Chapter 7 Flashcards
1
Q
what is a mixed tumor
A
single neoplastic clone along 2 lineages
2
Q
what is a mixed tumor of salivary gland
A
epithelial parts in mixed stroma
3
Q
what is a pleomorphic adenoma
A
different size and shapes
4
Q
what is a teratoma
A
mature or immature cells of tissues from more than 1 germ line
5
Q
what are cystic teratomas
A
differentiate along extodermal line to make cystic tumor lined by skin with hair, teeth etc
6
Q
what is desmoplasia
A
a lot of collagen stroma in tumor
7
Q
what are 2 main parts of any tumor
A
stroma and parenchyma
8
Q
what is a scirrhous tumor
A
stony hard
9
Q
what is a hamartoma
A
benign appearing masses made of cells indigenous to a site
10
Q
what does -oma mean
A
of msenchymal origin
11
Q
what is an adenoma
A
benign epithliela neoplasm from glands
12
Q
what are papillomas
A
benign epithelial neoplasms with finger like progections from surfaces
13
Q
what are polyps
A
when neoplasm makes macroscopically visible projection
14
Q
what are sarcomas
A
arise in mesenchymal tissue and have a fleshy look with little stroma
15
Q
what is a carcinoma
A
malignant neoplasm of epithelial origin from any germ layer
16
Q
what is the most common carcinoma
A
squamous cell
17
Q
where do squamous cell carcinomas arise in lung “bronchogenic”
A
hilar regions centrally
18
Q
what is a sign of leukoplakia and what should you order
A
white patches in oral cavity
order biopsy immediatelt
19
Q
what is anaplasia
A
lack of differentiation
20
Q
mitoses of undifferentiated tumors reflects what
A
increase in proliferative activity or parenchymal cells
21
Q
what is dysplasia
A
loss in uniformity of cells and architectural orientation
22
Q
What is carcinoma in situ
A
dysplasia changes involving thickeness of epithelium but NOT invading BM
23
Q
what factors determine rate of growth for a tumor
A
doubling time of tumore cells
fraction of cells in replicative pool
rate at which cells are shed or die
24
Q
how do cancer stem cells have high R to conventioinal therapies
A
low rate cell division and expression of factors like MDR1
25
What is CML from
malignant counterpart of normal hematopoietic cells
26
what is AML from
more differentiated myeloid precurors that gain abnormal capacity for self renewal
27
what cancers do not metastasize
glial cells in CNS gliomas
| basal cell carcinoma in skin
28
what are the pathways of spreading cancer
seeding, lymph , blood
29
what is pseudomyxomaperitoneal
mucus secreting appendicieal carcinomas filling peritoneal cavity with a gelatinous neoplastic mass
30
what do you do when detect undifferentiate small cell carcinoma in lungs
close becasue metastasizes and responds well to chemo
31
where does cancer enter lymph node
subcapsular sinus
32
where do carcinomas of thyroid and prostate metastasize to
vertebral column
33
where do renal cell carcinomas metastasize to
renal v, IVC then R heart
34
where do adenocarcinomas metastasize to
liver, see central necrosis
35
hispanics are at high risk for what cancers
stomach, liver, uterine cervix and gallbladder
36
what cause increase cancer
accumulations mutations, decline in immune competence
37
Describe characteristics autosomal dominant cancer
early onset with increase risk. Usually point mutaiton in TSG
38
What is retinoblastoma and what kind of cancer is it
autosomal dominant
| carry mutant RB allele
39
what causes familial adenomatous polyposis
mutation of APC TSG
40
what causes Li-Fraumeni syndrome
mutations in p53
41
What causes Multiple endocrine neoplasia type 1/2
MEN 1 2
| mutations in TF for RET tyrosine kinase
42
what is HNPCC from
inactivation DNA mistmatch repair gene
43
What type of pattern are defective DNA repair syndromes
autosomal recessive
44
examples of defective DNA repair syndrome
xenodermapigmentosum, ataxia-telangiectasia and Bloom syndrome
45
what is an autosomal dominant form of defective DNA repair
HNPCC
46
what are the most common familial cancers
carcinomas of colon, breast, ovary and brain
| usually b/l
47
What cancers are common with AIDs
non-hodgkin lymphoma, squamous cell carcinoma, cervical neoplasia, kaposi sarcoma
48
how can chronic inflammation lead to cancer
immune response becomes maladaptive
49
what are some precancerous conditions
chronic atrophic gastritis or pernicious anemia, solar keratosis of skin, chronic ulcerative colitis, leukoplakia of oral caivity vulva and penis
50
what are the 4 classes of normal reg genes
growth promoting proto-oncogenes, growth inhibiting TSG, genes that regulate programmed cell death, genes involved in DNA repair
51
what type of mutation in a single allel is enough (dominant) to cause cancer
in proto-oncogenes.
| TSG you need both alleles
52
what is haploinsufficiency
loss of genetic function caused by damage to single allele
53
What is a FLT3 mutation assoc with
constitutive signaling in meyloid leukemia
54
what type of tumors have active c-kit tyrosine kinase
GI stromal tumors
55
What R gene is overexpressed in majority cell carcinomas of lung
EGF R ERBB1
56
What is ERRB2 overexpressed in
breast cancers and human adenocarcinomas in ovary, lung, stomach and salivary glands
57
What is the single most common abnormalibyt of pro to-oncogenes in human tumors
point mutations in RAS oncogene H K N
58
mutations in KRAS are what
carcinomas
59
mutations in hRAS are what
bladder tumors
60
mutations in nRAS are what
blood tumors
61
In inactive state what is RAS bound to
GDP
62
what is the downstrem regulator of RAS
MAP kinase
63
What does the mutation in RAS cause
GTPase activity, uncontrolled RAS
64
What is the 9-22 translocation
BCR-Abl fusion cuasing CML and acute lymphoblastic leukemias
65
polycythemia vera and primary myelofibrosis have point mutations in what
JAK2
66
What is MYC activation do
apoptosis without survival signals
67
what causes Burkitt lymphoma
dysregulated c-MYC
68
what cancers are n-MYC and L-MYC amplified in
neuroblastoma and small cell cancers of lung
69
activation of cyclin D causes what cancers
breast, esophagus, liver, lymphomas
70
activation of CDK4s cause what cancers
melanomas, sarcomas and glioblastomas
71
what is responsible for G1/S checkpoint
p53 via p21 to arrest cell cycle if DNA damage detected
72
Where is the RB allele
13q14
73
familial vs spradic RB
familial inherit mutant allele which them mutates other allele
sporadic aqcuire somatic mutation son both alleles
74
What cancers have genes on short arm CS11
Wilms tumor, hepatoblastoma and rhabdomyosarcoma
75
What is VHL
TSG that causes familial clear cell renal carcinoma
76
when is RB active
in hypoPi state
77
What is RB dependent on to get out of G1
E cyclin
78
where is the p53 gene
17p13.1
79
what are the most common tumors from p53 mutations
sarcomas, breast, leukemias, brain, carcinomas of adrenal Cx
80
What viruses can promote degradation p53
E6 and HPV
81
what genes regulate p53
MDM2 and MDMX
82
what does MDM2 do
activates mir34 which binds mRNA preventing translation
83
ATM and RAD3 (ATR) influence p53 how
Pi it to active so that there is a puase in cell cycle
84
when DNA repair is successful wha tis role of p53
upregulate MDM2 to destruct and release cell cycle block
85
what is p63 related to
differentiations of stratified squamous epithelium
86
what is p73 assoc with
pro-apoptotic effects after DNA damage from chemo
87
What does the APC gene control
down regulation growth promoting signals
88
defect in APC gene results in
familial adenomatous polyposis (adenomatous polyps in colon)
89
describe B catenin- APC pathway
B catenin binds E cadherin resultin gin cell adhesion
90
loss of contact inhibition by mutation of E cadherin/b catenin are key in what cancers
carcinomas
91
What type of mutation occur in colon cancer with bcatenin APC zxis
APC fine but mutations in b catenin that prevent destruction APC and accumulation in cytoplasm
92
What is the role of INK4/ARF
blocks Pi of RB and activates p53 pathway bu inhibiting MDM2
93
describe TGFb pathway in cell cycle arrest
binds serine-threonine kinase complex dimerization causing Pi SMADs activation p15 and dec Pi RB
94
what is common mutaion in pancreatic cancer
SMAD4
95
all pancreatic cancers have a mutation where
in TGFb pathway
96
What is mutated in cowden syndrome
PTEN
| acts as TSG for the pro-apoptotic PI3K/AKT pathway
97
What happens in NF1 mutation
benign neuroblastomas and optic n gliomas
| conversion of RAS from active to inactive
98
what happens in NF2 mutation
neurofibromin or merlin deficiency
lack of cell cell junctions and insensitivity to normal growth arrest
parth of SWH TSpathway
99
what type of cancers form with VHL
hereditary renal cell cancers, pheochromocytomas, hemangioblastomas of CNS, retinal angioma and renal cysts
100
What factor does VHL need
HIF1a do cause degradation
| except in hypoxia causes angiogenic GF proliferation
101
What is from a mutation in WT1
```
Wilms tumor (kidney)
TSG
```
102
where is WT1 overexpressed
leukemias and breast cancers
103
What is PAtched PTCH
TSG of hedgehog
104
what is syndrome from mutation in PTCH
gorlin syndrome (nevoid basal cell carcinoma)
105
how do cancers evade apoptosis
inactivate p53 or activate anti-apoptotic genes
106
pro-apoptotic genes
BAX BAK
107
what regulate pro and anti apoptotic B proteins
BAD BID PUMA
108
What is the main antiapoptotic protein
BCL2
109
hwo do cancer cells accomplish limitless replicative potential
don't deplete telomerase
110
What is main cause of epithelial tumors
down regulation E cadherin expression or mutation in catenin
111
How do tumors degrade BM and interstitial CT
proteolytic enzymes, MMPs, cathepsin D, urokinase plasminogen activator
112
what direct mobility of tumors
the cytokines (autocrine)
113
how do tumor cells migrate to selective sites in lymph
CD44
114
What chemokines for breast cancer are markers for metastasis
CXCR4 and CCR7
115
what mir promote or suppress metastasis of breast
mir335 and 126 suppress while 10b promotes
116
What oncogenes promote epithliela to mesenchymal transition
SNAIL and TWIST which encode the TFs needed
117
Xeroderma Pigmentosum is at increased risk for what
development of cancers of skin follwing UV light because cross linking pyrimidine residues
118
What are the main metabolic alterations in tumore cells. warburg effect
switch to aerobic glycolysis
119
what are the advantages of hypoxic conditions for tumors
HIF1a
| allows carbons to be shunted to anabolic pathways
120
what genes cause metabolic changes in tumor cells
RAS, p53 and PTEN
121
What TSG are mutated in TB
TSC 1 and 2
122
what type of translocations occur in lymphoid tumors
overexpression of pro to-oncogenes by changing regular elements with another gene
123
what type of cancers arise from fusion of translocated CCS
hematopoietic, sarcomas, certain carcinomas
124
What is the translocation if Burkitt lymphoma
8q24 where MYC gene is and replaced with IGH locus with B cell precursor gene
125
what occcurs from cyclin D1 gene overexpressed on 11q13 by juxtaposition to chrom 14
mantel cell lymphoma
126
what is the most common translocation of lymphoid malignancies
follicular lymphomas from activation of BCL2 gene
127
what is the philedelphia chrom
BCR ABL 9-22 translocation
| target for leukemia therapy
128
What causes prostatic adenocarcinoma
translocation in androgen regulate gene and one E family TFs
129
What type of tumors occur from deletions
nonblood assoc solid tumors
130
What mutation causes small cell lung carcinoma
3p
131
what deletions can cause colorectal cancers
17p, 5q and 18q
132
What cancer is EzH2 overexpressed in
breast and prostate carcinoma repressing TSG p21
133
leukemias and lymphomas have increased expression of what
BCL2
134
what are direct acting agents for carcinogenesis
do not need a metabolic conversion and are weak
135
what are indirect acting agents for carcinogenesis
require metabolic conversion
polycyclic hydrocarbons
benzopyrene
p450 dependent mono oxygenases
136
people with CYP1A1 genotype are at higher risk for what
lung cancer
137
What are the molecular targets from carcinogens
RAS, p53
138
what does aflatoxin B1 do
mutations in p53
139
What form of UV ray cause cutaneous cancers
UVB 280-320, and the nucleotide excision repair pathway is overwhelmed
140
what are the most common cancers from ionizing radiation
AML and CML
141
Describe integration HPV
interupts viral DNA within E1/2 reading farm so lose E2 viral repressor and then overexpression E6 and 7
142
What is the role of HPV E6 and 7
interact with growth regulatin proteins
143
E7 HPV has higher affinity for what gene
RB, inactivates CDKIs p21 and 27 then activates cyclin E and A
144
E6 HPV does what
degrades p53 and BAX
145
what tumors are more likely in EBV
herpes, burkit lymphoma, B cell lymphoma, gastric carcinomas NK lymphomas
146
how does EBV get into cells
infects B cells via CD21 C' R
147
What proteins does EBV to evade death
MLP1 to actvate BCL2
EBNA2 activates NOTCH
IL10
148
what is most common child tumor in central africa and new guinea
burkitt lymphoma
149
nasopharyngeal carcinomas are endemic where
southern china, africa and inuits in artic
150
HBV causes cancer how
indirect: activates NFkB for apotosis hepatocytes
direct: HBx gene TFs and signal tranduction
151
Helicobacter pylori is common in what cancers
gastric adenocarcinomas and gastric lymphomas
152
gastric lymphomas arise from what lymphocyte
B cell origin associated with MALTomas
153
what is histo fro H. pylori gastric adenocarcinoma
have T reactive cells to H pylori but also poly clonal B cell proliferation
154
What cells kill latent DNA virus Ag
CD8
155
what proteins are at higher levels in melanomas
GM2 GD2 and GD3
156
what protein is higher expressed in breast cancer
MUC1
157
What IL activat eNK to kill tumors
2 and 15
158
how do macrophages kill tumors
ROS and TNF
159
What Ab are used to Tx lymphomas
monoclonal Ab CD20 (B cell)
160
How do tumor cells evade immune system
```
loss MHC R
lack costimulation for binding
T cell inhibitory R CTLA4
Ag masking via glycocalyx
Apoptosis CTLs
```
161
what cancer is assoc with HMWkeratin
squamous cell carcinoma
162
how do most neoplasms cause hyper Ca
PTH related protein
163
what is acanthosisnigircans
gray black patches of verruvous hyperkeratosis on skin
164
what is hypertrophic osteoarthropathy and what Pts do you see it with
new bone on distal long bones, clubbing of digits
| seen with bronchogenic carcinoma
165
What is trousseau syndrome and what cancers can lead to it
migratory thrombophebitis
| usually carcinomas of lung or pancreas
166
Acute DIC is most common with what
acute promyelocytic leukemia and prostatic adenocarcinoma
167
nonbacterial thrombotic endocarditis is seen with what
vegetations of mucin secreting adenocarcinomas
168
What is the grade of a tumor
level of differentiation of tumor and number of mitoses or architectural features
169
what is the stage of a tumor
size o primary lesion, spread and presence of blood bourne metastasis
170
What is the TNM rating
T0-4 N0-3 M0-2
171
when is needle aspiration used
palpable lesions like breast, thyroid and nodes
172
what is immunohistochemistry used for
determination site of origin and detection of certain R or Ab
173
flow cytometry is used with what cancers primarily
leukemias
174
PCR we can differentiate what
monoclonal vs polyclonal
175
what is comparative genomic hybridization used in
gains/losses tumors
176
What is the most useful analyses of tmors
molecular progiles
177
Increased IgG and kappa chain is key to what disease
Mult myelmoa
