Ch9 Neoplasia EC Flashcards
1
Q
“-oma”s are generally indicates a benign tumor. What are some exceptions?
A
Seminoma (testicular) Lymphoma (lymph nodes) Glioma (glial cells in brain) Mesothelioma (Pleural serosa) Neuroblastoma (neuroblasts)
2
Q
Skin cancer that invades but does not metastesize
A
Basal Cell Carcinoma (most common)
3
Q
Tumor with two patterns both from the same germ cell layer
A
Mixed tumor
ie pleomorphic adenoma of parotid gland
4
Q
Tumor containing tissue from all three germ layers. Most common sites?
A
Teratoma
Midline structures (Ovary, Testes, Mediastinum, Pineal gland
5
Q
Malignant tumor derived from epithelial tissue
A
Carcinoma
6
Q
Most common sites for squamous cell carcinoma
A
Mouth
Larynx
Cervix
7
Q
Malignant tumor composed of glands. Most common locations?
A
Adenocarcinoma
Distal esophagus Rectum Pancreas Breast Kidneys
8
Q
Malignant tumor derived from connective tissue. Most common locations?
A
Sarcoma
(therefore all mesodermal)
(40% in lower extremities)
Osteogenic sarcoma
~Codman’s triangle- b/c making bone
9
Q
Malignant tumor of smooth muscle
A
Leiomyosarcoma
10
Q
Malignant tumor of striated muscle
A
Rhabdomyosarcoma
11
Q
Malignant tumor of fat
A
Liposarcoma
12
Q
Biopsy from girl having necrotic mass coming out of vagina removed. Vimentin and Keratin -. Desmin +
A
Embryonal rhabdomyosarcoma
MC sarcoma of children (penis in boys)
13
Q
Movable mass at angle of jaw
A
Mixed tumor in parotid (two types of tissue from SAME cell layer)
MC salivary tumor
14
Q
Nonneoplastic overgrowth of tissue
A
Hamartoma
15
Q
Normal tissue in foreign location (ie pancreatic tissue in stomach)
A
Choristoma
16
Q
Neoplastic component of a tumor
A
Parenchyma
17
Q
Nonneoplastic supporting tissue of a tumor
A
Stroma
18
Q
Does cancer resemble parent tissue?
A
Grade
Low grade-keratin pearls, glands with lumen
High grade/anaplastic-no differentiating features
19
Q
Changes in organelles in malignanct cells
A
Fewer mitochondria
Less prominent RER (don’t secrete hormones for others)
LOSS OF CADHERINS (allows metastasis)
Nucleus/Nucleoli enlarged and irregular
20
Q
Metabolism in malignant cells
A
Use anaerobic glycolysis
Store glycogen in cytosol
21
Q
PET scan
A
Measures glucose uptake
Diagnosis, staging, monitoring of therapy in cancer
22
Q
Monoclonality
A
Cancers arise from single precursor
ie G6PD A or B found in leiomyoma of uterus, not both
23
Q
Upregulation of DAF (decay accelerating factor)
A
Inhibits C3 and C5 convertase and thus MAC complex - cannot be killed
24
Q
Important in stimulating synthesis of angiogenesis factors
A
TNF (released by macrophages)
25
Drug that inhibits binding of VEGF to endothelial cells in new capillary sprouts
Bevacizumab
Treats metastatic colon cancer and non-small cell carcinoma of the lung
26
1st step in tumor invasion
Lose cadherins (cell to cell adhesion)
27
2nd step of tumor invasion
Attach to basement membrane (laminin) and degrade it (collagenases)
28
3rd step of tumor invasion
Attach to ECM (fibronectin) and degrade it
29
4th step of tumor invasion
Stimulate cell motility
30
Tumor invasion of capillaries to enter circulation
Intravasation
31
Most important criterion of malignancy
Metastasis
32
Lymphatic spread through lymphatics to regional nodes before entering systemic circulation
Carcinomas
33
Initially have hematogenous spread. Avoid lymph nodes
Sarcomas
34
Metastasis in liver, from what vein did it come?
Portal vein
35
Metastasis in lungs. From what vein did it come?
Vena cava
36
Exfoliation from serosal surface and invade tissue in a body cavity. What are some examples?
Seeding
Malignant surface-derived ovarian cancer --> Omental implants
Peripheral adenocarcinomas of lung seed pleural cavity
Glioblastoma multiforme uses CSF to seed brainstem and spinal cord
37
Most common site of bone metastasis. Why?
Vertebrae
Batson paravertebral plexus has connections with vena cava and vertebral bodies
38
Most common cause of osteoblastic metastases
1 Prostate cancer
| 2 Breast cancer
39
Increased serum ALP and radiodensities on radiograph
Osteoblastic metastasis
40
Radiolucencies in bone. Hypercalcemia, pathologic fractures.
Osteolytic metastases
*PGE2 and IL-1 produced by osteoclasts*
41
Most common osteolytic cancers
1 lung
2 kidney
3 breast
42
Increased risk of prostate cancer and multiple myeloma
African Americans
43
Decreased incidence of prostate and breast cancer
Japanese
44
Most common cancers in children
Leukemia (ALL)
CNS (cerebellar)
Neuroblastoma
45
Most common cancers in men
Prostate
Lung
Colon
46
Most common cancers in women
Breast
Lung
Colon
47
Most common sites of gynecologic cancers
Endometrium
Ovary
Cervix
48
Common sites of cancer deaths in men
Lung
Prostate
Colon
49
Common sites of cancer deaths in women
Lung
Breast
Colon
50
Common sites of gynecologic cancer death
Ovary
Endometrium
Cervix
51
AD Cancer syndromes
```
Retinoblastoma
Familial adenomatous polyposis
Li-Fraumeni syndrome
HNPCC
BRCA1/2
```
52
AR cancer syndromes of DNA repair
```
Xeroderma pigmentosum
Ataxia telangiectasia (chromosomal instability)
Bloom syndrome (chromosomal instability)
Fanconi syndrome (chromosomal instability)
```
53
Nasopharyngeal carcinoma and SCC of the esophagus geographic location
China (EBV and alcohol)
54
Stomach adenocarcinoma geographic location
Japan (smoked foods)
55
Hepatocellular carcinoma geographic location
Southeast Asia (HBV)
56
Burkitt lymphoma and Kaposi sarcoma geographic location
Africa (EBV and HHV-8)
57
What cancer does treatment of H. pylori prevent?
Gastric lymphoma
does NOT decrease adenocarcinoma of the stomach
58
Neoplasms associated with Down syndrome
ALL, AML
"ALL fall DOWN"
59
Neoplasms associated with Xeroderma pigmentosum and albinism
SCC
Melanoma
BCC
60
Neoplasms associated with Chronic atrophic gastritis, pernicious anemia, postsurgical gastric remnants
Gastric adenocarcinoma
61
Neoplasms associated with tuberous sclerosis (facial angiofibroma, seizures, mental retardation)
Giant cell astrocytoma
Renal angiomyolipoma
Cardiac rhabdomyoma
62
Neoplasms associated with Actinic keratosis
SCC of the skin
63
Neoplasms associated with Barrett's esophagus
Esophageal adenocarcinoma
64
Neoplasms associated with Plummer-Vinson syndrome (decreased Fe)
SCC of the esophagus
65
Neoplasms associated with Cirrhosis (alcoholic, Hep B or C)
Hepatocellular carcinoma
66
Neoplasms associated with Ulcerative colitis
Colonic adenocarcinoma
67
Neoplasms associated with Paget's disease of bone
Secondary osteosarcoma and fibrosarcoma
68
Neoplasms associated with Immunodeficiency states
Malignant lymphomas
69
Neoplasms associated with AIDS
Aggressive malignant lymphomas (NHL)
| Kaposi's sarcoma
70
Neoplasms associated with Autoimmune disease (Hashimoto's, myasthenia gravis)
Lymphoma
71
Neoplasms associated with acanthosis nigricans (hyperpigmentation and epidermal thickening)
Visceral malignancy (stomach, lung, uterus)
72
Neoplasms associated with dysplastic nevus
Malignant melanoma
73
Neoplasms associated with radiation exposure
Leukemia
Sarcoma
Papillary thyroid cancer
Breast cancer
74
Neoplasms associated with chronic irritation at sinus orifice or third degree burn scars
SCC
75
ABL proto oncogene (function, mutation, and cancers)
Nonreceptor Tyrosine Kinase
t(9;22) fusion forms BCR-ABL (Philadelphia chromosome)
CML (also ALL)
76
ERBB2 (Her-2Neu) proto oncogene (function, mutation, and cancers)
Receptor synthesis
Amplification results in
Breast carcinoma
77
C-MYC proto oncogene (function, mutation, and cancers)
Nuclear transcription
t(8;14) results in
Burkitt lymphoma
78
N-MYC proto oncogene (function, mutation, and cancers)
Nuclear transcription
Amplification results in
Neuroblastoma "N-myc Neuroblastoma"
SCC of the lung
79
RAS proto oncogene (function, mutation, and cancers)
GTP signal transduction
Point mutation results in
Colorectal carcinoma
Just about any cancer
80
RET proto oncogene (function, mutation, and cancers)
Receptor synthesis
Point mutation results in
MEN IIa/IIIb
Leukemia
81
SIS proto oncogene (function, mutation, and cancers)
Growth factor synthesis
Overexpression leads to
Osteogenic sarcoma
Astrocytoma
82
L-MYC proto oncogene (function, mutation, and cancers)
Transcription factor
Results in Lung tumor
"L-myc Lung tumor"
83
BCL-2 proto oncogene (function, mutation, and cancers)
Anti-apoptotic molecule
Associated with
Follicular lymphoma
Undifferentiated lymphoma
84
APC tumor suppressor gene (function, associated cancers)
Prevents nuclear transcription (degrades catenin, an activator of nuclear transcription)
```
Familial polyposis (inherited)
Colona & stomach cancer (somatic)
```
85
BRCA1/BRCA2 tumor suppressor gene (function, associated cancers)
Regulated DNA repair
Female breast and ovary cancer, male breast cancer (inherited)
86
NF1 tumor suppressor gene (function, associated cancers)
Inhibits RAS signal transduction (cell cycle inhibitor)
NF1: Pheochromocytoma, Wilms tumor (kidney), Neurofibrosarcomas (inherited)
Neuroblastoma (somatic)
87
NF2 tumor suppressor gene (function, associated cancers)
Cytoskeletal stability
NF2: Bilateral schwannomas, meningioma
88
p53 tumor suppressor gene (function, associated cancers)
Inhibits G1/S phase
Repairs DNA
Inhibits BCL2 antiapoptotic gene
Li-Fraumeni: Breast, Brain, Leukemia, Sarcoma
89
RB1 tumor suppressor gene (function, associated cancers)
Inhibits G1/S phase
Retinoblastoma, osteogenic sarcoma, breast, lung, colon
90
TGF-beta tumor suppressor gene (function, associated cancers)
Inhibits G1/S phase
Familial stomach cancer
Pancreatic, Colorectal cancers
91
VHL tumor suppressor gene (function, associated cancers)
Regulates nuclear transcription
von Hippel-Lindau: cerebellar hemangioma, retinal angioma, RCC (bilateral), pheochromocytoma (bilateral)
92
WT1 tumor suppressor gene (function, associated cancers)
Regulates nuclear transcription
Wilms tumor (kidney)
93
p16 tumor suppressor gene (function, associated cancers)
Melanoma
94
DPC4 tumor suppressor gene (function, associated cancers)
Pancreatic cancer
"DPC=Deleted in Pancreatic Cancer"
95
DCC tumor suppressor gene (function, associated cancers)
Colon cancer
"DCC=Deleted in Colon Cancer"
96
Ingestion of maize and peanuts grown in hot/humid climates and later develop HCC associated with Hep B
Aflatoxin (Aspergillus)
97
Oncology chemotherapy resulting in malignant lymphoma
Alkylating agents
98
Herbicides (vineyard workers), fungicides, animal dips, metal smelting, incidental poisoning leading to SCC of the skin, lung cancer, or liver angiosarcoma
Arsenic
99
Paints, printing inks, varnishes, leather, carpets, food products leading to hepatocellular carcinoma
Azo dyes
100
Roofing material, insulation of pipes in shipyards, old homes, old cars with brake liners later develop Bronchogenic carcinoma or mesothelioma
Asbestos
101
Component of light oil, used in print industry, dry cleaning, paint, adhesives and coatings leading to Acute leukemia and Hodgkin lymphoma
Benzene
102
Used in space industry leading to bronchogenic carcinoma
Beryllium
103
Industrial industries where ore is being smelted leading to prostate and lung cancer
Cadmium
104
Chemotherapy agent leading to transitional cell carcinoma of urinary bladder
Cyclophosphamide
105
Once used to treat women with threatened abortions daughters later develop clear cell carcinoma of the vagina/cervix
DES (diethylstilbestrol)
106
Workers in the rubber, chemical, leather, textile, metal, and printing industries who develop transitional cell carcinoma of the urinary bladder
Beta-Naphthylamine and aromatic amines
107
Nickel plating, byproduct of stainless steel welding, ceramics, batteries, spark plugs leads to bronchogenic carcinoma and nasal cavity cancer
Nickel
108
Leading to breast and cervical cancer and hepatic adenoma
Oral contraceptives
109
These are formed when coal, soot, wood, gasoline, oil, tobacco, or other organic material are burned leading to SCC of the skin, adenocarcinoma of esophagus, pancreas, or kidney, or transitional cell carcinoma
Polycyclic hydrocarbons
110
Found in plastic piping material adhesive plastics, refrigerant leading to liver angiosarcoma
polyvinyl chloride
111
By product of decay of uranium, hazard in quarries and underground mines leading to bronchogenic carcinoma
Radon
112
Chemical silicon dioxide, rock quarries, sandblasting leading to bronchogenic carcinoma
Silica
113
Substance released by cancer cells that causes degradation of skeletal muscle
PIF (proteolysis inducing factor)
114
Substance released by cancer cells that decreases body fat, Increases TNF which suppresses appetite and initiates apoptosis of fat cells
LIF (lipolysis mobilizing factor)
115
Marrow replacement by cancer/fibrotic tissue with immature normal cells in peripheral blood and teardrop RBCs
Myelophthisic anemia
116
Acanthosis nigricans
Stomach cancer
117
Myasthenia gravis-like symptoms with antibody directed against Ca channel (paraneoplastic syndrome)
Eaton-Lambert syndrome
associated with SCC of lung
118
Periosteal reaction of distal phalanx (paraneoplastic syndrome)
Hypertrophic osteoarthropathy
associated with bronchogenic carcinoma
119
Sterile vegetations on mitral valve (paraneoplastic syndrome)
Nonbacterial thrombotic endocarditis
Mucous secreting pancreatic and colorectal cancers
120
Sudden appearance of numerous pigmented seborrheic keratoses (Leser-Trelat sign)
Seborrheic keratosis
Stomach carcinoma
121
Release of procoagulants (Trousseau sign-Paraneoplastic)
Superficial migratory thrombophlebitis
Pancreatic carcinoma
122
Diffuse membranous glomerulopathy (paraneoplastic syndrome)
Nephrotic syndrome
Lung, breast, and stomach carcinomas
123
Cushings syndrome as a paraneoplastic syndrome (hormone and neoplasms)
ACTH or ACTH like peptide
SCC of lung
124
SIADH paraneoplastic syndrome (hormone and neoplasms)
ADH
SCC of lung
Intracranial neoplasms
125
Hypercalcemia paraneoplastic syndrome (hormone and neoplasms)
PTHrP (SCC of lung, RCC, breast cancer)
Calcitriol (vit D) - Lymphomas
126
Polycythemia paraneoplastic syndrome (hormone and neoplasms)
Erythropoietin
RCC, hemangioblastoma, HCC, pheochromocytoma
127
Used to follow up prostate carcinoma. Can also be elevated in BPH
PSA (prostate specific antigen)
128
Produced by 70% colorectal and pancreatic cancers (can also be gastric, breast, or thyroid carcinomas)
CEA (Carcino Embryogenic Antigen)
129
Normally made by fetus. Elevated in hepatocellular carcinomas and germ cell (yolk sac) tumors
AFP
130
Elevated in Hydatidiform mole and Choriocarcinomas
beta-HCG
131
Marker for ovarian cancer
CA-125
132
Marker for melanoma, neuronal tumors, schwannomas
S-100
133
Elevated in metastasis to bone, liver, Paget's disease
Alkaline phosphatase
134
Marker for Neuroblastoma, lung and gastric cancer
Bombesin
135
Elevated in Hairy cell leukemia (B cell neoplasm)
TRAP (Tartrate Resistant Acid Phosphatase)
136
Marker for pancreatic adenocarcinoma
CA-19-9
137
Marker for medullary thyroid carcinoma
Calcitonin
138
Laminated concentric, calcified pheres
Psammoma bodies
Papillary thyroid cancer
Serous cancer of ovary
Meningioma
Mesothelioma
"PSaMMoma"
