakeratosis 
Atypia/dysplasia
Inflammation 
Not full thickness
126
Q

Keratocanthoma

A

SCC histology
rapidly growing dome, necrotic, crusted centre

Clears spontaneously

127
Q

Bowen’s Disease

A

Flat, red, scaly patches in sun-exposed areas

Basement membrane intact
Full thickness

128
Q

Skin SCC

A

Bowen’s + Ulceration

Histology = Atypia through epidermis, spreads through basement membrane

129
Q

Skin BCC

A

Rodent Ulcer
Pearly with telangiectasia

Histology -> Mass of basal cells pushing down into dermis

Palisading (nuclei align in outer layer)

130
Q

Melanoma histology

A

Atypical melanocytes

Radial growth phase -> horizontally into epidermis

Vertical growth phase -> buckshot appearance

131
Q

Melanoma Prognosis

A

Breslow Thickness

132
Q

Melanoma Subtypes

A

Lentigo maligna (sun exposed areas, flat, slow)

Superficial spreading (irregular borders, variation in colour)

Nodular malignant (younger)

Acral Lentiginous (palms, soles)

Meded Path Lectures (15 decks)

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