Ch 7: Neoplasia Flashcards
what are the hallmarks of cancer
set of properties that produce certain cellular phenotypes that dictate the natural history of cancer and response to therapy
what is neoplasia
new tissue growth that is unregulated, irreversible, and monoclonal
what is monoclonal
neoplastic cells derived from a single mother cell
what is benign
microscopic and gross features are innocent, the humor is localized, and easily removable
what is malignant
lesion can invade and destroy nearby structures, can spread, and can cause death
what are the two basic microscopic components of neoplasia
parenchyma is made of transformed cells
supporting host stroma contains connective tissue, blood vessels, and inflammatory cells
what is a fibroma
benign growth of fibrous tissue
what is a chondroma
benign growth of cartilage
what is an adenoma
benign lesion that produced gland-like features
what is a papilloma
benign lesion on the surface that produces fronds
what is a cystadenoma
benign hollow cystic mass
usually in ovary
what is a sarcoma
malignant tumor of mesenchymal tissue
what are leukemias and lymphomas
malignant tumor of mesenchymal cells in the blood
what is a carcinoma
malignant tumor of epithelial cells
what is an adenocarcinoma
malignant, epithelial tumor with glandular pattern of growth
what is a squamous cell carcinoma
malignant, epithelial tumor that produces squamous cells
what does differentiation mean
when new growing parenchymal cells resemble the corresponding normal parenchymal cells
(does the cell still look and function like itself)
if poorly differentiated, suggestive of malignancy
what is divergent differentiation and what are three examples
mixed tumors due to the progenitor cell having the ability to differentiate into more than one lineage
ex. pleomorphic adenoma, fibroadenoma, and teratoma
what is a pleomorphic adenoma
mixed salivary gland tumor made of a epithelial component and fibromxyoid stroma
example of divergent differentiation
what is a pleomorphic tumor
tumor with more than one form; mixed tumors
what is a fibroadenoma
proliferating ductal elements and in loose fibrous tissue
example of divergent differentiation
what is a teratoma
mixed tumor of mature and immature elements derived from one or more germ layers
example of divergent differentiation
what is a solitary fibrous tumor
benign, lung pleural tumor made of solid dense fibrous tissue
not linked to asbestos exposure
what is malignant mesothelioma and what is it caused by
malignant lung pleural tumor with disseminated nodules or plaques
spreads
caused by homozygous deletion of chromosome 9p leading to loss of the tumor suppressor gene CDKN2A
what is a hamartoma
benign mass of proliferating cartilage outside of the bronchial tree in the lung parenchyma
appear as coin lesions
what is a choristoma
a benign congenital anomaly consisting of a heterotropic nest of cells in a place where they shouldn’t be
believed to occur during embryonic development
what is a lingual osseous choristoma
benign area of bone found in the tongue due abnormal folding during embryonic development
what is a choristoma of foregut
presence of pancreatic tissue in different places of the foregut or mesentery
what is anaplasia
lack of differentiation - cells don’t look like they should
indication of malignancy
what is hyperchromatic
darkly stained nuclei that is suggestive of malignancy
what is pleomorphism
variation in size and shape of tumor cells that is suggestive of malignancy
what is anisonucleosis
variation in size and shape of nuclei that is suggestive of malignancy
what is nuclei-cytoplasmic ratio
ratio of size of nucleus to cell (normal is 1:4 - 1:6)
can increase 1:1 and be suggestive of malignancy
what are nucleolar changes
prominent or lots of changes in the nucleolus which are suggestive of malignancy
what is loss of polarity
disrupted orientated of cells (they become crooked) which is suggestive of malignancy
what are mitotic figures
numerous mitotic figures which can be suggestive of malignancy
easiest thing to recognize malignancy through
what are tumor giant cells
multinucleate tumor giant cells with large bizarre nuclei that are suggestive of malignancy
what are functional changes
certain things like glands stop functioning which can be suggestive of malignancy
what are chromosomal abnormalities in relation to malignancy
those with certain chromosomal abnormalities are more susceptible to malignancy
what are a few of the main differences between a benign and malignant tumor
capsulated vs non-capsulated
slow vs fast growing
metastasis
cell morphology
necrosis vs no necrosis
invasive vs non-invasive
what are the three pathways of malignant dissemination (metastasis)
seeding
lymphatic spread
hematogenous spread
what is seeding within the body cavities
a metastasis mechanism where seeds of the tumor break off and spread to other areas
typical of ovarian cancers going to peritoneal surfaces
what is lymphatic spread and which cancers use it most
tumor travels through lymphatics
typical of carcinomas like breast cancer
what is hematogenous spread and which cancers use it most
tumor spreads through vascular supply
typical of sarcomas
what is a sentinel lymph node
the first node in a regional lymphatic basin that receives lymph flow from the primary tumor
what are the four steps of metastasis
1.) loosening of cell to cell contacts
2.) degradation of the extracellular matrix
3.) attachment to the novel extracellular matrix components
4.) migration of tumor cells
what is loss of cell-to-cell contacts
first step of metastasis which is caused by inactivation of E-cadherin by a variety of pathways
what is the breakdown of the extra-cellular matrix
second step of metastasis which is mediated by proteolytic enzymes secreted by the tumor and stroma
what is the attachment of extra-cellular matrix components
third step of metastasis where proteolytic enzymes release growth factors that cleave fragments from the ECM
what is the migration of tumor cells
fourth step of metastasis where tumor moves, usually to a specific site
what is organ tropism
when a primary tumor metastasizes to a specific site
where do breast, colon, kidney, and lung cancers like to metastasis to
liver and lung
what is skip metastasis
cancer reaches blood vessel by thoracic duct
which tumor tends to grow in veins
renal cell carcinoma
what is the relationship between age and cancer
as you age, you’re more likely to get cancer
cancer accounts for what % of all deaths in children under 15
10%
what are three acquired predisposing conditions to cancer
chronic inflammation (IBD)
immunodeficiency status (HIV)
precursor lesions (cervical dysplasia)
what are proto-oncogenes
genes that are essential for cell growth and differentiation
once mutated, become oncogenes which lead to unregulated cell growth
what is p53
protein produced by the tumor suppressor gene TP53 gene
regulates progression of cell cycle from G1 to S phase (guardian of the genome)
induces apoptosis if cells are beyond repair
what is the most frequently mutated gene in human cancers
TP53
50% of cancer cases have this gene mutated
what is Li-Fraumeni Syndrome
mutation in TP53 gene with one defective copy
gives a 25-fold greater chance of developing a malignant tumor before age of 50
can cause: sarcoma, breast cancer, leukemia, brain cancer, and adrenal cortex cancer
what is RB gene
tumor supressor gene that regulates progression of cell cycle from G1 to S phase
called governor of cell cycle
if both alleles are mutated, leads to retinoblastoma
what do tumor suppressor genes do
stop cell proliferation
what are some hallmarks of cancer
self sufficient in growth signals
insensitive to growth inhibitory signals
altered cell metabolism
won’t go through apoptosis
limitless replicative potential
angiogenesis
metastasis
evasion of immune surveillance
what is a point mutation
mutation in single nucleotide that can either activate or deactivate protein products
convert porto-oncogenes to oncogenes
can reduce suppressor genes ability to suppress
what is the most common, point mutated oncogene
KRAS (rat sarcoma)
seen in 30% of tumors
higher in pancreatic adenocarcinoma
what are passenger mutations
acquired genes that are neutral and do not affect cell behavior
occur randomly throughout genome
what are driver mutations
alter function of cancer genes and directly contribute to the development or progression of a given cancer
usually acquired but can be inherited
what are gene rearrangements
translocation or inversions
seen commonly in hemopoietic or mesenchymal derived malignancies
can activate proton-oncogenes
occur mostly in lymphoid tumors
what are gene deletions
deletion of specific regions of chromosomes can lead to loss of particular tumor suppressor gene